10/7/2023 0 Comments Ed visits![]() However, little is known about the composition of reductions in urgent relative to non-urgent visits. Early evidence indeed suggests that outpatient, ED visits, and hospital admissions declined by up to 60% from February to April 2020 in some parts of the country, followed by a bounce back after June, ,, ,, , ]. A current report indicates that patients are more likely to call their primary care provider or the hospital help line before deciding to seek care in the ED during the ongoing pandemic. Although postponed or foregone care can result in impaired or even detrimental short- and long-term health outcomes, particularly for high-risk patients, reductions in care for non-urgent visits may provide the opportunity to shift resources to urgent care seekers. Īs shelter in place orders and fear of COVID-19 spread across the country, one could expect ED use to decline if people choose to forgo or postpone their non-urgent care needs or use other care settings. The legal mandate to treat all patients in the ED, independent of their ability to pay, may further contribute to care seeking in such settings. Common reasons for ED utilization for non-urgent conditions include convenience and timely access to care, lack of alternatives, discrepancies in patient-provider perceptions, lapse of care management, and the need for a second-opinion. However, more than one-third of all ED visits are estimated to be non-urgent and can be treated in other care settings, , ]. One particularly hard-hit area were emergency departments (EDs), which serve as a safety net for many patients and generally treat individuals with acute conditions. Uncertainty on the spread of COVID-19 and changing recommendations in the following months generated confusion and fear among many residents and disconnected many patients from potentially necessary health care, , ]. Many state officials issued stay at home orders, and restricted elective medical and surgical procedures to redirect constrained hospital resources to COVID-19 patients. All rights reserved.The spread of the coronavirus disease 2019 (COVID-19) in spring of 2020 led to a sudden inflow of patients with acute respiratory symptoms to hospitals in the United States. Published by Oxford University Press in association with the International Society for Quality in Health Care. Our findings provide a better understanding of what policy initiatives could potentially reduce these 'avoidable' ED visits to address the gaps in our healthcare system, such as increased access to mental health and dental care.Īvoidable emergency care emergency department health policy healthcare system non-urgent setting of care. Alcohol-related disorders and mood disorders accounted for 6.8% (95% CI: 5.7-8.0) of avoidable visits, and dental disorders accounted for 3.9% (95% CI: 3.0-4.8) of CCS-grouped discharge diagnoses.Ī significant number of 'avoidable' ED visits were for mental health and dental conditions, which the ED is not fully equipped to treat. Alcohol abuse, dental disorders and depressive disorders were among the top three ICD-9 discharge diagnoses. In total, 3.3% (95% CI: 3.0-3.7) of all ED visits were 'avoidable.' The top five chief complaints included toothache, back pain, headache, other symptoms/problems related to psychosis and throat soreness. We defined 'avoidable' as ED visits that did not require any diagnostic or screening services, procedures or medications, and were discharged home. ![]() We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home. We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. ![]() To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits.
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