Most unscheduled hospital admissions now come through the ER

More than three-quarters (81.8 percent) of unscheduled admissions to the hospital now come through the emergency department, which is a sharp increase from the previous decade when only 64.5 percent of unscheduled admissions came through the ER. A study, published early online this week in the journal Medical Care, re-confirms recent findings by the RAND Corporation highlighting the growing role emergency physicians play in health care beyond the emergency department ("Changes in the Source of Unscheduled Hospitalizations in the United States").

"Although generally sicker, patients admitted to the hospital from the emergency department had lower mortality and shorter hospital stays than patients admitted directly from the community," said lead study author Keith Kocher, MD, MPH, of the Department of at the University of Michigan in Ann Arbor, Mich. "The ER was the source of admission for a wide variety of clinical conditions, from medical and surgical disease to . It was also the source of admission for more vulnerable populations like the elderly, minorities and the uninsured."

Dr. Kocher and his team compared over a 10-year period, from 2000 through 2009, using the Nationwide Inpatient Sample. Admissions through the emergency department increased substantially at the expense of direct admissions from clinics or doctors' offices which declined from 31 percent to 14 percent of unscheduled admissions.

"Our study and the RAND study demonstrate that the emergency department has become the major portal for unscheduled hospitalizations," said Dr. Kocher. "Administrators and policy makers would be advised to focus their attention on physicians and caregivers in the who make more and more of these decisions to admit. As acute care management continues to evolve away from primary care providers, this trend also has the potential to exacerbate an already fragmented U.S. ."

add to favorites email to friend print save as pdf

Related Stories

ER docs are key to reducing health care costs

May 20, 2013

Emergency physicians are key decisionmakers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation.

Nearly 50 percent increase in ICU admissions, new study says

May 14, 2013

A study released today by George Washington University School of Public Health and Health Services (SPHHS) researchers offers an in-depth look at hospitals nationwide and admissions to intensive care units (ICU). The study, ...

ERs have become de facto psych wards

Apr 24, 2013

Long waits for insurance authorization allowing psychiatric patients to be admitted to the hospital from the emergency department waste thousands of hours of physician time, given that most requests for authorization are ...

Recommended for you

The hunt for botanicals

12 hours ago

Herbal medicine can be a double-edged sword and should be more rigorously investigated for both its beneficial and harmful effects, say researchers writing in a special supplement of Science.

Mozambique decriminalises abortion to stem maternal deaths

13 hours ago

Mozambique has passed a law permitting women to terminate unwanted pregnancies under specified conditions, a move hailed by activists in a country where clandestine abortions account for a large number of maternal deaths.

Infertility, surrogacy in India

14 hours ago

Infertility is a growing problem worldwide. A World Health Organization report estimates that 60-to-80 million couples worldwide currently suffer from infertility.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.