Insured population overuses ED
Truven study finds insured individuals use ED for non-urgent matters
A recent study from Truven Health Analytics found that the uninsured population isn’t the only group using the emergency room for non-urgent matters. Seventy-one percent of ED visits made by patients with employer-sponsored insurance coverage are for non-urgent issues or are preventable with proper outpatient care.
The study examined insurance claims data for around 6.5 million emergency room visits made in 2010 and were broken up by industry type, gender, geographical region, age and clinical condition. Overall, it was found that 29 percent of the patients required immediate attention in the ED.
[See also: ED wait times highest since 2002]
More specifically, 24 percent of the patients studied did not require immediate attention, 41 percent received care that could have safely been provided in a primary care setting and 6 percent received care that would have been preventable or avoidable with proper primary care.
According to the study, results did not vary by much between a patient’s industry, region and insurance plan type but there were variances between gender when it came to visits to the ED. The overall ED visit rate for females was 17 percent higher than males, and females showed a higher percentage of non-emergent visits and a lower percentage of emergent visits.
[See also: Overuse of ambulatory care services continues to plague healthcare system]
The study estimated that if 10 percent of these unnecessary visits to the ED had been diverted to an office setting (such as a visit to a primary care physician), it would result in a net savings of $18.68 in total allowed costs per health plan member per year. Based on the 24 million enrollees in Truven’s databases, this represents a total potential savings of $461 million per year, according to the report.
