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Only 3.3% of emergency room visits are 'avoidable,' study says

Most patients who are in the emergency department belong there and insurers should cover those visits, ACEP says.

Susan Morse, Executive Editor

Only 3.3 percent of emergency room visits are avoidable, according to a study published Thursday in the International Journal for Quality in Health Care.
https://academic.oup.com/intqhc/article-lookup/doi/10.1093/intqhc/mzx081

This is because those visits deemed 'avoidable' involve mental health or dental care, issues with which the ER is generally not equipped to deal, according to the study published in the peer-reviewed journal.

[Also: Medicaid expansion results in more emergency room trips; fewer patients uninsured]

The study shows that despite the health insurance industry's campaign about avoidable ER visits, most patients in the emergency room belong there, said American College of Emergency Physicians President Becky Parker, MD.

The 'avoidable' emergency department visits are defined as visits in which patients did not require any diagnostic or screening services, procedures, or medications, and were discharged home.

"Most patients who are in the emergency department belong there and insurers should cover those visits," Parker said. "The myths about 'unnecessary' ER visits are just that – myths."

The study analyzed data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011.

The most common 'avoidable' ER visits in the study included cases in which patients were discharged with alcohol- and mood-related disorders, or with dental conditions.

The study showed that 10.4 percent of visits by patients diagnosed with alcohol-related disorders, 16.9 percent for mood-related disorders and 4.9 percent for dental-related conditions, were 'avoidable.'

While these visits were deemed avoidable, the majority of patients with these conditions still required some form of diagnostic or treatment service, said the study's authors.

"We found that many of the common conditions of 'avoidable' emergency department visits involved mental health and dental problems, which ERs are generally ill-equipped to treat," said lead study author Renee Hsia, MD, of the Department of Emergency Medicine at the University of California, San Francisco. "This suggests a lack of access to healthcare rather than intentional inappropriate use is driving many of these 'avoidable' visits. These patients come to the ER because they need help and literally have no place else to go."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com