MDs Increasingly Refer Patients to ED

Despite being targeted as the most expensive place to get medical care, emergency departments (EDs) are responsible for half of all hospital admissions in the U.S., according to a new study.

The RAND Corporation’s “The Evolving Role of Emergency Departments in the United States” reported that EDs accounts for nearly all of the growth in hospital admissions between 2003 and 2009.

"Use of hospital emergency departments is growing faster than the use of other parts of the American medical system," Art Kellermann, MD, the study's senior author and a senior researcher at RAND, said in a statement. "While more can be done to reduce the number of unnecessary visits to emergency rooms, our research suggests emergency rooms can play a key role in limiting growth of preventable hospital admissions."

According to the report, the pattern of decreased admissions from doctors’ offices and other outpatient settings and increased unscheduled inpatient admissions from EDs might suggest that office-based physicians are directing to EDs some of the patients they previously admitted to the hospital

While ED care is typically the most expensive care, the contribution of EDs to the health care spending growth is small, according to the report. However, EDs are playing a growing role as the gateway to inpatient treatment, which accounts for nearly a third (31%) of health care spending.

RAND interviewed primary care physicians to discover a little more about the increased use of EDs:

“Asked why more patients are being admitted through the ED than before, PCPs cited the growing shortage of primary care providers, group practices (where a providers may be on call but unfamiliar with their partner’s patient), and the relative ease of sending a patient to the ED.”