Avoidable Admissions: The Role of Non-urgent Emergency Visits

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ACCESS AND EFFICIENCY CLUSTER – PROJECT 03-05161.TAM

Avoidable Admissions: The Role of Non-urgent Emergency Visits

Description

Many CHOT industry members are health systems, such as Main Line Health, who have been faced with increased emergency department (ED) utilization in recent years, partially due to the Medicaid expansion efforts in many states. Therefore, these systems are potentially dealing with avoidable admissions via the ED. The research question to be addressed is: What percentage of these admissions through the ED are avoidable admissions and how to redesign the system to assure the most appropriate level of care for patients? Some health systems have developed “ED rerouting” initiatives to urgent care centers as part of addressing this problem, but access to the most appropriate level of care still remains a problem in the U.S.

How is this different from related research?

This study will first inform industry about factors associated with admission decisions and analyze variations based on patient and provider characteristics. Once practice patterns and variations in admission decisions through the ED are explained in Year 1 of this study, CHOT researchers will focus on understanding and re-designing the ED patient flow process to assure the most appropriate level of care for patients in the system. This study is focused on not only a better understanding of what is going on in a costly care setting, but will also provide industry members with strategies for cost savings by the end of Year 2.

Value Proposition

  • Identify patient conditions that are associated with likelihood of admission and understand variations in practice patterns in the emergency department and by admitting physicians
  • Develop decision process improvement tool to achieve appropriate levels of care
  • Improve triaging before the patient enters the emergency department through a new system design
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