Emergency department physicians are now responsible for nearly half of all hospital admissions, according to a study conducted by the RAND Corporation.
The research suggests that despite efforts to reduce patients’ reliance on the ED, the number of hospital admissions that come from the ED has increased 17% from 2003 to 2009. During the same period, hospitals saw a 10% reduction in admissions from doctors’ office and other outpatient settings. This is in part because primary care physicians have increasingly been turning to the ED to evaluate their complex patients. The study found that four in five people who contacted a primary care physician or other medical provider before seeking emergency care were told to go directly to the emergency room. The study suggests that ED physicians may need to add a new wrinkle to their role as they will play a bigger role in reducing the number of unnecessary hospital admissions and readmissions. ED physicians have greater access to complex diagnostic tests that are not available in physician offices or retail clinics, making them better equipped to evaluate whether a patient requires inpatient admission. “One of the most important elements of patient-centered care is deciding when individuals can’t be safely managed in community settings,” said Dr. Wes Fields, chair of the Emergency Medicine Action Fund, which sponsored the RAND research. “Emergency physicians are trained to rapidly evaluate a wide array of conditions that are complex or time sensitive, and facilitate observation or admission of the most acutely ill patients.” It appears that emergency medicine physicians are doing a good job of limiting admissions. Researchers say that people with chronic conditions such as asthma and heart failure are visiting the ED more frequently, yet admissions for those conditions have remained flat. The American College of Emergency Physicians says that although efforts should continue to reduce the number of nonemergent ED visits, hospital administrators, policymakers, payers and federal research agencies should recognize the role emergency medicine physicians play in coordinating care for millions of patients. For example, ED physicians also provide overflow, after-hours, and weekend coverage to primary care physicians. With so much attention being paid to reducing unnecessary admissions, having a staff of capable ED physicians who can evaluate patients can protect hospitals and health systems from readmission penalties and ensure proper care for patients. Furthermore, the fact that primary care physicians are increasingly relying on ED physicians to evaluate patients means demand for ED services is likely to also increase. At Barton, we have an extensive network of locum tenens emergency medicine physicians and nurse practitioners who help emergency departments manage short and long term staffing needs. Organizations that use locum tenens emergency medicine providers though Barton Associates are able to effectively manage demand for ED services. For more information visit our facilities page.
