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Researchers: new resources, tools needed to reduce variation in the admissions decisions.
ED Manag. 2014 Nov;26(11):128-31
Authors:
Abstract
New research suggests there is considerable variation in the decisions emergency providers make regarding whether to admit patients with certain common, low-mortality conditions. ln some cases, the researchers found that patients were as much as six times more likely to be admitted at some hospitals than others. While available resources and cultural differences likely play a role in this variation, the researchers estimate that reducing this variation in decision making could potentially save as much as $5 billion per year. Data show that EDs are the main source of hospitalizations in this country, and emergency providers make a decision about admission approximately 350,000 times each day, resulting in close to 20 million admissions per year. Researchers found that variation in the admission decision was most prominent for patients presenting with chest pain but no heart attaclk, soft-tissue infections, urinary tract infections, asthma-related difficulties, and COPD. There was little variation in the admission decisions regarding patients with high-risk conditions such as heart attacks, sepsis, or kidney failure. Researchers suggest that reducing this variation in admission decisions will require better tools for determining which patients with lower-mortality conditions likely require hospitalization, and more resources so that physician have good alternatives to hospitalization at their disposal.
PMID: 25362751 [PubMed - indexed for MEDLINE]