Leading Health Care Research Organizations to Examine Emergency Department Overuse

LEADING HEALTH CARE RESEARCH ORGANIZATIONS TO EXAMINE

EMERGENCY DEPARTMENT OVERUSE

 New England Healthcare Institute Partners with Institute for Healthcare Improvement to Redirect Non-Urgent Visits to Alternative Settings

CAMBRIDGE, MA (June 16, 2008) -- In response to the growing crisis of overuse of emergency departments (EDs), the New England Healthcare Institute (NEHI) announced today that it is partnering with the Institute for Healthcare Improvement (IHI) in a joint initiative to identify and test strategies for reducing non-urgent ED visits.

EDs are currently the only place in the U.S. health care system where an individual has access to a full range of halth care services at any time, without regard to ability to pay or severity of the condition.  This open-door policy, combined wiht a primary care system  weakened by disjointed care, low reimbursement rates and a provider shortage, has resulted in the number of non-urgent ED visits increasing dramatically from 9.2 million in 1997 to 16 million, or nearly 14 percent of total ED visits, in 2005.

The uninsured and Medicaid populations are drivers of this increase, but they are not the only ones.  Contrary to popular belief, the increase is spread across all payer groups.

"There is a widely held notion that the uninsured are single-handedly driving up the cost of health care by overusing emergency departments," said Wendy Everett, ScD, president of the New England Healthcare Institute.  "But in fact, non-urgent ED use is increasing in tandem among all payer groups, including those covered by both privately and publicly sponsored insurance."

Non-urgent ED use is problematic from both a health care cost and quality standpoint.  Experts estimate that the cost of an ED visit is two to five times greater -- adding up to an estimated $1 billion annually in Massachusetts alone -- than the cost of a visit to a primary care provider for the same symptoms.  Not only do EDs lack the continuity of care typically provided in a primary care setting, they also are not designed to promote prevention or monitor patient follow-up and compliance.

NEHI's parthership with IHI, a Cambridge-based nonprofit dedicated to helping lead improvement in health care throughout the world, will entail working with a number of hospitals and other health sites to test innovative strategies for reducing non-urgent ED use.  This will enable an assessment of the feasibility of changes in practice that would discourage these visits and instead encourage primary care or alternative encounters.  The goal of the project is to provide a roadmap for organizations that are ready to implement strategies to address the problem of ED overuse.

"Non-urgent ED visits are consuming more and more of our health care dollars at the expense of quality," said Everett.  "Addressing this growing problem will lead to better, more cost-efficient care."

About NEHI

The New England Healthcare Institute is an independent, not-for-profit organization dedicated to transforming health care for the benefit of patients and their families.  In partnership wiht hmembers from all across the health care system, NEHI conducts evidence-based research and stimulates policy change to improve the quality and value of health care.  Together with this unparalleled network of committed health care leaders, NEHI brings an objective, collaborative and fresh voice to health policy.  For more information, visit www.nehi.net