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Avoidable emergency department visits: a starting point.

Renee Y Hsia1,2, Matthew Niedzwiecki1,2

  • 1Department of Emergency Medicine, University of California at San Francisco, 1001 Potrero Ave, 1E21, San Francisco, CA 94110, USA.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|October 10, 2017
PubMed
Summary
This summary is machine-generated.

A conservative definition identified 3.3% of emergency department (ED) visits as avoidable, primarily for mental health and dental issues. Policy interventions should focus on increasing access to care for these conditions.

Keywords:
avoidableemergency careemergency departmenthealth policyhealthcare systemnon-urgentsetting of care

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Area of Science:

  • Health Services Research
  • Public Health Policy
  • Emergency Medicine

Background:

  • Emergency departments (EDs) are crucial for urgent care but face challenges with non-urgent visits.
  • Understanding 'avoidable' ED visits is key to optimizing healthcare resource allocation.
  • A conservative definition of 'avoidable' ED visits was previously lacking detailed characterization.

Purpose of the Study:

  • To define and characterize 'avoidable' emergency department (ED) visits using a conservative definition.
  • To provide policymakers with insights into interventions targeting non-urgent ED visits.
  • To identify the nature and prevalence of visits that do not require ED-level care.

Main Methods:

  • Retrospective analysis of the National Hospital Ambulatory Medical Care Survey (2005-2011).
  • Inclusion of 115,081 records representing 424 million ED visits for patients aged 18-64 discharged home.
  • Definition of 'avoidable' visits as those not requiring diagnostic services, procedures, or medications, with patients discharged home.

Main Results:

  • Approximately 3.3% of all ED visits were classified as 'avoidable' under the conservative definition.
  • Top chief complaints included toothache, back pain, headache, psychosis-related issues, and sore throat.
  • Mental health (alcohol and mood disorders) and dental conditions constituted significant proportions of avoidable visits.

Conclusions:

  • A substantial portion of avoidable ED visits are linked to mental health and dental conditions.
  • The ED is not optimally equipped to manage these primary conditions.
  • Increased access to mental health and dental care could reduce avoidable ED utilization and address healthcare system gaps.