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What if we used the emergency room for MORE routine care?

What if the nature of primary care practice is shifting?  What if office-based physicians are coming to rely more heavily on the emergency room to work up patients with acute problems?  This leaves the primary care physician to concentrate on wellness and chronic care in the office, while directing patients with acute problems for diagnostic workup in the ED.  And what if this is not a bad thing because patients receive care quickly and have access to sophisticated diagnostic and treatment on site.  Moreover, this can have several advantages from the hospital’s viewpoint.  The resources are staffed and ready; the ED serves as the hospital’s “front door” and generates admissions for inpatient care.  The Morganti, et al., study is a RAND white paper that takes a comprehensive look at the literature and several data sources to analyze trends in ED use between 2003 to 2009. 

The Kutscher article in Modern Healthcare is a news report about the RAND study that adds some comments from other sources about ED trends — including the trend towards including larger observation areas in new emergency departments and the elimination of triage.

What do I like about these items?  The ideas presented upend conventional wisdom that we should be trying to avoid emergency department use for non-urgent patients and presents a whole different model for consideration.  The white paper is from an authoritative analytical firm and based on reputable data sources.

Sources: Kutscher, B.  One-stop shop for care: hospital ERs seeing increase in patients, capital.  Modern Healthcare;43(21):6-7, May 27, 2013.  Click here for publisher’s website: www.modernhealthcare.com; and, Morganti, K.G., and others.  The Evolving Role of Emergency Departments in the United States.  Santa Monica, CA: RAND Corp., 2013.  Click here for text: http://www.rand.org/content/dam/rand/pubs/research_reports/RR200/RR280/RAND_RR280.pdf   Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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