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EMERGENCY: Which patients are likely to benefit the most from emergency care?

…we identified 51 condition groups most sensitive to emergency care, conditions where timely, high-quality emergency care is expected to make an impact on mortality and morbidity.”

A comprehensive list of emergency care sensitive conditions (ECSC) developed by an expert panel to represent adult patient conditions that are most appropriate for emergency care is the focus of this research article.  The conditions were then paired with national ED utilization data.  There were about 16 million (14 percent) of the roughly 114 million total ED visits in 2016 that were considered to be ECSC.  Here are the utilization data for the top 5 most frequent of these ECSC visits:

  • 10.7 percent of all ECSC visits were related to sepsis and SIRS
  •   7.9 percent were related to pneumonia
  •   7.9 percent were related to chronic obstructive pulmonary disease
  •   6.1 percent were related to asthma
  •   5.7 percent were related to heart failure

You can also determine those conditions that are most likely to be admitted after presenting in the ED.  Here are the 5 highest:

  • 94.8 percent of patients with sepsis and SIRS were admitted
  • 88.1 percent with respiratory failure
  • 83.9 percent with femur fractures
  • 80.0 percent with cerebral infarction
  • 79.7 percent with meningitis

Other patient disposition data and median emergency department charges are also included.

Source: Vashi, A.A., and others. (2019, August 7). Identification of emergency care-sensitive conditions and characteristics of emergency department utilization. JAMA Network Open, 2(8).  Click here for free full text:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2747479 Posted by AHA Resource Center (312) 422-2003 rc@aha.org

Hospital cost drivers, market power, and relationship to hospital prices

A new report looks at hospital cost trends, why the cost drivers may vary among hospitals, and the relationship of those costs to hospital prices. Is market power due to a lack of competition a key factor for pricing, as some claim? This study from Compass Lexecon finds hospital prices are most directly related to the costs of providing patient care, with rising labor expenses over the past decade accounting for a significant proportion of overall hospital costs. Key factors found that account for price differences among hospitals include case mix, teaching intensity, Medicare and Medicaid payer mix, regional wage and other cost differences, uncompensated care, and patient demographics. Other  unexplained factors are discussed, but the authors conclude they found no basis to attribute these to hospital market power.

As antitrust concerns are raised with the formation of  accountable care organizations, medical homes, and other types of clinical integration to improve the quality of care and control costs, this report provides valuable perspective.

Source:

Guerin-Calvert ME and Israilevich G. Assessment of cost trends and price differences in U.S. hospitals. Washington, DC: Compass Lexecon, March 2011. http://www.aha.org/aha/content/2011/pdf/11costtrendspricediffreport.pdf

Related documents:

Cost trends & price differences; Assessment of cost trends and price differences for U.S. hospitals refutes unsupported claims of market power. Chicago: American Hospital Association, March 2011. http://www.aha.org/aha/content/2011/pdf/11costtrendspricediffppt.pdf

Guerin-Calvert ME and Israilevich G. A critique of recent publications on provider market power. Washington, DC: Compass Lexecon, Oct. 4, 2010. http://www.aha.org/aha/content/2010/pdf/100410-critique-report.pdf