![]() ![]() Some literature, particularly from nationalized healthcare systems, focuses on a cancer diagnosis in the ED as a particular subset of preventable ED use 74, 76. Published by Oxford University Press in association with the International Society for Quality in Health Care. Identifying potentially preventable ED visits is also challenging in international settings. Our findings provide a better understanding of what policy initiatives could potentially reduce these 'avoidable' ED visits to address the gaps in our healthcare system, such as increased access to mental health and dental care.Īvoidable emergency care emergency department health policy healthcare system non-urgent setting of care. Alcohol-related disorders and mood disorders accounted for 6.8% (95% CI: 5.7-8.0) of avoidable visits, and dental disorders accounted for 3.9% (95% CI: 3.0-4.8) of CCS-grouped discharge diagnoses.Ī significant number of 'avoidable' ED visits were for mental health and dental conditions, which the ED is not fully equipped to treat. Alcohol abuse, dental disorders and depressive disorders were among the top three ICD-9 discharge diagnoses. In total, 3.3% (95% CI: 3.0-3.7) of all ED visits were 'avoidable.' The top five chief complaints included toothache, back pain, headache, other symptoms/problems related to psychosis and throat soreness. ![]() We defined 'avoidable' as ED visits that did not require any diagnostic or screening services, procedures or medications, and were discharged home. We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home. We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. All rights reserved.To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits. Further study is needed to generalize these findings as well as investigate novel strategies such as telehealth to improve quality of care, decrease utilization, and provide cost-effective care for this vulnerable population.Ĭhild Chronic Disease Emergency Medical Services Pediatrics children with medical complexity complex chronic disease emergency department.Ĭopyright © 2021 Academic Pediatric Association. The evidence base is currently small and observational nature of interventions and their evaluations limit definitive, generalizable recommendations.Ĭonclusions and implications of key findings:Ĭurrent research suggests that real-time access to knowledgeable providers and expedited appointments can prevent ED visits. Of these, studies that included 24/7 access to knowledgeable providers for acute care needs by phone (telehealth) or expedited or next-day appointments were the most consistently successful in reducing ED visits. Sixteen included studies described outpatient interventions to prevent ED utilization. Two independent reviewers used a structured screening protocol to include English language articles summarizing studies that included CMC, emergency care, or ED utilization. PubMed Plus, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases through October 2019, and hand search of bibliographies. We sought to determine what components of ambulatory care programs focused on CMC were most effective in preventing ED visits. ![]() How to reduce preventable ED visits is poorly understood. Children with medical complexity (CMC) represent a growing population with high emergency department (ED) utilization. ![]()
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