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A Retrospective Review of Emergency Department Visits That May Be Appropriate for Management in Non-Emergency Settings. | LitMetric

AI Article Synopsis

  • - The study analyzed emergency department (ED) visits at Brooke Army Medical Center to identify how many patients could have been treated in a primary care setting instead of the ED, given ongoing issues like overcrowding and long wait times.
  • - Out of 75,205 patient visits reviewed from September 2019 to August 2020, approximately 56.7% were determined to be eligible for primary care, particularly in fast-track and pediatric areas.
  • - Despite a decrease in overall ED visits from pre-COVID to post-COVID, the rate of visits that could have been managed in primary care remained consistent, indicating a need for improved healthcare delivery options to alleviate ED pressure.

Article Abstract

Background: Emergency departments (EDs) continue to struggle with overcrowding, increasing wait times, and a surge in patients with non-urgent conditions. Patients frequently choose the ED for non-emergent medical issues or injuries that could readily be handled in a primary care setting. We analyzed encounters in the ED at the Brooke Army Medical Center-the largest hospital in the Department of Defense-to determine the percentage of visits that could potentially be managed in a lower cost, appointment-based setting.

Materials And Methods: We conducted a retrospective chart review of patients within our electronic medical record system from September 2019 to August 2020, which represented equidistance from the start of the COVID-19 pandemic, resulting in a shift in ED used based on previously published data. Our study also compared the number of ED visits pre-covid vs. post-covid. We defined visits to be primary care eligible if they were discharged home and received no computed tomography imaging, ultrasound, magnetic resonance imaging, intravenous medications, or intramuscular-controlled substances.

Results: During the 12 month period, we queried data on 75,205 patient charts. We categorized 56.7% (n = 42,647) of visits as primary care eligible within our chart review. Most primary-care-eligible visits were ESI level 4 (59.2%). The largest proportion of primary-care-eligible patients (28.3%) was seen in our fast-track area followed by our pediatric pod (21.9%). The total number of ED visits decreased from 7,477 pre-covid to 5,057 post-covid visits. However, the proportion of patient visits that qualified as primary care eligible was generally consistent.

Conclusions: Over half of all ED visits in our dataset could be primary care eligible. Our findings suggest that our patient population may benefit from other on-demand and appointment-based healthcare delivery to decompress the ED.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9383230PMC
http://dx.doi.org/10.1093/milmed/usab553DOI Listing

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