health care

Report: ER costs in U.S. ‘as high as 10%’ of total health spending

Posted 4/30/13

PROVIDENCE – The real national costs of emergency department visits may be as high as 10 percent of national health care expenditures, according to a report released by Brown University’s Dr. Michael H. Lee.

A review by Lee and other researchers, analyzing national datasets, suggested that emergency visits occurred with much higher frequency than previously reported, debunking minimal cost folklore endorsed by the federal medical researchers that peg emergency care at just 2 percent of the national healthcare expenditure, a sum of all medical supplies, labor and training.

A copy of Lee’s report, titled “Owning the Costs of Emergency Medicine: Beyond the 2% Myth,” said that true emergency department costs are more than twice the amount that the government alleges—nowhere near $48 billion, but more like $127 billion, and possibly as high as $260 billion—perhaps up to a tenth of the estimated $2.8 trillion national health expenditure.

Unscheduled hospital medical visits prove a wasteful bane to the industry, the report alleges, which is countered by claims by that emergency department costs are a minimal contributor to total expenditures.

“The ER has become increasingly important as a place where people go for acute unscheduled care,” said Lee in prepared remarks.

While the remedy for frequent emergency department visits may be to reallocate emergency room care to primary care facilities, the report warns that this practice could “shift costs onto…offices and clinics which may not have the infrastructure to accommodate a large volume of unscheduled care.” The report adds that more attention needs to be placed on getting the emergency department story right—rather than underestimating the costs, determine if the costs correspond to value of emergency care.

The most frequent emergency department visits involve patients with stomach or abdominal pain, chest pain and fever; up to 76 percent of emergency room visits in 2010 were classified as “urgent” or “semi-urgent,” while 11 percent of patients required the highest priority care, according to data from the Center for Disease Control.

Lee’s economic findings were published in the Annals of Emergency Medicine on April 26.

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