A recent study published in the International Journal for Quality in Health Care found that 3.5% of all emergency department visits analysed were 'avoidable'. Of these, the top 3 discharge diagnoses were alcohol abuse, dental disorders, and mood disorders such as anxiety or depression. A significant find since 'avoidable' emergency department visits can impact the cost of health insurance, the study suggests that 'avoidable' emergency department visits could be reduced by increasing access to dental and mental health facilities.
The study analysed data from 424 million visits made to emergency departments in the USA by patients aged 18 to 64 between 2005 and 2011. It defines 'avoidable' as those cases where there was no requirement of diagnostic or screening services, procedures, or medications and the patients were discharged home. It found that 6.8% of all avoidable visits were caused by alcohol-related or mood disorders and 3.9% of all avoidable visits related to disorders to the teeth and jaw. It also notes that 14% of avoidable visits were made by ambulance.
Emergency departments are designed to treat conditions which threaten life and limb and are not equipped to deal with conditions arising from mental health or dental problems. The study notes that 16.9% of all mood disorder related visits, 10.4% of all alcohol related visits, and 4.9% of all tooth and jaw related visits were avoidable. Despite these significant percentages, the vast majority of diagnoses in these areas were not deemed avoidable so it should not be assumed that all patients with these conditions should not attend the emergency department.
However, these findings do suggest that policy initiatives could alleviate pressure on emergency departments by addressing gaps in the provision of dental and mental health care in order to treat this group of emergency department visitors at a lower cost elsewhere.
Article: Avoidable emergency department visits: a starting point, Renee Y. Hsia, Matthew Niedzwiecki, International Journal for Quality in Health Care, doi: 10.1093/intqhc/mzx081, published 31 August 2017.