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

Abstract

Emergency departments (ED) continues 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. 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. During the 12-month period, we queried data on 75,205 patient charts. We categorized 59% (n=42,647) of visits as primary care eligible within our chart review. However, the proportion of patient visits that qualified as primary care eligible was generally consistent. We assessed over half of all emergency department admissions could be primary care eligible. Our findings suggest that our patient population may benefit from offering additional lower-cost, appointment-based healthcare delivery to decompress the ED.

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Document Details

Document Type
Technical Report
Publication Date
Jul 19, 2021
Accession Number
AD1143459

Entities

People

  • Adrianna Long
  • Ashley D. Tapia
  • Brit Long
  • Eric J. Chin
  • James A. Pfaff
  • Jeffrey T. Howard
  • Michael D. April
  • Natasha L. Bebo
  • Steven G Schauer
  • Wesley A. Trueblood
  • William Fernandez

Tags

DTIC Thesaurus Topics

  • Covid-19
  • Data Sets
  • Department Of Defense
  • Diagnostic Imaging
  • Health Services
  • Hospitals
  • Information Science
  • Magnetic Resonance
  • Magnetic Resonance Imaging
  • Medical Personnel
  • Military Hospitals
  • Military Medicine
  • Pain
  • Patient Care Management
  • Statistical Analysis

Fields of Study

  • Medicine

Readers

  • Medical Imaging.
  • Medical or Health Care Field.
  • Mental Health of Military Veterans with Posttraumatic Stress Disorder (PTSD): Risk Factors, Prevalence, Symptoms, and Treatment.

Technology Areas

  • Microelectronics