Frequent users of the emergency room are not abusing the system and do not have higher rates of nonurgent visits to the ER than more typical ER patients, according to a group of studies (PDF)
published in the Annals of Emergency Medicine.
“I think there are some misconceptions about the patients who are frequent users,” Dr. Andy Sama, ACEP's newly seated president, said at a news conference.
In addition to the study of ER visits at a single academic medical center in Massachusetts showing no difference between the odds that a frequent user or a nonfrequent user was making a nonurgent visit to the ER, another study showed that high-frequency repeat users of the ER tend to be sicker. That study of a six-month period at a university medical center in Virginia found that high-frequency users of the ER have more chronic illness, greater numbers of co-morbidities and higher two-year mortality rates, as well as high rates of readmission. The authors conclude that it may be unreasonable for the federal government to penalize hospitals for readmissions for all patient populations given the differences in readmission rates.
The Massachusetts study also showed that the frequent users of the ER represented 2.1% of ER patients and 11.5% of patients.
All the studies used different definitions for frequency of ER use by patients.