Emergency departments in the United States are facing a significant challenge when it comes to assessing the urgency level of patient visits. A recent cross-sectional study conducted by Benjamin Ukert from the Texas A&M University School of Public Health, along with colleagues from the University of Alabama at Birmingham and University of South Carolina, revealed that doctors and patients only agree on the urgency level of the situation about 38% to 57% of the time.
This lack of agreement between doctors and patients has important implications, as nearly 40% of emergency department visits are not actually medical emergencies. This discrepancy in perception can lead to unnecessary costs in terms of resources, staffing, and financial burden. Policies have been implemented to transfer less-urgent cases to doctors’ offices and urgent care centers, but the challenge lies in accurately assessing the severity of the condition based on the information provided by the patient.
The study highlighted the limitations of using retrospective review and adjudication processes to determine the appropriateness of emergency department visits. These processes rely on medical claims and algorithms related to discharge diagnoses, which may not always align with the reasons patients give for their visit. The researchers analyzed data from the National Hospital Ambulatory Medical Care Survey, focusing on adult emergency department visits between 2018 and 2019.
The findings showed that there was a lack of association between the reasons patients provided for their visit and the final discharge diagnoses. Even visits classified as very emergent based on discharge diagnoses did not always align with the initial reasons given by patients for seeking care. This discrepancy underscores the challenge that physicians face in accurately assessing the urgency of a situation without a thorough evaluation.
To address these concerns, the researchers suggested the need for additional information from patients upon their arrival at the emergency department. Gathering more details about the patient’s main concern, symptoms, and mode of arrival could help in developing more objective tools to assess the complexity of emergency department visits accurately. This approach could lead to more effective decision-making and resource allocation in emergency departments.
Overall, the study sheds light on the complexities involved in assessing the urgency of emergency department visits and highlights the importance of improving communication between patients and healthcare providers. By enhancing the evaluation process and developing objective tools for triage, emergency departments can better manage patient care and optimize resource utilization.
