Avoidable ED Utilization

According to the 2019 Premier Inc White Paper on Improving Care for Patients with Chronic Conditions, 4.3 million out of 24 million yearly emergency department visits by patients with chronic conditions could have been avoided: Costing an additional $8.3 billion for the 18% of avoidable visits. A 2017 Health Affairs study indicates that patients who regularly see their primary care physicians are far less likely to use the ED. Reasons a patient may choose to visit the ED as opposed to their PCP include convenience, cost, and perceived urgency. For example, people who live in medically underserved areas or have less access to primary care have higher odds of using the ED instead of visiting primary care. Additionally, medicare beneficiaries and medicaid clients are far more likely to visit the ED based off a 2015 Emergency Department Use study.

Fortunately, predictive analytics can target patients that are going to utilize the ED with issues that could have been treated or prevented had they visited their primary care physicians instead: these patients are considered at risk. The advantage to targeting at-risk patients before the ED utilization occurs is that it helps reduce costs for both hospitals and the patient, as well as preventing the patient’s health from worsening. With this knowledge in mind, organizations can work on strengthening relationships with primary care physicians and their patients by developing intervention programs specific to each individual’s need.

Did you know...

$8.3 Billion

Medicaid

beneficiaries are more likely to use the ED than any other patient population

Emergency Department Visits

are the main source of hospital admissions

How Can ClosedLoop Predict Patients Mostly Likely to Overuse the ED?

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Appointment No-Shows

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Readmissions

There were approximately 3.3 million adult 30-day all-cause hospital readmissions in the U.S. in 2011, and they were associated with about $41.3 billion in hospital costs.

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Hospital Acquired Conditions & Infections

Annually, approximately 2 million patients suffer with HAIs in the U.S., and nearly 90,000 are estimated to die. The overall direct cost hospitals incur due to HAIs is estimated to be as high as $45 billion annually.

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Opioid Addiction

130 deaths per day result from the misuse of opioids. Physicians can write alternative scripts or offer different treatments to patients who are identified as likely to overuse.

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