![]() Patients not only incur significant costs from ED use, but they also experience poorer outcomes and reduced quality of care. 3 Eliminating unnecessary ED use for mental illness could save about $4.6 billion annually, the Premier report indicates. The $8.3 billion spent each year on ED care represents an increase from $4.4 billion in 2010 annual costs for unnecessary ED visits, according to a study published in Health Affairs. 2Ĭosts of Avoidable ED Visits and Impact on PatientsĪccording to a study published in the Journal of Clinical Psychiatry, between 20, about 8.4 million (8.3%) of 100.9 million ED visits nationwide were for psychiatric or substance use-related diagnoses. When primary care facilities are not open on nights or weekends or have long wait times, they are not accessible. 2ĮDs may also be more accessible than other forms of care, such as primary or preventive forms of care. Going to the ED in a mental health crisis is an option only because EDs are required to stabilize all patients regardless of their ability to pay, under the Emergency Medical Treatment & Labor Act. Patients may use EDs for mental health due underinsurance or uninsurance, or inadequate access to in-network mental health providers. “Often patients are portrayed as the problem, when really the problem is that the resources they need are not easily available to them, so there is a failure in the system.”Īvoidable ED visits occur for a variety of reasons related to health insurance and access. “The term ‘avoidable ED visits’ suggests that there is an appropriate and alternative place to care for people who have medical needs,” Renee Hsia, MD, MSci, professor of emergency medicine and health policy at the University of California at San Francisco, wrote in an email exchange with The American Journal of Managed Care ®. There are a multitude of reasons that account for why patients face barriers to accessing mental health care, and those reasons are not reflected in the language often used to describe the problem. Interventions to improve patient access to mental health care and expand available resources can reduce avoidable ED visits, cut costs, and improve patient health outcomes by following the principle of meeting patients where they are. 1 However, the term “avoidable ED visits” places the onus of these effects on patients, when the issue is much larger, explained one expert. These preventable, or avoidable, ED visits place a strain on ED capacity and have high costs-an estimated $8.3 billion per year, according to a 2019 analysis by Premier. Emergency department (ED) visits by patients who access care for mental health or substance abuse–related issues that could have been treated in another setting are often referred to as “avoidable” ED visits.
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