Reducing Inappropriate Emergency Department and Avoidable Hospitalization Rates: Assessing the Influence of Medical Group Practice Characteristics

February 2014

Concern is growing over escalation in the improper and avoidable use of emergency departments (ED) by patients who did not receive appropriate care from their physicians. In a HCFO-funded study, John Kralewski, Ph.D., M.H.A., University of Minnesota and Medica Research Institute, and colleagues examined a national sample of 212 medical group practices and documented the characteristics of practices that influence these rates.

They found that hospital-owned practices have higher nonemergent and emergent primary care treatable ED rates and higher ambulatory care sensitive hospitalization rates. Practices with electronic health records have lower inappropriate ED rates but those in rural areas have significantly higher rates. Practices with lower operating costs have higher inappropriate ED and ambulatory care sensitive rates, raising questions about the costs of preventing these incidents at the medical group practice level. Their findings were published in the October-December 2013 issue of The Journal of Ambulatory Care Manage (subscription required).