Emergency Departments Treating Healthier Populations Have Higher Rates of Death
Recently, research showed that hospitals in the lowest fifth of rates of inpatient admission from the emergency department had the highest rates of early death, whereas smaller increases in admission rate were linked to large decreases in risk. This is a startling fact given that hospitals with lower admission rates also serve healthier populations.
According to a study published by The BMJ last year, nearly 20% of the United States’ population visits the emergency department every year and, as a result, the decision to discharge or admit patients is made at least hundreds of thousands of times each day, often leading to errors that cost patients their lives. In fact, among this 20% sample of discharged patients, 12,375 died within an average of 7 days, most of whom were elderly Medicare beneficiaries over the age of 60 without any previous diagnoses of life limiting conditions that may have played a role in the sudden deterioration of their health. This is excluding patients who were transferred.
The leading causes of death among these patients were atherosclerotic disease, myocardial infraction, and chronic obstructive pulmonary disease, though a small percentage also died from a narcotic overdose after visits for musculoskeletal problems. Prior to this study, past research suggested that patients who die shortly after they have been discharged from the emergency department are potentially avoidable if the death occurs from unanticipated deterioration.
However, earlier studies have a limited scope, relying on reviews of individual charts or data from single health systems, making it difficult to assess the findings in a more meaningful way. Despite the new light this current study sheds, further research is required to truly determine whether or not such deaths are actually preventable.
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