Healthcare News & Insights

New ways for hospitals to stop unnecessary ED use

Even with all the changes brought about by healthcare reform, “superutilizers” continue to be a big problem in hospital emergency departments (ED). And some facilities are coming up with unique ways to curb this problem.

ThinkstockPhotos-152976282Superutilizers visit the ED due to health issues that usually don’t require a hospital stay. Many of these patients are from disadvantaged backgrounds and don’t get regular care for their medical issues outside of the ED.

A good portion of these patients are homeless, and some come to the ED just so they won’t have to spend the night on the streets.

As described in a recent piece in the New York Times, facilities are coming up with better strategies for helping these people.

Several states have programs in place where hospitals work with patients to connect them with social services and community organizations to meet their needs across the care spectrum, from providing them with food to connecting them with low-income health clinics.

Some facilities go even further when it comes to providing patients with necessary social services. Outreach workers help patients get driver’s licenses and apply for utility assistance to keep the power on in their homes.

Addressing all needs

One comprehensive program addressing patients’ social needs and saving healthcare dollars is an initiative at Hennepin County Medical Center in Minneapolis. The pilot program is focused on 10,000 patients who ended up on the Medicaid rolls when the program was expanded.

The hospital gets a stipend from the county to help each patient stay out of the hospital. In turn, the facility works with the county to meet needs that indirectly relate to patient health.

Once these patients arrive at the ED and it’s determined their health isn’t in immediate danger, they speak to county social workers instead of doctors. Then the social workers direct them to other, more appropriate resources for their situations.

Working with the hospital, county social workers have placed homeless patients into permanent housing. The county’s even invested in a special clinic where homeless patients with alcohol issues can go to sober up instead of doing so in the ED.

In the first year of the program, avoidable medical costs fell 11% for the county, in part because of the hospital’s work in addressing these patients’ socioeconomic needs.

Benefits to interventions

More and more hospitals are getting involved to improve the continuum of care for disadvantaged patients, and these partnerships can be helpful in many areas.

Not only can hospitals avoid providing costly charity care in the ED, they can also prevent readmissions, as well as prevent adverse outcomes post discharge.

Even in states that don’t have government support to form these alliances, it may be worthwhile for hospitals to go the extra mile and forge partnerships with community organizations to fight back against some of the underlying socioeconomic problems that contribute to ED overuse.

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