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Non-Emergency Department Interventions to Reduce ED Utilization: A Systematic Review

Hospitals are constantly trying to reduce the number of visitors in the Emergency Department in order to lower costs and improve the quality of care. Many strategies have been tested and implemented including preventative efforts.

A systematic review conducted by Jesse Pines, M.D., director of the Office of Clinical Practice Innovation and professor of emergency medicine at the George Washington University (GW) School of Medicine and Health Sciences, researched the types of interventions that had been implemented outside of EDs that were designed to reduce ED use.

The interventions reviewed consisted of five categories:

  • Patient education
  • Creation of additional non-ED capacity
  • Managed care
  • Pre-hospital diversion
  • and patient financial incentives

The studies that have explored interventions outside of the ED in the past have revealed mixed evidence. According to Pines' research, published in the journal Academic Emergency Medicine, two-thirds of the published studies on this topic show actual reductions in ED use. From the abstract of the report, "The interventions with the greatest number of studies showing reductions in ED use include patient financial incentives and managed care, while the greatest magnitude of reductions were found in patient education." It was noted that the findings from the report have implications for insurers and policymakers seeking to reduce ED use. 

The full report can be found here.

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