Washington, DC - A new study to be published online in the Annals of Emergency Medicine finds that even one hour of ambulance diversion can result in significant revenue losses for emergency departments and that increasing bed capacity in hospitals can significantly decrease diversion and increase monthly net revenues.
"It's important that hospitals understand that decreasing ambulance diversion can translate into higher revenues," said study author K. John McConnell, Ph.D., of the Center for Policy & Research in Emergency Medicine at the Oregon Health and Science University in Oregon. Dr. Frederick Blum, president of the American College of Emergency Physicians added, "Ambulance diversion is a serious public health concern, and it is critical that we find ways - through leadership, changes in regulatory policy and financial pressure - to reverse this dangerous trend. Lives literally depend on it."
The study examined a 400-bed, acute care teaching hospital with a level one trauma center in an urban area, which treats approximately 43,000 emergency patients each year. Data were collected and analyzed over a two-year period, and ambulance diversion and revenues were analyzed hour by hour, and also in eight-hour blocks of time.
The study determined that every hour of ambulance diversion cost the hospital approximately $1,100 in revenues, even without including trauma patients who typically generate the highest revenues. This is due in part to the fact that ambulance patients are more likely to be admitted to the hospital and are significantly more likely to be covered by Medicare.
"The findings offer further evidence that emergency departments can be important revenue generators for hospitals," said Dr. McConnell. "While the patient benefits and financial gains provide incentives for hospitals to reduce ambulance diversion, these incentives may be only a partial solution. True relief will probably require support from other areas, such as external financial payments and better regulatory policies concerning emergency departments."
Visits by ambulance patients resulted in average net revenues and charges that were almost three times larger than patients arriving at the emergency department by other means. When the ICU beds were increased and ambulance diversion decreased, the hospital gained approximately $175,000 per month in additional revenues generated by ambulance patients. This reflects a 10-percent increase in revenues from ambulance patients.
An accompanying editorial by Robert M. Williams MD, DrPH, of the University of Michigan School of Public Health, praises the study for its ultimate "goal of improving health outcomes for the greater public good of society."
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 23,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.
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