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How Coordinated Care Can Ground Frequent Fliers

Joe Cantlupe, for HealthLeaders Media, June 7, 2012

One of the biggest problems for hospital leaders who run emergency departments are the "frequent fliers," those patients who repeatedly use the ED for ailments such as chronic back pain.  When they keep coming back, their overuse and inappropriate use of hospital services drains resources, money, and time that could be spent on other, more seriously ill patients.

It's not all the patients' fault. Far from it. The problem often originates with primary care physicians themselves, who steer patients to the ED, which is to say—they steer them wrong. 

As HealthLeaders Media reported this week, one in five patients who went to the ED but were not sick enough to require an inpatient bed, said they sought treatment in emergency departments because their primary care doctor told them to go there, according to a federal survey.

While some patients are referred to the ED, others "self-refer." They go to the ED because they feel they have nowhere else to turn for care, and not because it's the weekend, either. Apparently some primary care physicians are to blame for this scenario, too.

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