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Care Continuity Cuts Seniors' Trips to ER

News  |  By HealthLeaders Media News  
   August 26, 2016

Medicare patients who maintain relationships with the same physicians have better odds of staying out of emergency departments, research shows.

Traditional Medicare patients who consistently see the same outpatient physician have lower odds of visiting the emergency department, according to an Annals of Emergency Medicine study.

Researchers studied the administrative data of more than 3 million Medicare beneficiaries between 2011 and 2013 and found that the relative risk of an ED visit, observation stay, or admission through the emergency department fell by up to 20% for patients with the highest continuity of care, compared with the lowest continuity of care.

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"Visits with the same physician or a small number of physicians fosters long-term relationships for Medicare patients, which is ultimately good for their health," said lead study author David Nyweide, a social science researcher at the Centers for Medicare & Medicaid Services.

"The critical factor seems to be consistent visits with one physician or few physicians, not lots of them," Nyweide said. "Seniors would be well-advised to maintain an ongoing relationship with the same physician for many reasons, including avoiding emergency department visits."

The study found, however, that when an ED visit occurred the patient was more likely to be hospitalized. Among beneficiaries with ED episodes, higher continuity was associated with a 1% lower risk of observation stay but a 3% to 4% higher risk of hospital admission relative to an ED visit with discharge home.

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"One possible explanation is that when a patient with a usual care physician comes to the ER, the physician may provide clearer guidance on which situations are serious enough to warrant a hospital admission," Nyweide said.

In related news, seniors in the ED might benefit from one that's designed for them. Geriatric EDs, such as the one at Mount Sinai Hospital in New York, may have the potential to lower healthcare costs and reduce hospitalizations for the elderly. Care is specifically tailored for them and providers are able to better determine who needs hospitalization and who doesn't.

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