Distribution of emergency department costs

Annals of Emergency Medicine
R M Williams

Abstract

To report the distribution of emergency department costs by category of expense and level of patient urgency. Cost-to-charge and relative-value methods were used to determine direct and indirect physician, facility, supply, pharmacy, laboratory, radiology, and miscellaneous costs for 24,010 ED patients. Explicit criteria were used to classify patient visits as nonurgent, semiurgent, or urgent. For all patients, the average costs were physician, $64; facility, $84; laboratory, $21; radiology, $24, and total, $209. Laboratory and radiology costs accounted for 5% of the total costs for nonurgent visits and 23% of the total costs for urgent visits. The distribution of ED costs varies significantly according to the urgency of the medical condition. For nonurgent patient visits, most costs are represented by the hospital facility and ED physicians' costs. Ancillary services represent a much greater proportion of costs for patients with urgent conditions. Although reduced test-ordering might result in some savings among patients with urgent conditions, overall improved cost efficiency can be achieved only through reductions in the fixed costs of operation of hospital EDs.

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Citations

Sep 11, 2009·Health Care Management Science·Kyung Hye KimJames F Burgess
Aug 1, 1997·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·R M Williams
Dec 14, 1999·The Journal of Emergency Medicine·A Chinnis, K R White
Feb 5, 2003·Journal of Pain and Symptom Management·Barry V FortnerJana Munk
Nov 4, 1998·Journal of Occupational and Environmental Medicine·L F McCaigB J Stussman
Nov 3, 2001·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J Glauser
Sep 29, 2007·Emergency Medicine Journal : EMJ·Ian Higginson, Henry Guly
Mar 22, 2006·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Rade B Vukmir
Sep 20, 2006·Emergency Medicine Clinics of North America·Karin V Rhodes, Daniel A Pollock
Apr 28, 2005·Annals of Emergency Medicine·Anil BamezaiAmar Nawathe
May 22, 2013·Journal of Pain & Palliative Care Pharmacotherapy·Kuan-Ling KuoDavid D Stenehjem
Jan 28, 2015·Journal of the American College of Radiology : JACR·Vignesh A ArasuRobert A Novelline

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