Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215

Decreased Hospital Admissions and Mortality Among Medicare Patients Visiting ERs

MedicalResearch.com Interview with:
Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215Laura Burke, MD, MPH
Department of Emergency Medicine
Beth Israel Deaconess Medical Center
Boston, MA 02215 

MedicalResearch.com: What is the background for this study?

Response: There has been a lot of attention to the growing intensity and costs of emergency care, but relatively little study of how outcomes have changed in recent years for patients using the ED. We examined 30-day mortality rates for traditional Medicare beneficiaries age 65 and older using the emergency department (ED) from 2009-2016 and also examined how their rates of hospitalization have changed over time.  

MedicalResearch.com: What are the main findings?

Response: We found that patients are increasingly being discharged from the emergency department rather than remaining in the hospital for further care. We found that rates of mortality at 30 days as well as earlier time points also declined.  These mortality declines were greatest for the sickest patients.  While these declines were observed broadly across hospitals, some hospitals saw faster improvements than others. 

MedicalResearch.com: What should readers take away from your report?

Response: It appears that outcomes for emergency care may be improving over time for Medicare beneficiaries.  Given that rates of hospitalization are also declining, the overall value and efficiency of emergency care may have improved in recent years.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We are working on a study looking at how evolving patterns of emergency care have impacted total Medicare spending. It would also be helpful to examine trends costs and outcomes in other patient populations who seek care in the ED. 

MedicalResearch.com: Is there anything else you would like to add?

Response: I am an emergency physician and this study was funded by the Emergency Medicine Foundation. I have received previous funding outside of the submitted work from the Association of American Medical Colleges (AAMC).

Citation:

Burke LG, Epstein SK, Burke RC, Orav EJ, Jha AK. Trends in Mortality for Medicare Beneficiaries Treated in the Emergency Department From 2009 to 2016. JAMA Intern Med. Published online November 04, 2019. doi:10.1001/jamainternmed.2019.4866 

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Last Modified: Nov 5, 2019 @ 8:51 pm

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