![]() Spending estimates presented in this analysis rely on an existing dataset constructed for the broader DEX study, which leveraged 198 source-years of microdata to estimate health spending across all health care services, including the ED. Third, ED spending per visit estimates are summarized over time and across health conditions. Second, ED spending is delineated by disposition (“treat-and-release” ED visits versus those resulting in hospitalization). First, the distribution of ED spending is summarized across age groups, patient sex, payer, and 154 health conditions from 2006 to 2016. across a range of policy relevant variables from 2006 to 2016. In this context, the current study aims to describe ED spending in the U.S. These varying approaches make it difficult to assess ED spending trends over time and across key groups, which would be helpful as policymakers seek to improve its value. Prior work has generally shown overall ED spending to be a relatively small contributor to national health spending as compared to other sectors, but has lacked detail on where these dollars have been allocated, has been limited to specific conditions, or focused only on a subset of ED patients. ![]() Despite this heightened attention to ED costs, there are surprisingly few studies that provide a comprehensive assessment of ED spending over time, including how ED spending varies across health conditions and patient populations. Recent media coverage and ongoing legislative debates have brought greater attention to “surprise billing” practices and high ED charges, including during the current COVID-19 pandemic. īeyond policymaker and payer interest in decreasing ED spending, patients also have concerns about the cost of ED care. Efforts to promote improved value around emergency care have tended to focus on preventing avoidable ED visits that can be treated in less costly settings, as well as those that reduce low-value testing and interventions. As such, the ED has been subject to policymaker scrutiny as momentum has grown to curb healthcare spending and payers have moved towards delivery reforms and alternative payment models designed to improve the value of healthcare services more broadly. At the same time, ED visits can be expensive, particularly when compared to alternative sites of care. The emergency department (ED) fills a vital role in the health system, caring for patients with acute medical illness and injury 24 hours a day, 7 days a week, and serving as a critical safety net to millions of Americans each year. Road injuries, falls, and urinary diseases witnessed the highest levels of ED spending, accounting for 14.1% (CI, 13.1%-15.1%) of total ED spending in 2016. In terms of key groups, the majority of ED spending was allocated among females (versus males) and treat-and-release patients (versus those hospitalized) those between age 20–44 accounted for a plurality of ED spending. Nearly equal parts of ED spending in 2016 was paid by private payers (49.3% ) and public payers (46.9% ), with the remainder attributable to out-of-pocket spending (3.9% ). Overall ED spending was $79.2 billion (CI, $79.2 billion-$79.2 billion) in 2006 and grew to $136.6 billion (CI, $136.6 billion-$136.6 billion) in 2016, representing a population-adjusted annualized rate of change of 4.4% (CI, 4.4%-4.5%) as compared to total healthcare spending (1.4% ) during that same ten-year period. All spending estimates were adjusted for inflation and presented in 2016 U.S. to measure healthcare spending for ED care. This observational study utilized the National Emergency Department Sample, a nationally representative sample of hospital-based ED visits in the U.S.
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