Emergency rooms are often understaffed and overpopulated. Some Hospital budgets are strained to their breaking point. So why is a relatively common disorder putting a multi-million dollar burden on ERs when it could easily be treated on an outpatient basis? By treating the condition on outside of an emergency room setting, emergency room doctors can focus their efforts improving patient care and, by extension, reducing the rate of medical malpractice.

A team of researchers from Henry Ford Hospital in Detroit, Michigan examined why patients complaining of blood in the urine, known as hematuria, were visiting emergency rooms and what effect the related costs had on the health care industry. Because the disorder can usually be dealt with as an outpatient procedure, the researchers wanted to determine how often hematuria cases came through the emergency department (ED). The study used data from the Nationwide Emergency Department Sample, focusing on over 700,000 emergency visits with a hematuria diagnosis between 2006 and 2009. Their findings showed that emergency room visits for this disorder alone cost departments $238 million per year.

Diagnostic tests (including radiography, ultrasound, CT and MRI scanning) factored greatly in the annual costs associated with hematuria. Over 13 percent of emergency room patients diagnosed with the disorder underwent an imaging procedure, with the frequency of imaging increasing every year surveyed. When the researchers looked at reimbursement claims for these ER visits, they found that the average cost with diagnostic imaging was over $4,000, or three times as much as a visit with no imaging. Dr. Kurshid Ghani, lead author of the study, said, "Imaging alone was associated with an increase in ED charges of more than $75 million per year."

Unnecessary testing places a financial burden on patients and the health care system. The research team is hopeful that their findings can be used to help create care guidelines in the new health networks that are part of the Affordable Care Act. Those networks, scheduled to begin in 2014, are supposed to reduce costs and link reimbursement with quality of care. While this study focuses on just one disorder, it serves as an example of the toll excessive testing takes on emergency rooms and the health care system as a whole. As the researchers acknowledge, it will take a concerted effort on the part of all involved parties to bring lasting change.

Sources:

Medical News Today, $238 Million a Year in ER Costs Related to Diagnosis, Treatment of Hematuria, A Common Outpatient Disorder, 5-7-13