Healthcare spending in U.S. emergency departments by health condition, 2006-2016.

<h4>Background</h4>Healthcare spending in the emergency department (ED) setting has received intense focus from policymakers in the United States (U.S.). Relatively few studies have systematically evaluated ED spending over time or disaggregated ED spending by policy-relevant groups, inc...

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Autores principales:	Kirstin Woody Scott, Angela Liu, Carina Chen, Alexander S Kaldjian, Amber K Sabbatini, Herbert C Duber, Joseph L Dieleman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7402ed769b044b22bd6ed687a461dbdc
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spelling	oai:doaj.org-article:7402ed769b044b22bd6ed687a461dbdc2021-12-02T20:13:27ZHealthcare spending in U.S. emergency departments by health condition, 2006-2016.1932-620310.1371/journal.pone.0258182https://doaj.org/article/7402ed769b044b22bd6ed687a461dbdc2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258182https://doaj.org/toc/1932-6203<h4>Background</h4>Healthcare spending in the emergency department (ED) setting has received intense focus from policymakers in the United States (U.S.). Relatively few studies have systematically evaluated ED spending over time or disaggregated ED spending by policy-relevant groups, including health condition, age, sex, and payer to inform these discussions. This study's objective is to estimate ED spending trends in the U.S. from 2006 to 2016, by age, sex, payer, and across 154 health conditions and assess ED spending per visit over time.<h4>Methods and findings</h4>This observational study utilized the National Emergency Department Sample, a nationally representative sample of hospital-based ED visits in the U.S. to measure healthcare spending for ED care. All spending estimates were adjusted for inflation and presented in 2016 U.S. Dollars. 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% [CI, 1.4%-1.4%]) during that same ten-year period. The percentage of U.S. health spending attributable to the ED has increased from 3.9% (CI, 3.9%-3.9%) in 2006 to 5.0% (CI, 5.0%-5.0%) in 2016. Nearly equal parts of ED spending in 2016 was paid by private payers (49.3% [CI, 49.3%-49.3%]) and public payers (46.9% [CI, 46.9%-46.9%]), with the remainder attributable to out-of-pocket spending (3.9% [CI, 3.9%-3.9%]). 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. 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. ED spending per visit also increased over time from $660.0 (CI, $655.1-$665.2) in 2006 to $943.2 (CI, $934.3-$951.6) in 2016, or at an annualized rate of 3.4% (CI, 3.3%-3.4%).<h4>Conclusions</h4>Though ED spending accounts for a relatively small portion of total health system spending in the U.S., ED spending is sizable and growing. Understanding which diseases are driving this spending is helpful for informing value-based reforms that can impact overall health care costs.Kirstin Woody ScottAngela LiuCarina ChenAlexander S KaldjianAmber K SabbatiniHerbert C DuberJoseph L DielemanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258182 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kirstin Woody Scott Angela Liu Carina Chen Alexander S Kaldjian Amber K Sabbatini Herbert C Duber Joseph L Dieleman Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
description	<h4>Background</h4>Healthcare spending in the emergency department (ED) setting has received intense focus from policymakers in the United States (U.S.). Relatively few studies have systematically evaluated ED spending over time or disaggregated ED spending by policy-relevant groups, including health condition, age, sex, and payer to inform these discussions. This study's objective is to estimate ED spending trends in the U.S. from 2006 to 2016, by age, sex, payer, and across 154 health conditions and assess ED spending per visit over time.<h4>Methods and findings</h4>This observational study utilized the National Emergency Department Sample, a nationally representative sample of hospital-based ED visits in the U.S. to measure healthcare spending for ED care. All spending estimates were adjusted for inflation and presented in 2016 U.S. Dollars. 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% [CI, 1.4%-1.4%]) during that same ten-year period. The percentage of U.S. health spending attributable to the ED has increased from 3.9% (CI, 3.9%-3.9%) in 2006 to 5.0% (CI, 5.0%-5.0%) in 2016. Nearly equal parts of ED spending in 2016 was paid by private payers (49.3% [CI, 49.3%-49.3%]) and public payers (46.9% [CI, 46.9%-46.9%]), with the remainder attributable to out-of-pocket spending (3.9% [CI, 3.9%-3.9%]). 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. 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. ED spending per visit also increased over time from $660.0 (CI, $655.1-$665.2) in 2006 to $943.2 (CI, $934.3-$951.6) in 2016, or at an annualized rate of 3.4% (CI, 3.3%-3.4%).<h4>Conclusions</h4>Though ED spending accounts for a relatively small portion of total health system spending in the U.S., ED spending is sizable and growing. Understanding which diseases are driving this spending is helpful for informing value-based reforms that can impact overall health care costs.
format	article
author	Kirstin Woody Scott Angela Liu Carina Chen Alexander S Kaldjian Amber K Sabbatini Herbert C Duber Joseph L Dieleman
author_facet	Kirstin Woody Scott Angela Liu Carina Chen Alexander S Kaldjian Amber K Sabbatini Herbert C Duber Joseph L Dieleman
author_sort	Kirstin Woody Scott
title	Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
title_short	Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
title_full	Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
title_fullStr	Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
title_full_unstemmed	Healthcare spending in U.S. emergency departments by health condition, 2006-2016.
title_sort	healthcare spending in u.s. emergency departments by health condition, 2006-2016.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/7402ed769b044b22bd6ed687a461dbdc
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Healthcare spending in U.S. emergency departments by health condition, 2006-2016.

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