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Case/Article Review 8


A recent study published in the International Journal for Quality in Health Care found that 3.5% of all emergency department visits analysed were 'avoidable'. Of these, the top 3 discharge diagnoses were alcohol abuse, dental disorders, and mood disorders.

The study analysed data from 424 million visits made to emergency departments in the USA by patients aged 18 to 64 between 2005 and 2011. It defines 'avoidable' as those cases where there was no requirement of diagnostic or screening services, procedures, or medications and the patients were discharged home. It found that 3.9% of all avoidable visits related to disorders to the teeth and jaw.

Emergency departments are designed to treat conditions which threaten life and limb and are not equipped to deal with conditions arising from mental health or dental problems. The study notes that 16.9% of all mood disorder related visits, 10.4% of all alcohol related visits, and 4.9% of all tooth and jaw related visits were avoidable.
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These findings suggest that policy initiatives could alleviate pressure on emergency departments by addressing gaps in the provision of dental and mental health care in order to treat this group of emergency department visitors at a lower cost elsewhere.

Outline the main issues raised

(Reference: Adapted from: https://www.sciencedaily.com/releases/2017/08/170831092653.htm)
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Example Candidate Response
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This study has found that 3.5% of emergency department visits in the US between 2005 and 2011 were avoidable.
 
This is a significant waste of resources, and may result in many who come to A+E with legitimate presentations having a lower standard of treatment.
 
However, there should be triage systems in place to deal with this issue. Indeed, the danger of warning people from visiting A+E should not be underestimated.

Patients should feel confident that they can visit the emergency department if ever they feel ill, without fearing that they will be turned away, or that they will cause a hassle for medical staff.

A potential solution to this problem is a public health initiative that catches patients presenting with some of these concerns in the primary sector, before they have a chance to present in hospital. Additionally, the use of telephone triaige systems such as the NHS 111 system may help to direct patients to the most appropriate service provider, thus preserving limited resources.