The shifting landscape in utilization of inpatient, observation, and emergency department services across payers

Teryl K. Nuckols, Kathryn R. Fingar, Marguerite Barrett, Claudia A. Steiner, Carol Stocks, Pamela L. Owens

Research output: Contribution to journalArticlepeer-review

Abstract

Recent policies by public and private payers have increased incentives to reduce hospital admissions. Using data from four states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Patients had an expected primary payer of private insurance, Medicare, Medicaid, or no insurance. Across all four payer populations, inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased. Implications for quality of care and costs to patients warrant further examination.

Original languageEnglish (US)
Pages (from-to)443-446
Number of pages4
JournalJournal of hospital medicine
Volume12
Issue number6
DOIs
StatePublished - Jun 2017

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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