Factors most consistently and strongly associated with all levels of emergency department use were schizophrenia, homelessness, opiate prescriptions being filled and heart failure.
"This isn't a problem of insufficient medical care– providing access to more of the same outpatient care is unlikely to eliminate frequent ER use," said Dr. Doran.
Jesse Pines, MD, MBA, of the George Washington University in Washington D.C., the author of the accompanying editorial, wrote that the VHA "is an integrated delivery system that operates in many ways like an accountable care organization, a major cornerstone of the [Affordable Care Act]."
"Even accountable care organizations will have frequent ER users," said Dr. Pines. "Therefore efforts should focus on enhancing the quality of emergency care, rather than policies intended to undermine emergency departments. For example, non-payment for ER care for specific conditions is often discussed as a way to reduce costs. This study makes it even clearer that non-payment programs focused on emergency departments are just not good public policy."Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit www.acep.org. www.annemergmed.com twitter.com/emergencydocs SOURCE American College of Emergency Physicians (ACEP)