Frequent Flyers in the Emergency Room

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In 2010, the United States spent $2.6 trillion on healthcare (U.S. Census Bureau, 2012). Emergency room (ER) visits make up about 3 percent of the national healthcare bill, or $78 billion. (American College of Emergency Physicians).

Though the demand for emergency care is up by 32 percent — up to 128 million visits in 2008, or 340,000 people every day, the number of emergency departments has decreased by 5 percent in 10 years (JAMA, 2010).

Studies vary on the percentage of inappropriate ER visits The Centers for Disease Control cites 8%. Health Affairs puts it at 27%.

The most frequent ER users, also called “frequent flyers,” are often blamed for inappropriate visits. Frequent users are defined as those with more than four ER visits per year.

While frequent flyers account for only 4 percent of patients, they account for 25 percent of all ER visits.  A small cut in frequent flyer visits could dramatically decrease ER overcrowding and cost. Unfortunately, frequent flyers are easy to identify but difficult to fix. This extremely varied population presents to the hospital with a wide range of health conditions that require a broad assortment of treatments.

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To hear Dr. Parker’s talk to Duke Medical students about this project,

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