ROCKVILLE, Md.--A large portion of emergency room admissions include patients with chronic conditions that should have been managed outside of the hospital, according to a new statistical brief from the Agency for Healthcare Research and Quality.

According to the report, 72 percent of hospital admission cases with congestive heart failure, chronic obstructive lung disease and asthma were admitted through the ER. AHRQ said these were "chronic conditions that should be controlled on an outpatient basis with good primary care."

The report said "there is also concern that emergency departments care for patients with chronic conditions who may not be receiving adequate outpatient follow-up to control their conditions."

In 2003, more than 16 million patients entered the hospital through ERs, about 55 percent of hospital stays excluding pregnancy and childbirth. The average hospital stay for a patient admitted through the ER cost $7,400, according to the AHRQ, with Medicare and Medicaid covering 66 percent of all admissions.

Circulatory disorders were the most frequent reason for admission to the hospital through emergency rooms, accounting for 26.3 percent of ER admissions. Respiratory and digestive disorders were the next most common at 15.1 and 14.1 percent, and injuries made up 11.4 percent of admissions through the ER.

The report was issued as health care professionals voice concern about the overuse and inappropriate use of emergency rooms. Home care advocates have recently predicted that emergency room visits by home-based oxygen patients will increase because of a provision in the Deficit Reduction Act that caps oxygen rental at 36 months and transfers equipment ownership to the beneficiary (see HomeCare Monday, Feb. 27).

To view the AHRQ report, click here.

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The American Association for Homecare is urging providers to take advantage of the House and Senate's two-week recess today through April 21 to educate their members of Congress about the value and benefits of home care--and to oppose a provision in the Bush administration's 2007 budget proposal that would transfer ownership of oxygen equipment to beneficiaries after 13 months. To find your member of Congress, click here.

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