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Research Highlights
No Harm in Sending Non-Critical ER Patients Home With Next-Day Appointments
Taken from the Veterans Health Administration Highlights dated December 6, 2002
VA researchers found that emergency room (ER) patients in stable condition who were sent home with next-day appointments at primary care facilities fared as well as patients who received same day care at the ER.
VA investigator Dr. Donna Washington of the Greater Los Angeles VA Health Care System led the study. Findings were published in the Nov. 5 issue of Annals of Internal Medicine, and featured the same day in The New York Times.
Since 40 percent or more of all ER visits in the U.S. are for non-emergency conditions, researchers wanted to study sending patients with non-acute conditions to primary care the following day rather than same day "emergency" care.
The study was conducted at an inner-city public hospital with 91,000 ER visits each year. Patients were split into two randomized groups: those who would receive same day ER treatment, and those were given an appointment at the site’s primary care clinic for the next day (these patients were given a 24-hour telephone number in case they needed help sooner).
Findings may ease overcrowding, long waits, and patient frustration. At follow-up, both groups reported improved health status and fewer days in bed or with disability, although the primary care referral group reported less improvement. Larger studies are needed to assess the possibility of any adverse effects.
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