May 21—Nearly all of the growth in inpatient admissions at U.S. hospitals from 2003-2009 was due to a 17 percent increase in unscheduled inpatient admissions from hospital emergency departments (EDs), according to a recent study.

The growth in ED admissions offsets a 10 percent decrease in admissions originating from physician offices and other outpatient settings, according to a report released by Rand Corp., The Evolving Role of Emergency Departments in the United States. The findings suggest that physicians are sending some patients to the ED whom they might at one time have admitted to the hospital, the report states.

This shift in practice is putting ED physicians in the role of major decision makers for about half of all hospital inpatient admissions in the United States, according to the report. This has significant financial implications for hospitals: Admissions generate the bulk of facility revenue for hospitals, and inpatient care accounts for 31 percent of national healthcare spending, according to the report.

However, the report also states that although non-elective ED admissions have increased dramatically over the past decade, “potentially preventable admissions” have remained flat, suggesting that EDs may play a constructive role in constraining the growth of inpatient admissions.

Publication Date: Tuesday, May 21, 2013