Top
reasons for emergency visits & hospitalization
In the United States, the
Emergency Department (ED) sees around 136.6 million patients per year. Just
over 50% of that number falls between the ages of 25-64, and within this age
group, 40-55% of patients enter the ED with high blood pressure (>140/90). This
high percentage is instrumental to the fact that so many of the conditions seen
upon admittance to the ED are chronic diseases, as high blood pressure is a
factor for many including heart disease, respiratory disease and diabetes.
The top five reasons for
admission to the Emergency Department differs between age groups:
18-44 years
|
45-64 years
|
65-84 years
|
Mood disorders
|
Septicemia
|
Septicemia
|
Diabetes mellitus
|
Chest pain
|
Heart failure
|
Skin infection
|
Pneumonia
|
Pneumonia
|
Psychotic disorder
|
COPD
|
COPD
|
Gallbladder disease
|
Skin infection
|
Cardiac dysrhythmias
|
As age increases, the
number of hospital visits increase significantly and these visits tend to be
for chronic conditions. In fact, among the top 10 discharge diagnoses in the
upper age groups, half could be detected early. These include heart disease,
chest pain, cerebrovascular disease, ischemic heart disease and diabetes
mellitus. Early diagnosis of these conditions can make them more manageable and
sometimes even reversible.
Cost
factor of these visits
On average, the annual
aggregate cost of all hospital stays in the US is $375.9 billion. Adults
between 45-84 account for nearly two-thirds of this, and each visit in that age
group averages at $12,200. The costliest conditions involve those associated
with the circulatory system including acute myocardial infarction, coronary
atherosclerosis, congestive heart failure cerebrovascular disease and cardiac
arrhythmias.
The problem with
circulatory disease is that it often exists alongside metabolic conditions
including diabetes, respiratory disease and obesity. These chronic conditions
are becoming an undeniable global burden on the healthcare system and therefore
have become a primary focus for public health policy, early detection methods
and lifestyle intervention.
Can
early detection lower this number?
The aim of early detection is to diagnose people with
chronic diseases before they experience any symptoms. In most cases of disease,
the earlier it is detected, the better the prognosis is. As the presence of
chronic conditions at the ED account for over 15% of all visits, many public
health screening programs exist to identify people with these conditions. However,
these screening programs can be expensive and oftentimes may not be feasible to
run.
If both healthcare professional and patient are made aware
of a potential risk or likelihood of disease developing, more can be done to
monitor and avoid a severe medical event. If a patient is identified as high
risk, lifestyle behaviors can be modified and regular screening can be
prescribed.
Innovative mobile technology is now demonstrating that
it can in fact be used for both early detection and ongoing monitoring of
chronic disease. Mobile apps are able to assist in detecting disease through
complex algorithms which combine health information, medical history and
lifestyle factors to produce a risk level. If higher risk individuals are
alerted early enough, evidence shows that the number of hospitalizations, and
therefore overall cost of medical care, can significantly decrease.
References
Lee S (2004). Early
detection of disease and scheduling of screening examinations. Statistical Methods in Medical Research.
Charles M et al (2012).
Impact of early detection and treatment of diabetes on the 6-year prevalence of
cardiac autonomic neuropathy in people with screen-detected diabetes:
ADDITION-Denmark, a cluster-randomised study. Diabetoogia
Soriano JB (2010).
Screening for and early detection of chronic obstructive pulmonary disorder. The Lancet.
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb146.pdf
