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ARTICLE |

Hospital Admission Through the Emergency Department: Title and subTitle BreakThe Obstructed Pathway FREE

Carin M. Olson, MD
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Reprint requests to Scientific Publications Group, American Medical Association, 515 N State St, Chicago, IL 60610 (Dr Olson).


JAMA. 1991;266(16):2274-2274. doi:10.1001/jama.1991.03470160106043
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In this issue of The Journal, Stern et al1 compare hospital charges and lengths of stay for patients admitted through the emergency department with charges and lengths of stay for patients admitted through other routes to any of five Massachusetts hospitals. Even with adjustments for diagnosis related group, severity of illness, age, and income, patients admitted through the emergency department incurred hospital charges 13% higher and hospital stays 27% longer than other patients.

REFERENCES

Stern RS, Weissman JS, Epstein AM.  The emergency department as a pathway to admission for poor and high-cost patients. JAMA . 1991;;266:2238-2243.
 Emergency department overcrowding examined. Outreach . (November-December) 1989;;10:1,3.
Thorpe KE.  Why are urban hospital costs so high? the relative importance of patient source of admission, teaching, competition, and case mix. Health Serv Res . 1988;;22:821-836.
Hofferber M.  Hospitals in critical condition. Emergency . (January) 1989;;21:45-47.
Consolidated Omnibus Budget Reconciliation Act, Pub L No. 99-272, 42 USC §9121.
The 1991 Joint Commission. Accreditation Manual for Hospitals . Oakbrook Terrace, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1990;;1:33.
American College of Emergency Physicians.  Guidelines for transfer of patients. Ann Emerg Med . 1985;;14:1221-1222.
Thorpe KE, Brecher C.  Improved access to care for the uninsured poor in large cities: do public hospitals make a difference? J Health Polit Policy Law . 1987;;12:313-324.
Melnick GA, Serrato CA, Mann JM.  Prospective payments to hospitals: should emergency admissions have higher rates? Health Care Financ Rev . (Spring) 1989;;10:29-39.
American College of Emergency Physicians.  Measures to deal with emergency department overcrowding. Ann Emerg Med . 1990;;19:944-945.

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Stern RS, Weissman JS, Epstein AM.  The emergency department as a pathway to admission for poor and high-cost patients. JAMA . 1991;;266:2238-2243.
 Emergency department overcrowding examined. Outreach . (November-December) 1989;;10:1,3.
Thorpe KE.  Why are urban hospital costs so high? the relative importance of patient source of admission, teaching, competition, and case mix. Health Serv Res . 1988;;22:821-836.
Hofferber M.  Hospitals in critical condition. Emergency . (January) 1989;;21:45-47.
Consolidated Omnibus Budget Reconciliation Act, Pub L No. 99-272, 42 USC §9121.
The 1991 Joint Commission. Accreditation Manual for Hospitals . Oakbrook Terrace, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1990;;1:33.
American College of Emergency Physicians.  Guidelines for transfer of patients. Ann Emerg Med . 1985;;14:1221-1222.
Thorpe KE, Brecher C.  Improved access to care for the uninsured poor in large cities: do public hospitals make a difference? J Health Polit Policy Law . 1987;;12:313-324.
Melnick GA, Serrato CA, Mann JM.  Prospective payments to hospitals: should emergency admissions have higher rates? Health Care Financ Rev . (Spring) 1989;;10:29-39.
American College of Emergency Physicians.  Measures to deal with emergency department overcrowding. Ann Emerg Med . 1990;;19:944-945.
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