Effective liability reform could reduce hospital admissions

New Studies Show Hospital Admissions Ordered Out of Concern About Lawsuits, Underscoring Need for Comprehensive Medical Liability Reform

Visits to emergency departments climbed nearly 10 percent in one year to a new high of more than 136 million visits in 2009, according to preliminary estimates from the Centers for Disease Control and Prevention (CDC), just as emergency physicians are releasing new studies showing an association between medical liability concerns and rising hospital admissions from the emergency department.  More than 85 percent of patients had health insurance, and only 8 percent were classified as non-urgent, indicating that most people are appropriately seeking emergency care.

As the nation and Congress focus on reining in spending, the American College of Emergency Physicians (ACEP) is issuing another call for comprehensive medical liability reform, calling it a real avenue to cutting costs in health care.  ACEP is holding its annual meeting this week in San Francisco, where the studies are being presented.

"There can be no meaningful health care reform or cost control without liability reform," said ACEP's president, Dr. David Seaberg, MD, FACEP.  "One of the new studies shows emergency physicians applying a different standard of admission to their patients than they would apply to themselves largely because of concerns about being sued. The rapidly rising tide of patients coupled with increasing hospital admissions from the emergency department will create pressure on the health care system that is not sustainable.  Liability reform could relieve some of that pressure and bring down costs."

Two new studies about emergency heart patients find emergency physicians' decisions to admit, or not to discharge, from the emergency department are motivated in part by liability concerns.  

In one study of patients admitted to the hospital for potential acute coronary syndrome, emergency physicians reported choosing admission that they would not choose for themselves for 27 percent of patients.  Another study found the number of congestive heart failure patients discharged from the emergency department decreased by 63 percent between 2006 and 2010; the study authors surmise the trend is due to increasing concerns about medical malpractice litigation.

"Effective liability reform could potentially reduce the number of tests emergency physicians perform and the number of patients being admitted to the hospital overnight," said Dr. Seaberg.  "Legislation pending right now in Congress could go a long way toward reducing the high cost of defensive medicine."