Managers of emergency departments have had to deal with a relative lack of information on overall ED mortality trends until now, and the results are positive.
Researchers at the University of California, San Francisco analyzed ED visit data from the National Hospital Ambulatory Medical Care Survey from 1997 to 2011, finding that U.S. emergency department death rates have dropped by 48 percent, according to the report published in Health Affairs.
The findings were based on a public Centers for Disease Control and Prevention data set that represents more than 1.3 billion patient visits — one of the largest nationally representative data sets for information on emergency conditions in the U.S., says Hemal Kanzaria, M.D. assistant professor of clinical emergency medicine at the University of California, San Francisco and lead author of the study.
“I think [this] suggests an important trend — that we’re providing better care. I hope it also means we’re respecting patients’ wishes at the end of life,” says Kanzaria.
After looking at the numbers, it’s reasonable to ask: If mortality rates are down in the ED, have they gone up elsewhere? Based on the analysis, there has been no increase in mortality rate after admission to the ED, nor has there been a significant change in inpatient hospital mortality between 2005 and 2011, says Kanzaria.
Although the study can’t point to a single cause of the decrease in mortality, during the study period there has been “tremendous” increase in home deaths, with an accompanied decrease in hospital-based deaths, Kanzaria says. Increased attention on palliative care, where the focus is on improving care at the end of life, likely has affected those numbers.
Improvements in emergency care and public health, including gains in the management of heart attacks, strokes, traumas and sepsis, likely have contributed to the 48 percent decrease.
“If you look at the same types of data for hospitalized patients, or even the U.S. population, both areas in general, the mortality rate has gone down. That signifies to me that we are making continual improvements in health care,“ says Kanzaria.