Behavioral Interventions Reduce ED Visits; Pain Case Statistics

Reducing the number of visits a chronic pain patient makes to the emergency department may be accomplished by simply providing 15- to 30-minute consultations, according to results of a study published in Journal of Emergency Nursing.

The findings reveal that for those with frequent chronic pain that visited a hospital ED more than four times in six months pre-intervention experience an even greater reduction. The study was designed to analyze behavioral health intervention for chronic pain patients to “better serve this population and to help hospitals provide cost effective treatment at the appropriate level of care.”

A large portion of chronic patients continue to visit emergency rooms for medical care nationwide. Yet, the emergency department is a “less-than-optimal environment” for treating the needs of such patients.

Psychological factors play a key role in the “understanding and mechanisms that contribute to the development of chronic pain,” the authors write. The researchers selected a 40-bed, acute-care hospital with a 15-bed emergency department. The hospital sees 16,500 patients annually. All the participants had chronic pain. The participants utilized the emergency department.

The study utilized a “quasi-experimental, retrospective, pre-test/post-test, split-plot design.” The team compared high-utilizers to low utilizers in total ED visits six months before and after the intervention. High utilizers were those that had greater than 4 ED visits within the timeframe. The researchers used a repeated measures analysis of variance (ANOVA) to compile the information. An intervention took place for 15- to 30-minutes and included counseling, where the patients were taught pain management strategies. The counselors also reinforced the need for a primary-care physician to manage pain medication.

They found that the mean ED visits of the low utilzers remained stable both before and after the intervention. The high utilizers, however, showed a statistically significant decrease in ED utilization.

The authors concluded that, “an ED-based behavioral health consultation may be useful for reducing high utilization of ED services by some chronic pain patients, particularly those who consume the most services.”

The title of the study is, “The Efficacy of a Brief Behavioral Health Intervention for Managing High Utilization of ED Services by Chronic Pain Patients.” The authors include Jonathan Woodhouse, MA, of George Fox University.

Related:

Data recently released from VMG Health Multi-Specialty ASC Intellimarker 2010, provides new “statistics on mean gross charges and mean net revenue per pain management case.”

The aggregate statistical anaylsis reveals that:

-Mean gross charges per pain management case was $4,596

-Mean net revenue per pain management case was $1,132.

Based on region:

-Mean gross charges per pain management case in ASCs in the western United States was $4,458.

-Mean net revenue per pain management case in ASCs in the western United States was $885.

-Mean gross charges per pain management case in ASCs in the Southwest was $5,333.

-Mean net revenue per pain management case in ASCs in the Southwest was $1,218.

- Mean gross charges per pain management case in ASCs in the Midwest was $3,680.

- Mean net revenue per pain management case in ASCs in the Midwest was $918.

- Mean gross charges per pain management case in ASCs in the Southeast was $3,490.

-Mean net revenue per pain management case in ASCs in the Southeast was $826.

-Mean gross charges per pain management case in ASCs in the Northeast was $3,522.

-Mean net revenue per pain management case in ASCs in the Northeast was $651.

To see more pain management case statistics click here.