Resource Use Up With Supervised Visits in the ER

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Supervised Visits in the ER
Supervised Visits in the ER

(HealthDay News) — Resource use is increased for supervised visits, involving both resident and attending physicians, in the emergency department, according to a study published in the December 10 issue of the Journal of the American Medical Association, a theme issue on medical education.

Stephen R. Pitts, MD, MPH, from the Emory University School of Medicine in Atlanta, and colleagues compared resource use in supervised versus attending-only visits in a sample of patient visits to U.S. emergency departments. Data were collected from the National Hospital Ambulatory Medical Care Survey (2010) for 29,182 visits to 336 nonpediatric emergency departments.

The researchers found that 3,374 of the visits were supervised, and these were significantly associated with more frequent hospital admission (adjusted odds ratio [aOR], 1.42; 95% confidence interval [CI], 1.09–1.85), advanced imaging (aOR, 1.27; 95% CI, 1.06–1.51), and a longer median emergency department stay (adjusted geometric mean ratio, 1.32; 95% CI, 1.19–1.45), but not with blood testing (aOR, 1.18; 95% CI, 0.96–1.46), compared with attending-only visits. In major teaching emergency departments, supervised visits were not associated with hospital admission, advanced imaging, or any blood test, but were associated with longer emergency department stays (adjusted geometric mean ratio, 1.32; 95% CI, 1.14–1.53), compared with attending-only visits.

"In a sample of U.S. emergency departments, supervised visits were associated with a greater likelihood of hospital admission and use of advanced imaging and with longer emergency department stays," the authors write.

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