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American Academy of Emergency Medicine

Cost of Care Study

Cost of Care in the Emergency Department: Impact of an Emergency Medicine Residency Program.

Robert M. McNamara, M.D., John J. Kelly, D.O.

Ann Emerg Med. 1992;8:82-88.

The presence of medical teaching programs or the introduction of more extensively trained physicians has generally been found to increase the costs of inpatient care. This issue has not been studied for the specialty of Emergency Medicine.

The purpose of this study was to examine the impact on cost of care in the Emergency Department of an Emergency Medicine residency program with primarily Emergency Medicine residency-trained faculty. This was made possible when such a program assumed responsibility for physician staffing of an urban community hospital Emergency Department from a group of nonresidency-trained emergency physicians in July 1989.

A retrospective chart review was conducted on a consecutive sample of patients treated in the Emergency Department from January through March of 1989 and January through March 1990 who were discharged home with one of six common diagnosis. Overall charges for each diagnostic category were measured and compared.

The residency group charges did not exceed those of the preresidency group for any diagnoses and were significantly lower for three out of six diagnoses. This study indicates that the introduction of specialists in Emergency Medicine did not raise the cost care in this Emergency Department.