There was substantial variation across states in the rates of emergency department (ED) use among workers seeking care for new injuries between 2019 and 2021, according to a new study from the Workers Compensation Research Institute (WCRI).
The study, Initial Medical Treatment at Emergency Department or Physician Office: Interstate Comparisons and Early COVID-19 Impact—A WCRI FlashReport, was conducted between the first quarter of 2019 to the first quarter of 2021. The report looked at how the use of EDs vs. physician offices for initial medical services varies across states, as well as the factors behind it and how COVID-19 affected the use of Eds for initial medical services.
“The substantial interstate variation in the use of EDs across states, even for the same injury type, raises questions about why we observe this variation and whether it comes from the design of workers’ compensation systems or other factors,” said John Ruser, president and CEO of WCRI, in the release. “In addition to documenting the variation, this study sheds light on some of the factors accounting for it.”
In 2021, ED utilization for initial medical services ranged from 14% in Arizona to 37% in Massachusetts. The variation was even larger for conditions like sprains and strains, for which there is a wider scope of shifting between office and ED settings. Some factors explaining this variation may include local norms of ED utilization and state-specific workers’ compensation system features. During the COVID-19 pandemic, ED utilization as the source of initial medical services tended to be lower when the COVID-19 caseload was higher.
The study tracked evaluation and management and ED utilization patterns for workers injured in 28 states: Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. These study states represent 79% of the workers’ compensation benefits paid in the United States.
Access the survey here.