Ali A. Aalam, MBBS, MD1, Nofel Iftikhar, 1, Hoor ul Ain, 2, Naveen Baskaran, BS, MD1, William Mulkerin, MD3 1University of Florida, Gainesville, FL; 2King Edward Medical University, Dera Ghazi Khan, Punjab, Pakistan; 3Stanford University., Stanford, CA
Introduction: This study emphasizes tracking hospital trends in emergency department (ED) billing. Analyzing healthcare costs enables targeted strategies to ease patient financial burdens and ensure fair access to emergency services, which is vital for implementing effective interventions.
Methods: This study utilized data from the Nationwide Emergency Department Sample (NEDS) to perform a retrospective cohort study on ED billing trends over a decade, focusing on demographic factors and categorizing costs into four ranges: under $1,000, $1,000-$5,000, $5,000-$10,000, and $10,000-$50,000, with all subgroups measured in United States Dollars (USD). The analysis revealed disparities in billing practices across different groups. Odds ratios assessed admission rates relative to ED procedure costs, and a linear regression model projected ED visit volumes and expenses from 2022 to 2032.
Results: The study analyzed a diverse patient cohort from newborns to 90-year-olds, averaging 41 years old. The population included more females than males (55% vs. 45%) and ethnically consisted of White individuals (59.4%), African Americans (17.3%), Hispanics (13.1%), Asians/Pacific Islanders (6.5%), Native Americans (2.5%), and those identifying as “Other” (1.2%). Patients were covered by Medicare, Medicaid, or private insurance, with Medicaid being most prevalent. The dataset's ED patient was, on average, a 41-year-old white woman under Medicaid coverage. Analysis revealed significant shifts in ED billing trends between 2012 and 2021. These trends included notably fewer visits billed under $1,000 (dropping from 31.5% to 12.3%) and an overall increase in frequency of visits billed between $5,000 and $50,000 (from 44.1% to 52.9%). By 2021, there was a notable increase in visits resulting in billings from $10,000-$50,000 (Table. 1). Predictive models anticipate a steady climb in new ED visits and admissions to inpatient care, with a projected decrease in $1,000 billings and a rise in $5,000–$50,000 billings from 2022 to 2032 (Fig. 1).
Discussion: This study underscores the importance of understanding the evolving landscape of hospital billing in ED settings. By analyzing trends in healthcare costs over the last decade, policymakers and healthcare stakeholders can devise targeted strategies to alleviate financial burdens on patients and facilitate equitable access to emergency medical services.
Figure: Fig 1. (1a) Seaborn Bar plot showing number of ED visits from 2012 to 2021 with the categories of ED patients with cost up to $1,000, up to $5,000, up to $10,000, and cost up to $50,000. (1b) Linear Regression Model showing actual and predicted values for total number of ED visit, number of ED patients admitted to inpatient care, number of ED patients with billing cost up to $1,000, number of ED patients admitted to inpatient care, number of ED patients with billing cost up to $5,000, number of ED patients admitted to inpatient care, number of ED patients with billing cost up to $10,000 and number of ED patients admitted to inpatient care, and number of ED patients with billing cost up to $50,000.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ali Aalam indicated no relevant financial relationships.
Nofel Iftikhar indicated no relevant financial relationships.
Hoor ul Ain indicated no relevant financial relationships.
Naveen Baskaran indicated no relevant financial relationships.
William Mulkerin indicated no relevant financial relationships.
Ali A. Aalam, MBBS, MD1, Nofel Iftikhar, 1, Hoor ul Ain, 2, Naveen Baskaran, BS, MD1, William Mulkerin, MD3. P1518 - Unveiling the Cost of Care: A Decadal Analysis of Emergency Department Visits and Hospital Billing Trends Using NEDS Database (2012 - 2021), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
