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Arcadia (@ArcadiaHealthIT), a data analytics platform for healthcare, explored 2021 MSSP data, organizing what they found by groups of ICD-10 codes. The result is a list of the most common reasons for winter emergency room (ER) visits, and a window into what conditions a value-based care organization or provider network could target for preventive care. This week’s Friday Five takes a look at the top five reasons pulled from the data.
Nonspecific Chest Pain
Chest pain is a common complaint in emergency rooms, but unlike the flu, this affliction shows up year-round. What ailment could chest pain indicate? With thousands of ICD-10 codes, diagnosis grouper logic is used to classify all those codes into categories and subcategories so that health systems are able to see all the chest pain types of diagnoses without seeing several hundred different cuts and different variations of a single diagnosis.
Some instances might be preventable, but as heart disease is the leading cause of death for men and women in the US from most backgrounds, chest pain is a valid reason to head straight to the nearest hospital.
Superficial Injury
Emergency room doctors see injuries happen more frequently over the summer months, because people are out and doing things, mowing lawns and shooting fireworks.
Winter, though, has its fair share of risky activity, from sledding to slipping on icy stairs. This category presents an opportunity for individual health organizations to investigate the highest risks in their communities, and that might look different in Phoenix, AZ than it does in Minneapolis, MN.
Abdominal Pain and Other Digestive Symptoms
This is a category where the severity of the issue could run the gamut. These categories are groupings of related ICD-10 codes, which means “abdominal pain” could be constipation — take some fiber and stay out of the ER! — or a serious intestinal blockage. For mild pain, Mount Sinai recommends hydration and a mild diet until the discomfort passes, but watch for indications of a serious problem, which include accompanying chest, neck or shoulder pain, prolonged illness, or bloody stool
Urinary Tract Infection
One important factor that divides all of these diagnostic codes is urgency: does someone really need to go to the emergency room for a UTI versus urgent care or their primary care physician?
In many cases, healthcare networks could greatly reduce the number of UTI-related ED visits by educating the patients they serve.
Musculoskeletal Pain (not back pain)
ER visits for musculoskeletal pain might be avoidable. This category encompasses everything from arthritis (which is chronic, and best treated by a primary care physician and/or specialist) to repetitive stress injuries like carpal tunnel. In any case, preventing issues with ergonomic support or routine care at a doctor’s office could keep these patients healthy without the additional strain on a hospital’s ED
About Arcadia
Arcadia is dedicated to happier, healthier days for all. We transform data into powerful insights that deliver results. Through our partnerships with the nation’s leading health systems, payers, and life science companies, we are growing a community of innovation to improve care, maximize value, and confront emerging challenges. For more information, visit arcadia.io.
ICYMI – Our other Friday Fives and Blog posts from HCNR’s Nurse Lauren.
