Photo Credit: Ruslan Batiuk

ED clinicians show wide variability in their admission propensity, according to a study published in JAMA Internal Medicine. Stephen Coussens, PhD, and colleagues examined EHR data for 2,098 clinicians treating 2.1 million patients with visits across 105 EDs for chest pain, shortness of breath, and abdominal pain. Adjusted admission rates varied greatly within the same ED for chest pain (90th percentile of physicians: 56.6% admitted; 10th percentile: 32.6% admitted), although there were no associations between adjusted admission rates and patients’ prior health status as measured by their Elixhauser Comorbidity Index score before the emergency visit. Patients admitted by physicians with higher admission rates were more likely to be discharged within 24 hours (31.0% vs 24.8%). However, mortality rates did not differ between physicians with higher versus lower admission rates. “Future research that explores how such variation arises and the extent to which it is amenable to safe intervention may prove beneficial,” Dr. Coussens and colleagues wrote.