ER Costs the Most for UTI Treatments

Urinary tract infection treatments at emergency departments cost almost 2 billion dollars more

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When pain or an infection in the bladder presents itself, a visit to the hospital ER might be the first stop for patients. But treatment at the emergency department could take a bigger chunk out of your wallet.

A study presented at a conference found that seeking treatment at outpatient clinics for a urinary tract infection (UTI) could have saved patients almost $2 billion in 2009 versus seeking treatment at emergency departments.

According to these researchers, improved guidelines and increased access to primary care doctors could reduce the annual costs for UTI treatment.

"Check your options before going to the hospital."

Researchers under the direction of Jesse Sammon, DO, researcher at Henry Ford's Vattikuti Urology Institute, looked at the costs of being treated for a UTI among populations most likely to be treated and released by hospital emergency departments.

The study gathered information from the Nationwide Emergency Department Sample (NEDS), the largest all-payer database on emergency department information in the US, on about 10.8 million patients diagnosed with a UTI between January 2006 and December 2009.

The researchers examined emergency department costs and characteristics of the hospitals and patients, including their age, insurance coverage and income bracket.

Among the patients who sought treatment at emergency departments for a UTI, a little more than 81 percent of patients were treated and released.

Median emergency department charges for UTI treatment were $1,072 per visit, which the researchers found was $772 more expensive than seeking a single UTI treatment in an outpatient setting.

The difference in costs between treatment at outpatient clinics and at hospital emergency department added up to $1.6 billion in 2006. The cost difference jumped to $1.8 billion in 2009.

"The number of patients treated and released for a UTI from US emergency rooms increased from 2.0 million in 2006 to 2.3 million in 2009," the researchers wrote in their report.

Patients admitted to the emergency department for UTI treatment were younger and likelier to be female, in the lowest income quartile and on Medicaid or private insurance compared to patients treated at an outpatient clinic.

The median age of patients seen at emergency departments for a UTI was 32 years of age compared to 72 years of age for patients who were not treated there.

About 87 percent of the patients at emergency departments were female, compared to 73 percent treated elsewhere. More than a third of patients treated at the emergency department and almost 29 percent treated in outpatient clinics were in the lowest income quartile.

Concerning insurance, about 24 percent of emergency department patients had Medicaid and 33 percent had private insurance, compared to 13 and 17.6 percent of patients, respectively, treated at other clinics.

Greater access to primary care doctors and improved guidelines can help patients reduce yearly costs, the researchers said.

Adam Powell, PhD, healthcare economist and founder of payerprovider.com said, "It is well known within the healthcare management community that one of the most effective ways to reduce the cost of healthcare without reducing quality is to ensure that patients are receiving treatment at the appropriate site of service."

"When patients treatable in a less intense setting land in an emergency department, they tend to cost more and also have worse experiences."

"Emergency departments typically have long waits and do not treat patients on a first-come, first-serve basis. Increased access to care in other settings, such as walk-in clinics and outpatient offices, can enable patients to have a better experience while reducing healthcare expenditures."

The findings, which haven't yet been published in a peer-reviewed journal, were presented May 6 at the American Urological Association's annual meeting in San Diego. The study received no outside funding.

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Review Date: 
May 9, 2013
Last Updated:
September 30, 2013