Nov. 4 (UPI) -- The quality of care provided at U.S. hospital emergency rooms has improved significantly in recent years, but there is still work to be done.

That, according to researchers from Harvard Medical School and the university's T.H. Chan School of Public Health, is the underlying message of the findings of their most recent study, published Monday in the journal JAMA Internal Medicine.


Researchers note in the study that the percentage of Medicare recipients who died within 30 days of receiving care at American ERs declined from 5.1 percent in 2009 to 4.6 percent in 2016, even as visits to the ER continue to rise in the country.

"[Emergency medicine] is a relatively young specialty compared to others but it has become an increasingly competitive field," study co-author Laura Burke, of the Department of Emergency Medicine at Beth Israel Deaconess Medical Center in Boston, told UPI. "Technology has made it easier for physicians to share information and debate how best to approach a variety of problems. In just the 10 years that I have been practicing, I have seen marked improvements in our approach to a variety of problems and the science of our field continues to advance."

Estimates suggest that, in any given year, roughly one in five Americans will seek care in hospital ERs, often because they don't have access to primary care physicians.

The authors attributed the improvement in outcome among these patients to the enhanced diagnostic technology available in most ERs, as well as increased knowledge of "best practices" among emergency medicine physicians.

Burke and her colleagues randomly selected the case records of Medicare beneficiaries 65 years of age and older who received ER care over an eight-year period, from 2010 to 2016. In all, they reviewed data from more than 15 million cases from nearly 5,000 acute-care hospitals across the country and looked at 30-day mortality -- the percentage of patients who died within a month of receiving care -- factoring in the severity of patient illness at the time they visited the ER.

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Notably, they found that rates of death declined across all patients, regardless of illness severity or whether or not they were ultimately admitted to the hospital. The findings are significant, given that some insurance plans will not cover ER visits they later deem unnecessary, even as many Americans lack access to primary care doctors.

"While an ER visit is more expensive than a doctor's visit, it may not be more expensive than multiple doctor's visits and it certainly is less expensive than a hospital stay," Burke said. "And, even if we optimize primary care access and quality, people will still have emergencies -- it's hard for people to judge if they are having an emergency."

"Just because a problem is ultimately deemed to be non-life threatening doesn't mean the visit wasn't justified, like a person with chest pain ultimately found to have something minor like heartburn," she added. "Policies that deny coverage for ER care based on retrospective judgement of the appropriateness of a visit are likely to lead to patient harm."