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"As pressure builds to constrain further growth of healthcare spending, EDs are likely to come under greater scrutiny," study authors wrote. "Whereas policymakers and third party payers have largely focused on the cost of ED care relative to treatment in other outpatient settings, the role of EDs in either facilitating or preventing hospital admissions may be a bigger story."



ERs play a large role in caring for the uninsured and those without consistent access to primary care. Often, these functions result in a lack of compensation for hospitals, which spend billions of dollars on charity care every year.



The study reported that between 2000 and 2009, patients with conditions like asthma and diabetes, which don't tend to require hospitalization, visited ERs in greater numbers. But these visits did not result in an increase in related hospitalizations, suggesting that ERs are helping to ward off potentially preventable admissions.



The trend points to the growing power of emergency physicians, who now serve as a "major decision maker" for a considerable share of U.S. hospital admissions, the study said. This power is likely to increase amid a rising shortage of primary care providers.



In total, unscheduled hospital admissions from ERs grew by 17 percent between 2003 and 2009, offsetting a 10 point drop in other admissions, the study found.

