Elective patients have attributes that make them financially attractive. But there are efforts to make changes.
In a medical emergency, you may have a surprisingly difficult time finding a bed in a hospital. This is because elective admissions — that is, patients whose hospital stays have been scheduled in advance — take priority over emergencies.
Such a preference for elective admissions might be unexpected, as emergency patients are, by definition, emergencies. But elective patients have attributes that make them financially attractive. They arrive promptly in the morning; they are well-insured; and they undergo invasive procedures that represent a significant revenue stream for hospitals.indicates that hospitals earn about $700 more on each elective admission than on each patient admitted through the emergency department .
Predictability is often touted as a reason for prioritizing elective admissions. But while predictability is thought to be in short supply in the ED, the data — and our experience as ED doctors — argue otherwise. The number of patients admitted through the ED are about the same every day of the week, whereas elective admissions peak Mondays through Thursdays and tail off toward the weekend. This is designed to minimize the need for weekend work by the doctors who perform procedures.
The weekday peak in elective admissions creates a bottleneck that results in admitted patients “boarding” in the ED. Boarded patients have nominally been admitted to the hospital, yet they physically remain in the ED until vacancies in the hospital arise. But vacancies may not arise for hours or, in extreme cases, days.
Boarding increases the risk for patients whose condition might become unstable: patients with new-onset diabetes who require intensive monitoring; patients with metastatic cancer, who require high doses of pain medication; and
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