Hsia emphasizes that her report does not say that all patients brought to a hospital emergency department for ambulatory care-sensitive conditions don't need to be. Clearly some of them require that transfer.
"But maybe if you had other resources, or in a nursing home environment if there were other incentives available to treat the patient in that setting, they may not need to come to the ED."
"What we're asking is, 'Is there a significant portion of these nursing home patients who come to the ED because of conditions that might be treated in a nursing home?'" After all, skilled nursing homes have healthcare workers on staff, "and nursing homes tend to have relationships with physicians as well; There should be someone to at least call who is readily available for that."
"We need to ask, where is the best place that we can provide the care they need, and how do we get the most appropriate resources to the right patient at the right time?" Hsia asks. "Is it the ED, or should we provide more resources or create the right incentives so these people can be treated appropriately in an alternative setting?"
One finding from the study is that the percentage of nursing home patients transported to a hospital emergency department rose in that 10-year period by 12.8%, from 1.9 million patients in 2001 to 2.1 million in 2010.