NEWARK, NJ - Residents living in Newark's 07104 zip code had the fourth highest rate in New Jersey of people with chronic conditions seeking care in hospital emergency departments, a new study shows.

That could cause huge financial burdens for patients with chronic conditions, the Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association found after examining emergency room visits in 2017 by zip code. 

The average cost of an emergency room visit for a patient without a chronic condition was approximately $480 per visit, while patients managing one or more chronic condition had an average bill of $738, the report said.

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The study also found that chronic conditions often took the greatest toll on the poorest communities. 

Five of Newark's nine zip codes broke the top 20 ranking in the report, which also found links between unemployment rates and people with chronic conditions. The median household income for 07104 is $36,547, which is about $2,000 less than the rate for Newark as a whole.  Newark’s overall rate is lower than Essex County, at $54,860, and even lower still than New Jersey’s median household income at about $76,000.

About 7 percent of residents in 07104 received unemployment benefits. Comparatively, Essex County’s unemployment benefit rate is 5.7 percent.

“You can live well with a chronic condition, but that requires access to primary care, a medical home and care management,” said NJHA President and CEO Cathy Bennett. “CHART’s study zeroes in on hotspot zip codes where there are clear gaps in that level of care. These communities demand greater attention to make sure all individuals have access to the services they need.”

There were 30,791 emergency department visits in 2017 from residents living in 07104. Of those, 42 percent or 12,877 had chronic conditions, according to the CHART report.

Zip codes in Atlantic City, Jersey City and Trenton had more chronic condition patients receiving care in emergency departments than Newark, according to the study. A zip code in Atlantic City topped the list, with 18,618 chronic condition patients visiting emergency rooms.

The 07104 zip code also had a lot of chronic condition "high utilizers," or patients that presented at a single hospital emergency department 25 times or more in a given year. Ten people who fit this criterion resided in 07104, including three who visited a single emergency department more than 100 times in 2017.

In comparison, Atlantic City’s 08401 had 20 high utilizers, including five who showed up in a single hospital emergency department 45 or more times in a 12-month period. A zip code in Jersey City, which was ranked No. 2 in the study, had 11 high utilizers.

Hypertension was the top-ranked chronic condition for those in 07104, which was present 50 percent of the time during emergency department visits. Hypertension is also the top-ranked condition overall for the state.

The study also found that substance abuse was the second highest chronic condition for residents in 07104, present 31 percent of the time. Substance abuse was the second most occurring chronic condition in the state as well.

African Americans had the highest rate of emergency room visits in 07104, at 29 percent. But when looking at just those with chronic conditions, that number rises to 33 percent, according to CHART's analysis.

However, the analysis also found an abnormally high rate -- 40 percent -- of patients who declined to identify their race in 07104. In other zip codes, usually1 percent or less declined to answer.

Previous studies have shown that chronic conditions cost the state $29.3 billion in health care expenditures in 2016 and $69.5 billion in lost productivity, said CHART Senior Vice President Sean Hopkins.

“These are real, measurable impacts on our state,” said Hopkins. “But chronic diseases also have a myriad of additional consequences on individuals and communities that are more challenging to quantify. What we do know from our research is that there is a clear relationship between social determinants of health and chronic disease cases in the [emergency department].”

The report also recommended exploring more partnerships to expand mobile health clinics, school-based care programs and health fairs. Promoting the use of chronic disease management apps and monitoring devices may also help, the study said.

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