The Relationship Between Rural Health Clinic Use and Potentially Preventable Hospitalizations and Emergency Department Visits Among Medicare Beneficiaries

2017 ◽  
Vol 34 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Brad Wright ◽  
Andrew J. Potter ◽  
Amal N. Trivedi ◽  
Keith J. Mueller
Keyword(s):  
Emergency Department ◽  
Rural Health ◽  
Emergency Department Visits ◽  
Health Clinic ◽  
Medicare Beneficiaries ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
The Relationship

scholarly journals Rising Trends in Emergency Department Visits Associated With Hepatitis C Virus Infection in the United States, 2006-2014

2019 ◽  
Vol 134 (6) ◽  
pp. 685-694
Author(s):  
Shaoman Yin ◽  
Laurie Barker ◽  
Eyasu H. Teshale ◽  
Ruth B. Jiles
Keyword(s):  
United States ◽  
Emergency Department ◽  
Hepatitis C ◽  
Baby Boomers ◽  
The United States ◽  
Emergency Department Visits ◽  
Medicare Beneficiaries ◽  
Compensated Cirrhosis ◽  
Ed Visits ◽  
Medicaid Beneficiaries

Objective: Emergency departments (EDs) are critical settings for hepatitis C care in the United States. We assessed trends and characteristics of hepatitis C–associated ED visits during 2006-2014. Methods: We used data from the 2006-2014 Nationwide Emergency Department Sample to estimate numbers, rates, and costs of hepatitis C–associated ED visits, defined by either first-listed diagnosis of hepatitis C or all-listed diagnosis of hepatitis C. We assessed trends by demographic characteristics, liver disease severity, and patients’ disposition by using joinpoint analysis, and we calculated the average annual percentage change (AAPC) from 2006 to 2014. Results: During 2006-2014, the rate per 100 000 visits of first-listed and all-listed hepatitis C–associated ED visits increased significantly from 10.1 to 25.4 (AAPC = 13.0%; P < .001) and from 484.4 to 631.6 (AAPC = 3.4%; P < .001), respectively. Approximately 70% of these visits were made by persons born during 1945-1965 (baby boomers); 30% of visits were made by Medicare beneficiaries and 40% by Medicaid beneficiaries. Significant rate increases were among visits by baby boomers (first-listed: AAPC = 13.8%; all-listed: AAPC = 2.6%), persons born after 1965 (first-listed: AAPC = 14.3%; all-listed: AAPC = 9.2%), Medicare beneficiaries (first-listed: AAPC = 18.0%; all-listed: AAPC = 3.9%), and persons hospitalized after ED visits (first-listed: AAPC = 20.0%; all-listed: AAPC = 2.3%; all P < .001). Increasing proportions of compensated cirrhosis were among visits by baby boomers (first-listed: AAPC = 11.5%; all-listed: AAPC = 6.3%). Annual hepatitis C–associated total ED costs increased by 400.0% (first-listed) and 192.0% (all-listed) during 2006-2014. Conclusion: Public health efforts are needed to address the growing burden of hepatitis C care in the ED.

scholarly journals Variation in emergency department visits for conditions that may be treated in alternative primary care settings

CJEM ◽  
2005 ◽  
Vol 7 (04) ◽  
pp. 252-256 ◽  
Author(s):  
Chris A. Altmayer ◽  
Sten Ardal ◽  
Graham L. Woodward ◽  
Michael J. Schull
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Geographic Variation ◽  
Emergency Department Visits ◽  
Primary Care Settings ◽  
Rural Counties ◽  
Ed Visits ◽  
Care Capacity ◽  
The Relationship

ABSTRACT The purpose of this report is to examine Ontario's geographic variation in emergency department (ED) visits for conditions that may be treated in alternative primary care settings. We studied all visits to Ontario EDs in 2002/03 and calculated county-specific age-standardized rates. Overall in Ontario, there were 3174 ED visits per 100 000 population aged 1-74 for conditions that could be treated in alternate primary care settings, but rates varied widely across counties. They were higher in rural counties with rates up to 7-fold higher than the provincial average. Urban counties had lower rates, some were less than one-third of the provincial average. Further research is needed to determine the relationship between ED utilization and primary care capacity.

scholarly journals Effect of socio-demographic factors on the association between multimorbidity and acute care service use: a population-based retrospective cohort study

2020 ◽  
Author(s):  
Kathryn Ann Fisher ◽  
Lauren Griffith ◽  
Andrea Gruneir ◽  
Richard Perez ◽  
Lindsay Favotto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Demographic Factors ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
The Relationship ◽  
Acute Care Service

Abstract Background: This study explores how a broad-range of socio-demographic factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) among older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older in Ontario. Twelve chronic conditions identified from the administrative data were used to estimate multimorbidity (number of chronic conditions). We identified acute care service use over one year from the administrative data. We examined the relationship between multimorbidity and service use stratified by a comprehensive range of socio-demographic variables available from the CCHS. Logistic and Poisson multivariable regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in shaping this relationship. Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios for both services were higher at all levels of multimorbidity for men, older age groups, and those with lower annual household income. Rurality and immigrant status appeared to impact emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and most socio-demographic variables remained significant predictors of acute care service use in the multivariable regressions. Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that socio-demographic factors did not modify the relationship between multimorbidity and acute care service use, they were independently associated with acute care service use. Acute care service use was associated with perceived physical and mental health status as well as psychosocial factors, suggesting that optimizing service use requires attention to self-reported health status and social determinants, with programs that are multifaceted and integrated across the health and social service sectors.

scholarly journals Association of Rural and Critical Access Hospital Status With Patient Outcomes After Emergency Department Visits Among Medicare Beneficiaries

2021 ◽  
Vol 4 (11) ◽  
pp. e2134980
Author(s):  
Margaret Greenwood-Ericksen ◽  
Neil Kamdar ◽  
Paul Lin ◽  
Naomi George ◽  
Larissa Myaskovsky ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Emergency Department Visits ◽  
Medicare Beneficiaries ◽  
Critical Access Hospital

Choosing Home: The Impact of Choosing Where to Live on People With Intellectual and Developmental Disabilities' Emergency Department Utilization

Inclusion ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 92-103
Author(s):  
Carli Friedman
Keyword(s):  
Emergency Department ◽  
Developmental Disabilities ◽  
Social Determinants ◽  
Social Determinant ◽  
Emergency Department Visits ◽  
Emergency Department Utilization ◽  
Intellectual And Developmental Disabilities ◽  
Emergency Department Use ◽  
The Impact ◽  
The Relationship

Abstract Social determinants of health are conditions, factors, and environments that impact people's health. One such metric of people's health is emergency department utilization, but there is less research exploring how social determinants impact the emergency department use of people with intellectual and developmental disabilities (IDD). This exploratory study examined the relationship between people with IDD choosing where and with whom to live—a social determinant of health—and emergency department utilization. We analyzed secondary Personal Outcome Measures data, and emergency department data from 251 people with IDD. Our findings revealed people with IDD who chose where and with whom to live had a 74% decrease in emergency department visits, regardless of their impairment severity. Choice in housing may improve people with IDD's health outcomes.

scholarly journals Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to health administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn A. Fisher ◽  
Lauren E. Griffith ◽  
Andrea Gruneir ◽  
Ross Upshur ◽  
Richard Perez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
One Year ◽  
The Relationship ◽  
Acute Care Service

Abstract Background This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods We linked multiple cycles (2005–2006, 2007–2008, 2009–2010, 2011–2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship. Results Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions. Conclusions Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service use in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.

scholarly journals Emergency department increased use of observation care for elderly medicare patients

2018 ◽  
Vol 7 (3) ◽  
pp. 9 ◽  
Author(s):  
Gelareh Z. Gabayan ◽  
Li-Jung Liang ◽  
Brian Doyle ◽  
David Yu-Chuang Huang ◽  
Catherine A. Sarkisian
Keyword(s):  
Emergency Department ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Inpatient Service ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Medicare Patients ◽  
Nationally Representative ◽  
Using Data ◽  
The Relationship

Background: Over the past decade, a growing number of older Medicare beneficiaries visit the emergency department (ED) and have been placed in observation care. We investigated and compared the prevalence and factors associated with patients age ≥ 65 years with Medicare insurance who are placed in the hospital, observation care, or discharged following an ED visit.Methods: We conducted a retrospective cohort study using data from a nationally representative 5% sample of Medicare patients age ≥ 65 years during the year 2013. We performed multiple generalized estimating equation (GEE) logistic regression analyses to assess the relationship between placement in a hospital vs. discharge, observation care vs. discharge, and observation care vs. admission.Results: Of 537,455 Medicare beneficiaries age ≥ 65 years who visited an ED in 2013, 48.0% (N = 258,083) were discharged, 10.5% (N = 56,184) placed in observation care, and 41.5% (N = 223,188) were admitted to the inpatient service following the ED visit. The top 2 diagnoses associated with placement in the hospital vs. discharge were ischemic heart disease and renal disease. Patients with symptomatic diagnoses such as chest pain and dizziness were more likely to be placed in observation care following an ED visit as compared to admission to the hospital.Conclusions: Compared to prior studies, we found a greater number of older Medicare ED patients placed in observation care and a lower number admitted to the hospital. Most common diagnoses of placement in observation care were symptom-based as compared to being admitted to the hospital which were disease-based.

scholarly journals The Relationship between Same-Day Access and Continuity in Primary Care and Emergency Department Visits

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0135274 ◽  
Author(s):  
Jean Yoon ◽  
Kristina M. Cordasco ◽  
Adam Chow ◽  
Lisa V. Rubenstein
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Department Visits ◽  
The Relationship

scholarly journals Pilot study of publicly available data to evaluate the relationship between forest fires and emergency department visits due to asthma in the state of California

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1232
Author(s):  
Hayat Srour ◽  
Ruslan Fomenko ◽  
Joshua Baguley ◽  
Shandra Bellinger ◽  
Angel Jordan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Natural Disasters ◽  
Forest Fires ◽  
The State ◽  
Emergency Department Visits ◽  
Data Limitations ◽  
Ed Visits ◽  
Relationship Of ◽  
The Relationship

The focus of this study was to determine the relationship between asthma-related emergency department (ED) visits and fires in the state of California. Publicly available data of ED visits due to asthma, as well as occurrence of forest fires in California from 2005 to 2015 were obtained, where the California counties were grouped by region: North, Coastal, Motherload, Central, and South.  There were no statistical differences with regards to acres of forest burned, but statistically significant differences were found (although small) with regards to ED visits due to asthma attacks by region (Motherload higher than South region). When evaluating the relationship of ED visits due to asthma and acres of forest burned, forest fires barely explained the variability of emergency department visits (r2 = f 0.05, p<0.01). With aims to establish a connection between natural disasters and respiratory distress, we faced obstacles in data limitations and confounding variables. This paper serves as a pilot study supporting the need for further exploration of environmental, health, and socio-demographic variables that interplay when evaluating relationships of natural disasters and incidence of chronic diseases, such as asthma.

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