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Topics
- Access to Care (2)
- Adverse Events (1)
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (3)
- Brain Injury (1)
- Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
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- (-) Emergency Department (27)
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- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- Risk (3)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Substance Abuse (1)
- Surgery (2)
- Teams (1)
- Telehealth (2)
- Trauma (2)
- Vulnerable Populations (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedMyong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Ramgopal S, Aronson PL, Marin JR
United States' emergency department visits for fever by young children 2007-2017.
The authors estimated rates of emergency department (ED) visits for fever by children less than 2 years of age and evaluated frequencies of testing and treatment during these visits. They found that, given existing guidelines, blood and urine culture performance was low for infants up to 90 days old. For children 91 days up to 2 years, rates of radiography and antibiotic use were higher in general EDs compared to pediatric EDs. They concluded that their findings suggest opportunities to improve care among febrile young children in the ED.
AHRQ-funded; HS026006.
Citation: Ramgopal S, Aronson PL, Marin JR .
United States' emergency department visits for fever by young children 2007-2017.
West J Emerg Med 2020 Oct 27;21(6):146-51. doi: 10.5811/westjem.2020.8.47455..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization
Martsolf GR, Nuckols TK, Fingar KR
AHRQ Author: Stocks C, Owens PL
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
The purpose of this study was to compare the rate at which patients with nonspecific chest pain return to the hospital within 7 days after index observation visits versus after index emergency department and inpatient visits. Findings showed that up to 1 in 10 patients discharged with nonspecific chest pain returned to the hospital within 1week. Compared with emergency department and inpatient care, observation visits were associated with lower revisit rates. Recommendations include further research to refine clinical standards of care for nonspecific chest pain as well as to investigate the healthcare delivery and patient factors that influence 7-day revisit rates.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Nuckols TK, Fingar KR .
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
BMC Health Serv Res 2020 Jun 8;20(1):516. doi: 10.1186/s12913-020-05200-x..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Pain, Healthcare Utilization, Hospitals, Heart Disease and Health, Cardiovascular Conditions
Freeman RE, Boggs KM, Zachrison KS
National study of telepsychiatry use in U.S. emergency departments.
This study examined the use of telepsychiatry in US emergency departments (EDs). A survey was conducted of all 5,375 US EDs in 2016. The survey found that about 20% reported receiving telepsychiatry. EDs that utilized telepsychiatry the most tended to have higher annual total visit volumes, rural location, and Critical Access Hospital designation. Autonomous freestanding EDs tended to have a lower likelihood of telepsychiatry use. The majority (59%) reported telepsychiatry as their only form of emergency psychiatric services and 25% received services at least once a day. The most common uses were admission or discharge decisions (80%) and transfer coordination (76%).
AHRQ-funded; HS024561.
Citation: Freeman RE, Boggs KM, Zachrison KS .
National study of telepsychiatry use in U.S. emergency departments.
Psychiatr Serv 2020 Jun;71(6):540-46. doi: 10.1176/appi.ps.201900237..
Keywords: Emergency Department, Telehealth, Health Information Technology (HIT), Behavioral Health, Healthcare Utilization
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Melnikow J, Evans E, Xing G
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Investigators evaluated variation in the availability of primary care new patient appointments for Medi-Cal (California Medicaid) enrollees in Northern California and its relationship to emergency department (ED) use after Medicaid expansion. Data from the California Health Interview Survey, Medi-Cal enrollment reports, and California hospital discharge records were used. The investigators found that access to primary care in Northern California was limited for new patient Medi-Cal enrollees and varied across counties, despite standard statewide reimbursement rates. Further, counties with more limited access to primary care new patient appointments had higher ED use by Medi-Cal enrollees.
AHRQ-funded; HS022236.
Citation: Melnikow J, Evans E, Xing G .
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Ann Fam Med 2020 May;18(3):210-17. doi: 10.1370/afm.2502..
Keywords: Primary Care, Access to Care, Medicaid, Health Insurance, Emergency Department, Healthcare Utilization
Brown CS, Yang J, Meng Z
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Researchers examined emergency department (ED) utilization following three common surgeries: cholecystectomy, appendectomy, and inguinal hernia repair. A longitudinal analysis was conducted using data from the SPARCS New York (NY) administrative database on 746,633 who underwent those procedures from 2005 to 2014. Nearly 1 in 10 patients who underwent cholecystectomy or appendectomy and 1 in 20 patients went to the ED after discharge. Of those, only 9.5% cholecystectomy, 9.1% appendectomy, and 5.1% inguinal hernia repair patients were readmitted indicating possible overutilization of the ED following common operations.
AHRQ-funded; HS025778; HS000053.
Citation: Brown CS, Yang J, Meng Z .
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Surg Endosc 2020 May;34(5):1994-99. doi: 10.1007/s00464-019-06975-9..
Keywords: Emergency Department, Surgery, Healthcare Utilization
Beiser DG, Ward CE, Vu M
Depression in emergency department patients and association with health care utilization.
Depression is one of the most common illnesses in the United States, with increased prevalence among people with lower socioeconomic status and chronic mental illness who often seek care in the emergency department (ED). The investigators sought to estimate the rate and severity of major depressive disorder (MDD) in a nonpsychiatric ED population and its association with subsequent ED visits and hospitalizations.
AHRQ-funded; HS000084; HS025889.
Citation: Beiser DG, Ward CE, Vu M .
Depression in emergency department patients and association with health care utilization.
Acad Emerg Med 2019 Aug;26(8):878-88. doi: 10.1111/acem.13726..
Keywords: Depression, Emergency Department, Healthcare Utilization, Hospitalization, Behavioral Health
Gillespie SM, Wasserman EB, Wood NE
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
Individuals with dementia have high rates of emergency department (ED) use for acute illnesses. In this study, the investigators evaluated the effect of a high-intensity telemedicine program that delivered care for acute illnesses on ED use rates for individuals with dementia residing in senior living communities (SLCs; independent and assisted living).
AHRQ-funded; HS018047.
Citation: Gillespie SM, Wasserman EB, Wood NE .
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
J Am Med Dir Assoc 2019 Aug;20(8):942-46. doi: 10.1016/j.jamda.2019.03.024..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Dementia, Neurological Disorders, Healthcare Delivery, Chronic Conditions, Emergency Department, Healthcare Utilization
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Hongs S AS, Froehlich T, Clayton Hobbs S
Impact of a cancer urgent care clinic on regional emergency department visits.
In this study, the researchers investigated whether the creation of an urgent care clinic specifically for patients with cancer affected emergency department visits among adults newly diagnosed with cancer? They concluded that although only one in eight emergency department-visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.
AHRQ-funded; HS022418.
Citation: Hongs S AS, Froehlich T, Clayton Hobbs S .
Impact of a cancer urgent care clinic on regional emergency department visits.
J Oncol Pract 2019 Jun;15(6):e501-e09. doi: 10.1200/jop.18.00743..
Keywords: Cancer, Emergency Department, Hospitalization, Healthcare Utilization, Ambulatory Care and Surgery
Vogel JA, Gannon Sungar W, Boatright D
Denver ED Trauma Organ Failure Score predicts healthcare resource utilization in adult trauma patients.
This study examined the success of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score and the need for specialized healthcare resources for trauma patients. Outcomes measured included intensive care unit (ICU) length of stay (LOS), hospital LOS, procedures and costs. They included 3000 patients with 71% of them male, a median age of 42, and median injury severity score of 9 (IQR 5-16). Of that total, 46% were admitted to the ICU and 4% died. The tool was found to successfully predict healthcare resource utilization and can be used to identify patients early after injury that will require specialized trauma care.
AHRQ-funded; HS023901.
Citation: Vogel JA, Gannon Sungar W, Boatright D .
Denver ED Trauma Organ Failure Score predicts healthcare resource utilization in adult trauma patients.
Am J Emerg Med 2019 Jun;37(6):1108-13. doi: 10.1016/j.ajem.2018.08.073..
Keywords: Emergency Department, Healthcare Utilization, Outcomes, Trauma
Hanchate AD, Dyer KS, Paasche-Orlow MK
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
In this retrospective cohort study, the investigators estimated emergency department (ED) use differences across Medicare enrollees of different race/ethnicity who were residing in the same zip codes. The investigators found that among Medicare enrollees, blacks and Hispanics had higher ED use rates than whites overall and among subgroups by demographics and socioeconomic status.
AHRQ-funded; HS022242.
Citation: Hanchate AD, Dyer KS, Paasche-Orlow MK .
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
Ann Emerg Med 2019 Mar;73(3):225-35. doi: 10.1016/j.annemergmed.2018.09.007..
Keywords: Disparities, Emergency Department, Healthcare Utilization, Medicare, Racial and Ethnic Minorities
Burgdorf J, Mulcahy J, Amjad H
Family caregiver factors associated with emergency department utilization among community-living older adults with disabilities.
This study examined characteristics of family caregivers of older community-living adults with disabilities that use emergency departments (EDs). They found in their sample of 2521 community-living older adults that have visited the ED one or more times within 12 months of their interview that the primary caregivers provided greater than 40 hours of care per week, helped with health care tasks, or experienced physical strain.
AHRQ-funded; HS000029.
Citation: Burgdorf J, Mulcahy J, Amjad H .
Family caregiver factors associated with emergency department utilization among community-living older adults with disabilities.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719875636. doi: 10.1177/2150132719875636..
Keywords: Elderly, Emergency Department, Disabilities, Healthcare Utilization, Caregiving
Meyers DJ, Chien AT, Nguyen KH
Association of team-based primary care with health care utilization and costs among chronically ill patients.
This study analyzed the value of team-based care practice on the treatment of patients, especially those with multiple chronic conditions. A large study was conducted using data from 18 academically affiliated primary care practices in the Boston, Massachusetts, area between 2011 and 2015. The study included 83,953 patients total with 19% of patients being younger than 18 years and the rest from 19-64 years of age. For patients with multiple chronic conditions, there was a statistically significant reduction in hospitalizations and emergency department visits. Among patients with less than 2 comorbidities, there was an increase in outpatient visits, hospitalizations and ambulatory care hospitalizations.
AHRQ-funded; HS000011.
Citation: Meyers DJ, Chien AT, Nguyen KH .
Association of team-based primary care with health care utilization and costs among chronically ill patients.
JAMA Intern Med 2019 Jan;179(1):54-61. doi: 10.1001/jamainternmed.2018.5118..
Keywords: Chronic Conditions, Emergency Department, Healthcare Costs, Healthcare Utilization, Primary Care, Teams
Moulin A, Evans EJ, Xing G
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
The objective of this study was to identify characteristics unique to patients with psychiatric illness who are frequent emergency department (ED) users for mental health care. The authors suggest that understanding unique features of this population could lead to better care and lower healthcare costs. The authors concluded that patients with substance use disorders, homelessness and public healthcare coverage were more likely to be frequent users of EDs for mental illness.
AHRQ-funded; HS022236.
Citation: Moulin A, Evans EJ, Xing G .
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
West J Emerg Med 2018 Nov;19(6):902-06. doi: 10.5811/westjem.2018.9.38954..
Keywords: Emergency Department, Medicaid, Healthcare Utilization, Behavioral Health, Substance Abuse, Vulnerable Populations
Hirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
Yun BJ, Borczuk P, Zachrison KS
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
This study examined national trends in utilization of head computed tomography (CT) imaging in emergency department (ED) patients presenting with an injury-related visit. Data from the US National Hospital Ambulatory Medical Care Survey from 2012 to 2015 was used to find ED patients who had at least one head CT. Overall there was an increase (11.7-13.23%) but it was not statistically significant.
AHRQ-funded; HS024561.
Citation: Yun BJ, Borczuk P, Zachrison KS .
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
Am J Emerg Med 2018 Aug;36(8):1463-66. doi: 10.1016/j.ajem.2018.05.018..
Keywords: Healthcare Utilization, Emergency Department, Imaging, Injuries and Wounds, Practice Patterns
Chaaban MR, Zhang D, Resto V
Factors influencing recurrent emergency department visits for epistaxis in the elderly.
The objective of the study was to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly. The investigators concluded that additional ED visits for epistaxis were more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.
AHRQ-funded; HS022134.
Citation: Chaaban MR, Zhang D, Resto V .
Factors influencing recurrent emergency department visits for epistaxis in the elderly.
Auris Nasus Larynx 2018 Aug;45(4):760-64. doi: 10.1016/j.anl.2017.11.010..
Keywords: Elderly, Emergency Department, Risk, Respiratory Conditions, Healthcare Utilization
Arthur KC, Mangione-Smith R, Burkhart Q
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
The objective of this study was to examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. The investigators measured ED utilization and primary care continuity with the Bice-Boxerman continuity of care index for 1477 CMC using administrative data from Minnesota and Washington state Medicaid agencies. They concluded that continuity of care holds promise as a quality measure for CMC because of its association with lower ED utilization and more frequent receipt of care coordination.
AHRQ-funded; HS020506.
Citation: Arthur KC, Mangione-Smith R, Burkhart Q .
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
Acad Pediatr 2018 Aug;18(6):669-76. doi: 10.1016/j.acap.2018.04.009..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Emergency Department, Healthcare Utilization, Primary Care, Quality of Care, Quality Indicators (QIs), Quality Measures
Joseph D, Vogel JA, Smith CS
Alcohol as a factor in 911 calls in Denver.
This study analyzed data from 911 calls in Denver, Colorado to determine the impact of excessive alcohol consumption on those calls. The number of calls made from July 1, 2012 to June 30, 2014 was 169,642 and of those calls 30% had alcohol consumption has a main factor, and 29% as a contribution factor. These calls were more likely associated with male sex, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation.
AHRQ-funded; HS023901.
Citation: Joseph D, Vogel JA, Smith CS .
Alcohol as a factor in 911 calls in Denver.
Prehosp Emerg Care 2018 Jul-Aug;22(4):427-35. doi: 10.1080/10903127.2017.1413467..
Keywords: Alcohol Use, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Abdel Khalik H, Stevens H, Carlin AM
Site-specific approach to reducing emergency department visits following surgery.
The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. The investigators concluded that current practices aimed at reducing ED visits appeared to be ineffective. They suggested that due to heterogeneity in patient populations and local infrastructure, a more tailored approach to ED visit reduction may be more successful.
AHRQ-funded; HS023621; HS024403.
Citation: Abdel Khalik H, Stevens H, Carlin AM .
Site-specific approach to reducing emergency department visits following surgery.
Ann Surg 2018 Apr;267(4):721-26. doi: 10.1097/sla.0000000000002226.
Keywords: Adverse Events, Emergency Department, Healthcare Utilization, Obesity, Surgery
Malik S, Lee DC, Doran KM
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, the authors of this study performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy's landfall.
AHRQ-funded; HS024172.
Citation: Malik S, Lee DC, Doran KM .
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Disaster Med Public Health Prep 2018 Apr;12(2):184-93. doi: 10.1017/dmp.2017.44..
Keywords: Elderly, Emergency Department, Vulnerable Populations, Public Health, Healthcare Utilization
Cline DM, Silva S, Freiermuth CE
Emergency department (ED), ED observation, day hospital, and hospital admissions for adults with sickle cell disease.
In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) vaso-occlusive crisis (VOC), researchers prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) day hospital, and 4) hospital admission, of two different patient cohorts with SCD. They found that healthcare utilization varied dramatically between individual patients.
AHRQ-funded; HS019646.
Citation: Cline DM, Silva S, Freiermuth CE .
Emergency department (ED), ED observation, day hospital, and hospital admissions for adults with sickle cell disease.
West J Emerg Med 2018 Mar;19(2):311-18. doi: 10.5811/westjem.2017.9.35422.
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Keywords: Emergency Department, Healthcare Utilization, Hospitalization, Quality Improvement, Sickle Cell Disease
Sharp AL, Huang BZ, Tang T
Implementation of the Canadian CT Head Rule and Its association with use of computed tomography among patients with head injury.
The researchers evaluated the association of implementation of the Canadian CT Head Rule on head computed tomography (CT) imaging in community emergency departments (EDs). They found that a multicomponent implementation of the Canadian CT Head Rule was associated with a modest reduction in CT use and an increased diagnostic yield of head CTs for adult trauma encounters in community EDs.
AHRQ-funded; HS021271.
Citation: Sharp AL, Huang BZ, Tang T .
Implementation of the Canadian CT Head Rule and Its association with use of computed tomography among patients with head injury.
Ann Emerg Med 2018 Jan;71(1):54-63.e2. doi: 10.1016/j.annemergmed.2017.06.022.
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Keywords: Brain Injury, Clinical Decision Support (CDS), Shared Decision Making, Emergency Department, Guidelines, Healthcare Utilization, Imaging