Evidence map›Paper›PMID 28861915›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2017

Patients Visiting Multiple Emergency Departments: Patterns, Costs, and Risk Factors.

Todd W Lyons, Karen L Olson, Nathan P Palmer, Reed Horwitz, Kenneth D Mandl, Andrew M Fine

Abstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Todd W LyonsComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Karen L OlsonComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Nathan P PalmerDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA.
Reed HorwitzComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Kenneth D MandlComputational Health Informatics Program, Boston Children's Hospital, Boston, MA.
Andrew M FineDivision of Emergency Medicine, Boston Children's Hospital, Boston, MA.

Funding

RESEARCH TRAINING IN PEDIATRIC EMERGENCY MEDICINET32HD040128 · NICHD · CHILDREN'S HOSPITAL BOSTON · PI Kenneth D. Mandl · 2001 to 2026
$5.0M
NICHD NIH HHS T32 HD040128
6 · The paper itself

Abstract

objectivesWe sought to characterize the population of patients seeking care at multiple emergency departments (EDs) and to quantify the proportion of all ED visits and costs accounted for by these patients.

methodsWe performed a retrospective, cohort study of deidentified insurance claims for privately insured patients with one of more ED visits between 2010 and 2016. We measured the number of EDs visited by each patient and determined the overall proportion of all ED visits and ED costs accounted for by patients who visit multiple EDs. We identified factors associated with visiting multiple EDs.

resultsA total of 8,651,716 patients made 16,390,676 ED visits over the study period, accounting for $26,102,831,740 in ED costs. A significant minority (20.5%) of patients visited more than one ED over the study period. However, these patients accounted for a disproportionate amount of all ED visits (41.4%) and all ED costs (39.2%). A small proportion (0.4%) of patients visited five or more EDs but accounted for 2.8% of ED visits and costs. Among patients with two ED visits within 30 days, 32% were to different EDs. Having at least one ED visit for mental health or substance abuse-related diagnosis was associated with increased odds of visiting multiple EDs.

conclusionsA substantial minority of patients visit multiple EDs, but account for a disproportionate burden of overall ED utilization and costs. Future work should evaluate the impact of visiting multiple EDs on care utilization and outcomes and explore systems for improving access to patient records across care centers.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolCohort StudiesEmergency Service, HospitalFemaleHospitalsHumansInfantInfant, NewbornMaleMedical OveruseMental Disorders

Identifiers

PMID28861915
PMCPMC5681430

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.