Evidence map›Paper›PMID 31390036›Full record

ArticleJAMA network open2019

Identification of Emergency Care-Sensitive Conditions and Characteristics of Emergency Department Utilization.

Anita A Vashi, Tracy Urech, Brendan Carr, Liberty Greene, Theodore Warsavage, Renee Hsia, Steven M Asch

Abstract read
In one paragraph

Article in JAMA network open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing 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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

27 citing papers in PubMed.

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  19. Emergency department utilization and presenting chief complaints by Veterans living with dementia.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023
    Observational
  20. Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation.Journal of urban health : bulletin of the New York Academy of Medicine · 2022
    Article
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

7 authors.

Anita A VashiDepartment of Emergency Medicine, Stanford University, Stanford, California.
Tracy UrechCenter for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.
Brendan CarrDepartment of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Liberty GreeneCenter for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.
Theodore WarsavageDenver Center of Innovation for Veteran Centered and Value Driven Care, Rocky Mountain Regional VA Medical Center, Denver, Colorado.
Renee HsiaPhilip R. Lee Institute for Health Policy Studies, Department of Emergency Medicine, University of California, San Francisco.
Steven M AschCenter for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.

Funding

Veteran Access to Emergency CareI01HX002362 · VA · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · PI VASHI, ANITA A · 2018 to 2024
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Emergency Care Sensitive Conditions in the VAI21HX001746 · VA · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · PI VASHI, ANITA A · 2015 to 2015
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HSRD VA I01 HX002362HSRD VA I21 HX001746
6 · The paper itself

Abstract

Importance: Monitoring emergency care quality requires understanding which conditions benefit most from timely, quality emergency care. Objectives: To identify a set of emergency care-sensitive conditions (ECSCs) that are treated in most emergency departments (EDs), are associated with a spectrum of adult age groups, and represent common reasons for seeking emergency care and to provide benchmark national estimates of ECSC acute care utilization. Design, Setting, and Participants: A modified Delphi method was used to identify ECSCs. In a cross-sectional analysis, ECSC-associated visits by adults (aged ≥18 years) were identified based on International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes and analyzed with nationally representative data from the 2016 US Nationwide Emergency Department Sample. Data analysis was conducted from January 2018 to December 2018. Main Outcomes and Measures: Identification of ECSCs and ECSC-associated ED utilization patterns, length of stay, and charges. Results: An expert panel rated 51 condition groups as emergency care sensitive. Emergency care-sensitive conditions represented 16 033 359 of 114 323 044 ED visits (14.0%) in 2016. On average, 8 535 261 of 17 886 220 ED admissions (47.7%) were attributed to ECSCs. The most common ECSC ED visits were for sepsis (1 716 004 [10.7%]), chronic obstructive pulmonary disease (1 273 319 [7.9%]), pneumonia (1 263 971 [7.9%]), asthma (970 829 [6.1%]), and heart failure (911 602 [5.7%]) but varied by age group. Median (interquartile range) length of stay for ECSC ED admissions was longer than non-ECSC ED admissions (3.2 [1.7-5.8] days vs 2.7 [1.4-4.9] days; P < .001). In 2016, median (interquartile range) ED charges per visit for ECSCs were $2736 ($1684-$4605) compared with $2179 ($1118-$4359) per visit for non-ECSC ED visits (P < .001). Conclusions and Relevance: This comprehensive list of ECSCs can be used to guide indicator development for pre-ED, intra-ED, and post-ED care and overall assessment of the adult, non-mental health, acute care system. Health care utilization and costs among patients with ECSCs are substantial and warrant future study of validation, variations in care, and outcomes associated with ECSCs.

Indexed as

AdultAgedAged, 80 and overCross-Sectional StudiesEmergency Medical ServicesEmergency Service, HospitalEmergency TreatmentFemaleHumansMaleMiddle AgedQuality of Health CareYoung Adult

Identifiers

PMID31390036
PMCPMC6686774

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.