ArticleJAMA network open2020
Trends in Costs of Care for Medicare Beneficiaries Treated in the Emergency Department From 2011 to 2016.
Article in JAMA network open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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.
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Who cites it
12 citing papers in PubMed.
- Cost-Effectiveness Analysis Evaluating Delivery Strategies for Pain Coping Skills Training in Women With Breast Cancer.The journal of pain · 2023Trial
- Variation and Drivers of Spending Within 30-Day Emergency Department-Based Episodes of Care.Journal of general internal medicine · 2026Article
- Deriving a Simple Clinical Predictive Score for Posterior Circulation Ischemic Stroke (PCS-SCORE).Journal of central nervous system disease · 2026Article
- MC-MED, multimodal clinical monitoring in the emergency department.Scientific data · 2025Article
- Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage.Annals of emergency medicine · 2024Article
- Home Health Care Use and Outcomes After Coronary Artery Bypass Grafting Among Medicare Beneficiaries.Circulation. Cardiovascular quality and outcomes · 2024Article
- Trends in observation stays for Medicare beneficiaries with and without Alzheimer's disease and related dementias.Journal of the American Geriatrics Society · 2024Article
- Cost of care for Alzheimer's disease and related dementias in the United States: 2016 to 2060.npj aging · 2024Article
- Trends in healthy days at home for Medicare beneficiaries using the emergency department.Journal of the American Geriatrics Society · 2023Article
- Hospital Proximity and Emergency Department Use among Assisted Living Residents.Journal of the American Medical Directors Association · 2023Article
- Expenditures and Healthcare Utilization of Patients Receiving Care at a Specialized Primary Care Clinic Designed with and for Autistic Adults.Journal of general internal medicine · 2022Article
- Temporal trends of healthcare system use between symptomatic presentation and ovarian cancer diagnosis in the United States.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: There is little evidence regarding how total costs of care associated with an emergency department (ED) visit have changed, despite increasing policy focus on the value of acute care. Objective: To examine trends in total standardized 30-day costs of care associated with an ED visit. Design, Setting, and Participants: This cross-sectional study of 14 113 088 ED visits at 4730 EDs from 2011 to 2016 included a 20% national sample of traditional Medicare beneficiaries aged 65 years and older. Data analysis was conducted from August 2018 to April 2020. Exposures: Time (year) as a continuous variable. Main Outcomes and Measures: Trends in disposition from the ED and 30-day total standardized costs for all ED visits as well as the following spending components: index visit cost, physician costs, subsequent ED visit costs, subsequent inpatient costs, subsequent observation costs, non-ED outpatient care, postacute care, and aggregated total spending after the index ED visit. Results: The analytic sample consisted of 14 113 088 ED visits at 4730 EDs. The mean (SD) beneficiary age was 78.6 (8.6) years, 8 573 652 visits (60.7%) were among women, and 11 908 691 visits (84.7%) were among white patients. The proportion of patients discharged from the ED rose from 1 233 701 of 2 309 563 visits (53.4%) in 2011 to 1 279 701 of 2 268 363 visits (56.4%) in 2016. Total adjusted 30-day standardized costs of care declined from a mean (SE) of $8851 ($35.3) in 2011 to a mean (SE) of $8143 ($35.4) in 2016 (-$126/y; 95% CI, -$130 to -$121; P < .001) for all ED visits. This decrease was primarily associated with a decline in total spending on the index ED visit (-$48/y; 95% CI, -$50 to -$47; P < .001) as well as lower spending on postacute care (-$42/y; 95% CI, -$44 to -$41; P < .001) and subsequent inpatient care (-$34/y; 95% CI, -$36 to -$32; P < .001). There was an increase in spending after the index visit on downstream observation care ($3.6/y; 95% CI, $3.5 to $3.7; P < .001), outpatient ED care ($4.6/y; 95% CI, $4.4 to $4.8; P < .001), and other outpatient care ($15/y; 95% CI, $12 to $18; P < .001). Conclusions and Relevance: In this study, total 30-day standardized costs of ED care for Medicare beneficiaries decreased in recent years. It may be that more intensive ED spending up front is associated with reductions in total costs of an acute episode.
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