Evidence map›Paper›PMID 38864783›Full record

ArticleAnnals of emergency medicine2024

Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage.

Cameron J Gettel, Wafa Salah, Craig Rothenberg, Yixuan Liang, Hope Schwartz, Kirstin W Scott, Ula Hwang, Susan N Hastings, Arjun K Venkatesh

Abstract read
In one paragraph

Article in Annals of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

9 authors.

Cameron J GettelDepartment of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT. Electronic address: cameron.gettel@yale.edu.
Wafa SalahDepartment of Emergency Medicine, Yale School of Medicine, New Haven, CT.
Craig RothenbergDepartment of Emergency Medicine, Yale School of Medicine, New Haven, CT.
Yixuan LiangYale School of Public Health, New Haven, CT.
Hope SchwartzUniversity of California San Francisco School of Medicine, San Francisco, CA.
Kirstin W ScottDepartment of Emergency Medicine, University of Washington School of Medicine, Seattle, WA.
Ula HwangDepartment of Emergency Medicine, Yale School of Medicine, New Haven, CT; Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY; Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY.
Susan N HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC; Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, NC; Center for the Study of Human Aging and Development, Duke University School of Medicine, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Arjun K VenkateshDepartment of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Pepper OAIC Coordinating CenterU24AG059624 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI DALANE W KITZMAN · 2018 to 2026
$6.0M
Growing the Geriatric Emergency care Applied Research (GEAR 1.1) network: Expanding and sustaining an emergency care aging study infrastructure.R33AG058926 · NIA · YALE UNIVERSITY · PI Ula Y Hwang, Daniella Meeker · 2020 to 2026
$4.6M
Geriatric Emergency care Applied Research network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC)R61AG069822 · NIA · YALE UNIVERSITY · PI HWANG, ULA Y, SHAH, MANISH N · 2020 to 2021
$3.0M
NCATS NIH HHS UL1 TR001863NIA NIH HHS R33 AG058926NIA NIH HHS R61 AG069822NIA NIH HHS U24 AG059624
6 · The paper itself

Abstract

STUDY

objectiveWe sought to quantify differences in total and out-of-pocket health care costs associated with treat-and-release emergency department (ED) visits among older adults with traditional Medicare and Medicare Advantage.

methodsWe conducted a repeated cross-sectional analysis of treat-and-release ED visits using 2015 to 2020 data from the Medicare Current Beneficiary Survey. We measured total and out-of-pocket health care spending during 3 time periods: the 30 days prior to the ED visit, the treat-and-release ED visit itself, and the 30 days after the ED visit. Stratified by traditional Medicare or Medicare Advantage status, we determined median total costs and the proportion of costs that were out-of-pocket.

resultsAmong the 5,011 ED visits by those enrolled in traditional Medicare, the weighted median total (and % out-of-pocket) costs were $881.95 (13.3%) for the 30 days prior to the ED visit, $419.70 (10.1%) for the ED visit, and $809.00 (13.8%) for the 30 days after the ED visit. For the 2,595 ED visits by those enrolled in Medicare Advantage, the weighted median total (and % out-of-pocket) costs were $484.92 (24.0%) for the 30 days prior to the ED visit, $216.66 (21.9%) for the ED visit, and $439.13 (22.4%) for the 30 days after the ED visit.

conclusionOlder adults insured by Medicare Advantage incur lower total health care costs and face similar overall out-of-pocket expenses in the time period surrounding emergency care. However, a higher proportion of expenses are out-of-pocket compared with those insured by traditional Medicare, providing evidence of greater cost sharing for Medicare Advantage plan enrollees.

Indexed as

Emergency Service, HospitalHealth ExpendituresMedicareMedicare Part CAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleUnited States

Identifiers

PMID38864783
PMCPMC11343654

What OpenQuestion holds

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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.