Evidence map›Paper›PMID 40578914›Full record

Observational studyJournal of the American Board of Family Medicine : JABFM

Primary Care and Emergency Room Visits: The Virginia All-Payer Claims Database.

Michael Topmiller, Hannah Shadowen, Mark A Carrozza, Jacqueline B Britz, Roy T Sabo, Derek A Chapman, Scott M Strayer, Alex H Krist

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Women's Health Care, Prevention in Practice, and Common Medical Illnesses.Journal of the American Board of Family Medicine : JABFM
    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

8 authors.

Michael TopmillerFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK). mtopmiller@aafp.org.
Hannah ShadowenFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Mark A CarrozzaFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Jacqueline B BritzFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Roy T SaboFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Derek A ChapmanFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Scott M StrayerFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).
Alex H KristFrom The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study utilizes the Virginia all-payer claims database (APCD) to examine the relationship between primary care utilization and emergency department (ER) use and to explore geographic variation in primary care utilization and ER use. We hypothesize that higher rates of primary care utilization will be associated with lower ER use rates, with maps showing clear geographic patterns.

methodsThis retrospective observational analysis utilized Bayesian smoothing techniques, regression analysis, and geographic information system (GIS) mapping to explore the association of ER use with primary care utilization. Our analysis included 866 ZIP Code Tabulation Areas (ZCTAs) in Virginia.

resultsPrimary care utilization was significantly associated with ER usage rates. The results show that for every increase of 10 primary care visit rates per 1,000 population, ER use rates decline by 7 per 1,000. The maps show clusters of higher rates of PC utilization throughout central and eastern Virginia, with lower rates in many parts of southern Virginia. Higher rates of ER use are observed in western Virginia, particularly along the border with West Virginia, with clusters of lower rates in northern Virginia near Washington, DC.

conclusionsUtilizing the Virginia APCD and GIS mapping, this study finds that primary care utilization is associated with lower rates of ER use. The maps show clear geographic patterns for both ER use and primary care utilization. Important next steps include identifying priority areas, exploring their characteristics, and conducting qualitative research to better understand local factors contributing to their high or low rates of ER use.

Indexed as

Emergency Service, HospitalPrimary Health CareAdolescentAdultBayes TheoremDatabases, FactualEmergency Room VisitsFemaleGeographic Information SystemsHumansMaleMiddle AgedRetrospective StudiesVirginiaDatabase Management SystemsEmergency Room VisitsGeographic Information SystemsPrimary Health CareRegression AnalysisRetrospective StudiesSecondary Data AnalysisVirginia

Identifiers

PMID40578914
PMCPMC12616842

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.