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Kammien AJ, Zhu JR, Gouzoulis MJ, Moore HG, Galivanche AR, Medvecky MJ, Grauer JN. Emergency Department Visits Within 90 Days of Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med 2022; 10:23259671221083586. [PMID: 35340726 PMCID: PMC8941698 DOI: 10.1177/23259671221083586] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Emergency department (ED) visits after orthopaedic surgery such as anterior
cruciate ligament reconstruction (ACLR) affect patients and health care
systems and should be better understood. Purpose: To determine the incidence, predictors, and reasons for ED visits within 90
days after ACLR. Study Design: Descriptive epidemiologic study. Methods: Patients who had undergone ACLR between 2010 and 2020 were identified in a
national database, and 90-day ED visits, readmissions, risk factors, and
primary diagnoses for visits were determined. One-year postoperative data
were used to establish baseline weekly ED visits for the cohort. Patient
age, sex, Elixhauser comorbidity index, region of the country (Northeast,
Midwest, West, South), and insurance coverage (Medicare, Medicaid, and
commercial) were extracted, and these variables were compared using
univariate analysis and multivariate logistic regression. Results: Out of 81,179 patients, ED visits were identified for 6764 (8.3%), and
readmissions were identified for 592 (0.7%). Overall, 5300 patients had 1 ED
visit, 1020 patients had 2 visits, 275 patients had 3 visits, and 169
patients had ≥4 or more visits; visits occurred within 2 weeks of surgery
38% of the time. Notably, weekly visits returned to baseline at week 3.
Independent predictors of ED utilization from multivariate analysis were
insurance type (relative to commercial insurance: Medicaid [odds ratio [OR],
2.41; 95% CI, 2.23-2.60] and Medicare [OR, 1.38; 95% CI, 1.19-1.60]), higher
Elixhauser comorbidity index (per 2-point increase: OR, 2.24; 95% CI,
2.18-2.29), younger age (per 10-year decrease: OR, 1.23; 95% CI, 1.21-1.24),
female sex (OR, 1.05; 95% CI, 1.02-1.08), and region of the country
(relative to the West: Midwest [OR, 1.33; 95% CI, 1.26-1.39], Northeast [OR,
1.24; 95% CI, 1.18-1.30], and South [OR, 1.17; 95% CI, 1.12-1.23]). In the
first 2 weeks, 67.5% of ED visits were for issues involving the surgical
site, most commonly surgical-site pain (29% of all visits). In the total
90-day period, 39.4% of visits involved the surgical site. Conclusion: Within 90 days of ACLR, >8% of patients visited the ED, while 0.7% were
readmitted. ED visits increased in the first 2 postoperative weeks and
returned to baseline rates around week 3. Within the first 2 weeks,
two-thirds of visits involved the surgical site. Younger patients, patients
with greater comorbidity burden, those in certain regions of the country,
and those with Medicaid had greater odds of ED utilization.
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Affiliation(s)
- Alexander J Kammien
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Justin R Zhu
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael J Gouzoulis
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Anoop R Galivanche
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael J Medvecky
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jonathan N Grauer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
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Adejare AA, Gautam Y, Madzia J, Mersha T. Unraveling racial disparities in asthma emergency department visits using electronic healthcare records and machine learning. J Asthma 2022; 59:79-93. [PMID: 33112174 PMCID: PMC8221365 DOI: 10.1080/02770903.2020.1838539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Hospital emergency department (ED) visits by asthmatics differ based on race and season. The objectives of this study were to investigate season- and race-specific disparities for asthma risk, and to identify environmental exposure variables associated with ED visits among more than 42,000 individuals of African American (AA) and European American (EA) descent identified through electronic health records (EHRs). METHODS We examined data from 42,375 individuals (AAs = 14,491, EAs = 27,884) identified in EHRs. We considered associated demographic (race, age, gender, insurance), clinical (smoking status, ED visits, FEV1%), and environmental exposures data (mold, pollen, and pollutants). Machine learning techniques, including random forest (RF), extreme gradient boosting (XGB), and decision tree (DT) were used to build and identify race- and -season-specific predictive models for asthma ED visits. RESULTS Significant differences in ED visits and FEV1% among AAs and EAs were identified. ED visits by AAs was 32.0% higher than EAs and AAs had 6.4% lower FEV1% value than EAs. XGB model was used to accurately classify asthma patients visiting ED into AAs and EAs. Pollen factor and pollution (PM2.5, PM10) were the key variables for asthma in AAs and EAs, respectively. Age and cigarette smoking increase asthma risk independent of seasons. CONCLUSIONS In this study, we observed racial and season-specific disparities between AAs and EAs asthmatics for ED visit and FEV1% severity, suggesting the need to address asthma disparities through key predictors including socio-economic status, particulate matter, and mold.
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Affiliation(s)
- Adeboye A. Adejare
- Department of Biomedical Informatics, University of Cincinnati; Cincinnati, OH, USA
| | - Yadu Gautam
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Juliana Madzia
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Tesfaye Mersha
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA,Corresponding author: Tesfaye B. Mersha, Ph.D. Associate Professor Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, 3333 Burnet Avenue, MLC 7037, Cincinnati, OH 45229-3026. Phone: (513) 803-2766 Fax: (513) 636-1657.
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Wachtel G, Elalouf A. Addressing overcrowding in an emergency department: an approach for identifying and treating influential factors and a real-life application. Isr J Health Policy Res 2020; 9:37. [PMID: 32873328 PMCID: PMC7550853 DOI: 10.1186/s13584-020-00390-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 05/28/2020] [Indexed: 11/16/2022] Open
Abstract
Background Overcrowding in hospital emergency departments that arises from long length-of-stay is an unfortunate common occurrence. While some factors affecting length-of-stay are well known, there may be additional factors that have not yet been properly addressed. This research offers a method for emergency department managers to use available data from their departments to identify new factors that significantly influence emergency departments crowding and patient length-of-stay. Methods We propose an algorithm that can assist emergency department managers in determining which of these factors to address, given budgetary constraints. We implemented it in a case study which takes into account factors that are known to be influential, e.g., reason for arrival, occupancy in the emergency department, and arrival time, as well as factors that are explored for the first time in this paper, such as patient heart rate, the number of accompanying escorts, and the number of tests assigned to patients (e.g., blood tests and urinalysis). Results All the implemented and new factors are shown to have a significant influence on the length-of-stay and crowding. We also obtained additional support for our results by interviewing emergency departments physicians and nurses from various hospitals. Conclusions It is expected that, by taking all the above factors into consideration, emergency departments efficiency can be improved. The algorithm constructed here allows the choice of the most cost-effective factors to be improved, subject to a given budget. We have been able to derive practical recommendations that emergency departments managers might use to limit crowding and patient length-of-stay.
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Affiliation(s)
- Guy Wachtel
- Department of Management, Bar-Ilan University, 5290002, Ramat Gan, Israel.
| | - Amir Elalouf
- Department of Management, Bar-Ilan University, 5290002, Ramat Gan, Israel
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El Zahran T, El Sayed MJ. Prehospital Ultrasound in Trauma: A Review of Current and Potential Future Clinical Applications. J Emerg Trauma Shock 2018; 11:4-9. [PMID: 29628662 PMCID: PMC5852915 DOI: 10.4103/jets.jets_117_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ultrasound (US) is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.
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Affiliation(s)
- Tharwat El Zahran
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mazen J El Sayed
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Kalid N, Zaidan AA, Zaidan BB, Salman OH, Hashim M, Muzammil H. Based Real Time Remote Health Monitoring Systems: A Review on Patients Prioritization and Related "Big Data" Using Body Sensors information and Communication Technology. J Med Syst 2017; 42:30. [PMID: 29288419 DOI: 10.1007/s10916-017-0883-4] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022]
Abstract
The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.
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Affiliation(s)
- Naser Kalid
- Computing Department, Universiti Pendidikan Sultan Idris, Tg Malim, 35900, Perak, Malaysia.,Department of Computer Engineering Techniques, Al-Nisour University, Al Adhmia - Haiba Khaton, Baghdad, Iraq
| | - A A Zaidan
- Computing Department, Universiti Pendidikan Sultan Idris, Tg Malim, 35900, Perak, Malaysia.
| | - B B Zaidan
- Computing Department, Universiti Pendidikan Sultan Idris, Tg Malim, 35900, Perak, Malaysia
| | - Omar H Salman
- Networking Department, Engineering College, Al Iraqia university, Baghdad, Iraq
| | - M Hashim
- Computing Department, Universiti Pendidikan Sultan Idris, Tg Malim, 35900, Perak, Malaysia
| | - H Muzammil
- Department of Computer Science, University of Management and Technology, Lahore, Pakistan
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Blank JLT, van Hulst BL, Valdmanis VG. Concentrating Emergency Rooms: Penny-Wise and Pound-Foolish? An Empirical Research on Scale Economies and Chain Economies in Emergency Rooms in Dutch Hospitals. HEALTH ECONOMICS 2017; 26:1353-1365. [PMID: 27686779 PMCID: PMC5655724 DOI: 10.1002/hec.3409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 06/06/2023]
Abstract
In this paper, we address the issue of whether it is economically advantageous to concentrate emergency rooms (ERs) in large hospitals. Besides identifying economies of scale of ERs, we also focus on chain economies. The latter term refers to the effects on a hospital's costs of ER patients who also need follow-up inpatient or outpatient hospital care. We show that, for each service examined, product-specific economies of scale prevail indicating that it would be beneficial for hospitals to increase ER services. However, this seems to be inconsistent with the overall diseconomies of scale for the hospital as a whole. This intuitively contradictory result is indicated as the economies of scale paradox. This scale paradox also explains why, in general, hospitals are too large. There are internal (departmental) pressures to expand certain services, such as ER, in order to benefit from the product-specific economies of scale. However, the financial burden of this expansion is borne by the hospital as a whole. The policy implications of the results are that concentrating ERs seems to be advantageous from a product-specific perspective, but is far less advantageous from the hospital perspective. © 2016 The Authors. Health Economics Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Jos L. T. Blank
- Delft University of TechnologyDelftThe Netherlands
- Erasmus UniversityRotterdamThe Netherlands
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Lippi G, Bovo C, Buonocore R, Mitaritonno M, Cervellin G. Red blood cell distribution width in patients with limb, chest and head trauma. Arch Med Sci 2017; 13:606-611. [PMID: 28507576 PMCID: PMC5420636 DOI: 10.5114/aoms.2017.67282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/18/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION This study investigated the values of red blood cell distribution width (RDW), an emerging and independent predictor of morbidity and mortality, in patients with limb, chest and head trauma. MATERIAL AND METHODS The study sample consisted of all patients who attended the emergency department (ED) of the University Hospital of Parma for limb, chest and head traumas requiring admission to hospital wards during the year 2014. The controls consisted of outpatients living in the same geographical area and undergoing routine laboratory testing for health check-up. RESULTS The final study sample consisted of 290 patients with limb (n = 97), chest (n = 49) or head (n = 144) trauma and 967 outpatients. Significantly increased RDW values at admission were observed in all trauma patients compared with controls. Although the frequency of increased RDW (> 14.6%) was higher in all trauma patients than in controls, a subanalysis revealed that increased RDW values were significantly more frequent in patients with head trauma than in controls, but not in those with limb or chest trauma. In multivariate analysis, a significant association was found between head trauma and hemoglobin (p < 0.001) or RDW (p = 0.005). Head trauma patients had a ~3-fold higher likelihood of increased RDW values than controls. The negative and positive predictive values of increased RDW for predicting the presence of head trauma were 0.90 (95% CI: 0.88-0.92) and 0.24 (95% CI: 0.19-0.30). CONCLUSIONS The results of this study highlight that RDW is increased in patients admitted to the ED with head trauma.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Chiara Bovo
- University Hospital of Verona, Verona, Italy
| | - Ruggero Buonocore
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Giancotti M, Guglielmo A, Mauro M. Efficiency and optimal size of hospitals: Results of a systematic search. PLoS One 2017; 12:e0174533. [PMID: 28355255 PMCID: PMC5371367 DOI: 10.1371/journal.pone.0174533] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/11/2017] [Indexed: 11/29/2022] Open
Abstract
Background National Health Systems managers have been subject in recent years to considerable pressure to increase concentration and allow mergers. This pressure has been justified by a belief that larger hospitals lead to lower average costs and better clinical outcomes through the exploitation of economies of scale. In this context, the opportunity to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources. Methods and findings This paper analyses the stance of existing research on scale efficiency and optimal size of the hospital sector. We performed a systematic search of 45 past years (1969–2014) of research published in peer-reviewed scientific journals recorded by the Social Sciences Citation Index concerning this topic. We classified articles by the journal’s category, research topic, hospital setting, method and primary data analysis technique. Results showed that most of the studies were focussed on the analysis of technical and scale efficiency or on input / output ratio using Data Envelopment Analysis. We also find increasing interest concerning the effect of possible changes in hospital size on quality of care. Conclusions Studies analysed in this review showed that economies of scale are present for merging hospitals. Results supported the current policy of expanding larger hospitals and restructuring/closing smaller hospitals. In terms of beds, studies reported consistent evidence of economies of scale for hospitals with 200–300 beds. Diseconomies of scale can be expected to occur below 200 beds and above 600 beds.
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Affiliation(s)
- Monica Giancotti
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
- * E-mail:
| | - Annamaria Guglielmo
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - Marianna Mauro
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
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Carey K, Lin MY. Readmissions To New York Hospitals Fell For Three Target Conditions From 2008 To 2012, Consistent With Medicare Goals. Health Aff (Millwood) 2016; 34:978-85. [PMID: 26056203 DOI: 10.1377/hlthaff.2014.1408] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Medicare Hospital Readmissions Reduction Program (HRRP), an initiative of the Affordable Care Act, imposes considerable financial penalties on hospitals with excess thirty-day readmissions for patients with selected high-volume conditions. We investigated the intended impact of the program by examining changes in thirty-day readmissions among Medicare patients admitted for three conditions targeted by the program in New York State, compared to Medicare patients with other conditions and with privately insured patients, before and after the program's introduction. We also examined potential unintended strategic responses by hospitals that might allow them to continue to treat target-condition patients while avoiding the readmission penalty. We found that thirty-day readmissions fell for the three conditions targeted by the HRRP, consistent with the goals of the program. Second, there also was a substantial fall in readmissions for a comparison group although not as large as for the target group, which suggests modest spillover effects in Medicare for other conditions. We did not find strong evidence of unintended effects associated with the program. These early findings suggest that the HRRP is affecting hospitals in the direction intended by the Affordable Care Act.
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Affiliation(s)
- Kathleen Carey
- Kathleen Carey is a professor in the Department of Health Policy and Management at the School of Public Health, Boston University, in Massachusetts
| | - Meng-Yun Lin
- Meng-Yun Lin is a research data analyst in the section of general internal medicine at the Boston Medical Center
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Lee MH, Schuur JD, Zink BJ. Owning the Cost of Emergency Medicine: Beyond 2%. Ann Emerg Med 2013; 62:498-505.e3. [DOI: 10.1016/j.annemergmed.2013.03.029] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/23/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
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Definition of a prospective payment system to reimburse emergency departments. BMC Health Serv Res 2013; 13:409. [PMID: 24119285 PMCID: PMC3852522 DOI: 10.1186/1472-6963-13-409] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 09/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Payers are increasingly turning to Prospective Payment Systems (PPSs) because they incentivize efficiency, but their application to emergency departments (EDs) is difficult because of the high level of uncertainty and variability in the cost of treating each patient.To the best of our knowledge, our work represents the first attempt at defining a PPS for this part of hospital activity. METHODS Data were specifically collected for this study and relate to 1011 patients who were triaged at an ED of a major Italian hospital, during 1 week in December 2010.The cost for each patient was analytically estimated by adding up several components: 1) physician and other staff costs that were imputed on the basis of the time each physician claimed to have spent treating the patient; 2) the cost for each test/treatment each patient actually underwent; 3) overhead costs, shared among patients using the time elapsed between first examination and discharge from the ED. RESULTS The distribution of costs by triage code shows that, although the average cost increases across the four triage groups, the variance within each code is quite high. The maximum cost for a yellow code is €1074.7, compared with €680 for red, the most serious code. Using cluster analysis, the red code cluster is enveloped by yellow, and their costs are therefore indistinguishable, while green codes span all cost groups. This suggests that triage code alone is not a good proxy for the patient cost, and that other cost drivers need to be included. CONCLUSIONS Crude triage codes cannot be used to define PPSs because they are not sufficiently correlated with costs and are characterized by large variances. However, if combined with other information, such as the number of laboratory and non-laboratory tests/examinations, it is possible to define cost groups that are sufficiently homogeneous to be reimbursed prospectively. This should discourage strategic behavior and allow the ED to break even or create profits, which can be reinvested to improve services. The study provides health policy administrators with a new and feasible tool to implement prospective payment for EDs, and improve planning and cost control.
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Ogedegbe C, Morchel H, Hazelwood V, Chaplin WF, Feldman J. Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol. BMC Emerg Med 2012; 12:19. [PMID: 23249290 PMCID: PMC3546944 DOI: 10.1186/1471-227x-12-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 12/07/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS) system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1) real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2) Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED. METHODS Study participants are three healthy volunteers (one each with normal, overweight and obese BMI category). The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite) interfaced with a portable broadcast unit (by Live-U). Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators) using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS). DISCUSSION Findings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting.
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Affiliation(s)
- Chinwe Ogedegbe
- Emergency Trauma Department, Hackensack University Medical Center, 30 prospect Avenue, Hackensack, NJ, 07601, USA
| | - Herman Morchel
- Emergency Trauma Department, Hackensack University Medical Center, 30 prospect Avenue, Hackensack, NJ, 07601, USA
| | - Vikki Hazelwood
- Emergency Trauma Department, Hackensack University Medical Center, 30 prospect Avenue, Hackensack, NJ, 07601, USA
| | - William F Chaplin
- Department of Psychology, St. John’s University, 8000 Utopia Parkway, Jamaica, NY, 11439, USA
| | - Joseph Feldman
- Emergency Trauma Department, Hackensack University Medical Center, 30 prospect Avenue, Hackensack, NJ, 07601, USA
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