The evolving role of emergency departments in the United States [e-book] / Kristy Gonzalez Morganti ... [et al.] ; sponsored by the Emergency Medicine Action Fund.
- Santa Monica, CA : Rand Corporation, 2013.
1 online resource (196 p.)
- Emergency medicine -- United States.
Hospitals -- Emergency services -- United States.
- Electronic books.
- This report explores the evolving role that hospital emergency departments play in the U.S. health care system. EDs evaluate and manage complex and high-acuity patients, are the major point of entry to inpatient care, and serve as ""the safety net of the safety net"" for patients who cannot get care elsewhere. The report examines the role that EDs may come to play in either contributing to or reducing the rising costs of health care.
- Cover; Title Page; Copyright; Preface; Table of Contents; Figures; Tables; Executive Summary; Acknowledgements; Abbreviations; 1. Introduction; Trends Affecting the Evolution of Hospital EDs; Overall Growth in Health Care Spending; Growing Use of Hospital EDs; The Rising Cost of ED Care; Efforts to Discourage Non-Urgent Use of EDs; EDs as Entry Points to Inpatient Care; Aims of the RAND Study; Organization of This Report; 2. Conceptual Model of ED Use; 3. Methods; Quantitative Data Sources; Analytical Approach; Qualitative Data Sources; Emergency Physician Focus Groups
Hospital Physician Focus GroupIndividual Interviews with Primary Care Providers; Review of Qualitative Data; 4. Findings; What are the most important sources of inpatient admissions and how have they changed?; What are the sources driving growth of non-elective inpatient admissions?; Why are primary care physicians admitting fewer patients to hospitals?; Why are patients using EDs for non-urgent care?; Does a patient's insurance coverage influence likelihood of admission and his/her portal of entry to inpatient care?
Does a patient's source of primary health insurance influence his/her probability of hospitalization from the ED?Does a patient's type of insurance influence a primary care physician's decision to send the patient to the ED?; Do plans that offer care coordination have lower rates of inpatient admission from EDs than fee-for-service plans?; Are EDs playing a role in reducing preventable hospital admissions?; 5. Discussion; Assessing the Value of Emergency Department Care; The Evolving Relationship Between EDs and Primary Care Providers; Emergency Departments as Diagnostic Centers
Do Emergency Departments Prevent Costly Inpatient Admissions?Study Limitations; 6. Conclusions; Implications for Policy; References; Appendix A. Additional Quantitative Results; Appendix B. Focus Groups and Interviews
- "RAND Health."
"Research reort. RR-280-ACEP."
Includes bibliographical references (p. 57-63).
- Rand Corporation.
Emergency Medicine Action Fund.
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