How emergency department (ED) admission decisions differ when the same physician works in two different EDs.
How emergency department (ED) admission decisions differ when the same physician works in two different EDs.
- 2017
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: In this sample, some ED physicians made similar admission decisions in different settings while others increased or decreased their admission rates up to 25% when practicing in a different ED. Copyright c 2017. Published by Elsevier Inc. METHODS: We conducted a retrospective, cross-sectional study over two years (2012-3) in six EDs in three states. Included physicians had >200 encounters per site in two different EDs. "Admissions" were ED encounters resulting in admission to the hospital or transfer to another hospital. The primary outcome was the adjusted admission rate difference between the two sites. Hierarchical logistic regression analysis was used to calculate adjusted admission rates for each physician, which were then tabulated for each physician and compared across sites. RESULTS: In 51,807 ED encounters seen by 16 physicians the average admission rate was 20.0%, and unadjusted admission rates differed between sites by 2.9% (range 0-8.4%) for the same physician. The adjusted admission rate was 19.3% and differed between sites by 2.1% (range 0.4%-6.2%). STUDY OBJECTIVE: Emergency physicians often work in multiple hospital emergency departments (EDs). We study how emergency physician admission decisions vary in different settings.
English
0735-6757
*Emergencies
*Emergency Service, Hospital/sn [Statistics & Numerical Data]
*Patient Admission/sn [Statistics & Numerical Data]
*Physicians
*Practice Patterns, Physicians'/sn [Statistics & Numerical Data]
Adolescent
Adult
Aged
Attitude of Health Personnel
Child
Child, Preschool
Clinical Decision-Making
Cross-Sectional Studies
Female
Humans
Infant
Male
Middle Aged
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Washington Hospital Center
Emergency Medicine
Journal Article
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: In this sample, some ED physicians made similar admission decisions in different settings while others increased or decreased their admission rates up to 25% when practicing in a different ED. Copyright c 2017. Published by Elsevier Inc. METHODS: We conducted a retrospective, cross-sectional study over two years (2012-3) in six EDs in three states. Included physicians had >200 encounters per site in two different EDs. "Admissions" were ED encounters resulting in admission to the hospital or transfer to another hospital. The primary outcome was the adjusted admission rate difference between the two sites. Hierarchical logistic regression analysis was used to calculate adjusted admission rates for each physician, which were then tabulated for each physician and compared across sites. RESULTS: In 51,807 ED encounters seen by 16 physicians the average admission rate was 20.0%, and unadjusted admission rates differed between sites by 2.9% (range 0-8.4%) for the same physician. The adjusted admission rate was 19.3% and differed between sites by 2.1% (range 0.4%-6.2%). STUDY OBJECTIVE: Emergency physicians often work in multiple hospital emergency departments (EDs). We study how emergency physician admission decisions vary in different settings.
English
0735-6757
*Emergencies
*Emergency Service, Hospital/sn [Statistics & Numerical Data]
*Patient Admission/sn [Statistics & Numerical Data]
*Physicians
*Practice Patterns, Physicians'/sn [Statistics & Numerical Data]
Adolescent
Adult
Aged
Attitude of Health Personnel
Child
Child, Preschool
Clinical Decision-Making
Cross-Sectional Studies
Female
Humans
Infant
Male
Middle Aged
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Washington Hospital Center
Emergency Medicine
Journal Article