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The 2013 Dip: Factors Influencing Falling Emergency Department Visits and Inpatient Admissions in District of Columbia and Maryland.

MedStar author(s):

Citation: Journal of Emergency Medicine. 50(6):897-901, 2016 JunPMID: 27210903Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Emergency Service, Hospital/ut [Utilization] | *Patient Admission/sn [Statistics & Numerical Data] | District of Columbia/ep [Epidemiology] | Emergency Service, Hospital/sn [Statistics & Numerical Data] | Humans | Logistic Models | Maryland/ep [Epidemiology]Year: 2016 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:

0736-4679

Name of journal: The Journal of emergency medicineAbstract: BACKGROUND: Earlier reports have documented growth of United States emergency department (ED) visits since the early 1990s.CONCLUSIONS: In 2013, ED visits in fell in Maryland and District of Columbia hospitals, and inpatient admission volumes fell from 2011 to 2013. This is a reversal of decades-long trends in higher health care utilization. These trends were not explained by demographics, insurance, or ED alternatives, however, falling admission rates were more pronounced in Maryland hospitals participating in global payment programs.Copyright c 2016 Elsevier Inc. All rights reserved.METHODS: We analyzed monthly ED visit and inpatient admission volumes from 53 acute care hospitals in Maryland and the District of Columbia from 2011 to 2013. Fixed-effect regression was used to assess the relationship between community-level demographics, hospital insurance mix, urgent care/retail clinic density, and hospitals participating in Maryland's Total Patient Revenue (TPR) pilot-a global payment program-and changes in ED visit and hospital admission volume from 2012 to 2013.OBJECTIVE: In this report, we describe recent trends in ED utilization and inpatient admissions in Maryland and District of Columbia hospitals from 2011 to 2013.RESULTS: Across 53 Maryland and District of Columbia hospitals, ED visits grew 2.8% between 2011 and 2012. From 2012 to 2013, ED visits declined by 3.5%. Admissions declined by 3.3% from 2011 to 2012, then declined again 3.6% from 2012 to 2013. Community demographic or hospital insurance-mix variable and density of urgent care centers were not associated with lower ED visits. Inpatient admissions fell significantly more in hospitals participating in Maryland's TPR global payment pilot program.All authors: Alghamdi K, Frohna WJ, Pines JM, Zocchi MFiscal year: FY2016Digital Object Identifier:

https://dx.doi.org/10.1016/j.jemermed.2016.02.028

Date added to catalog: 2017-05-24

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	27210903	Available		27210903

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

BACKGROUND: Earlier reports have documented growth of United States emergency department (ED) visits since the early 1990s.

CONCLUSIONS: In 2013, ED visits in fell in Maryland and District of Columbia hospitals, and inpatient admission volumes fell from 2011 to 2013. This is a reversal of decades-long trends in higher health care utilization. These trends were not explained by demographics, insurance, or ED alternatives, however, falling admission rates were more pronounced in Maryland hospitals participating in global payment programs.

METHODS: We analyzed monthly ED visit and inpatient admission volumes from 53 acute care hospitals in Maryland and the District of Columbia from 2011 to 2013. Fixed-effect regression was used to assess the relationship between community-level demographics, hospital insurance mix, urgent care/retail clinic density, and hospitals participating in Maryland's Total Patient Revenue (TPR) pilot-a global payment program-and changes in ED visit and hospital admission volume from 2012 to 2013.

OBJECTIVE: In this report, we describe recent trends in ED utilization and inpatient admissions in Maryland and District of Columbia hospitals from 2011 to 2013.

RESULTS: Across 53 Maryland and District of Columbia hospitals, ED visits grew 2.8% between 2011 and 2012. From 2012 to 2013, ED visits declined by 3.5%. Admissions declined by 3.3% from 2011 to 2012, then declined again 3.6% from 2012 to 2013. Community demographic or hospital insurance-mix variable and density of urgent care centers were not associated with lower ED visits. Inpatient admissions fell significantly more in hospitals participating in Maryland's TPR global payment pilot program.

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