176888 Comparison of Emergency Department Visit Data Sources

Monday, October 27, 2008

Teresa B. Gibson, PhD , Statistical Informatics Department, Thomson Healthcare, Ann Arbor, MI
Pamela J. Owens, PhD , Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, MD
Marguerite Barrett, MS , M.L. Barrett, Inc., Del Mar, CA
Marc W. Zodet, MS , Agency for Healthcare Research and Quality, Rockville, MD
Steven R. Machlin, MS , Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD
Julie Nisbet, BS , Data Development and Analytic Computing, Thomson Healthcare, Santa Barbara, CA
Amy G. Mell, MPH , Statistical Informatics Department, Thomson Healthcare, Ann Arbor, MI
Robin M. Weinick, PhD , Harvard Medical School, Massachusetts General Hospital, Boston, MA
Background/Purpose

Emergency departments serve a dual role in the United States health infrastructure: as a point of entry for approximately 42% of inpatient admissions and as a treatment setting for treat-and-release outpatient visits. The purpose of this study was to compare emergency department (ED) visit counts from several sources to aid in understanding and improving this vital component of the nation's health infrastructure.

Methods

We compare 2005 ED visit counts from eight sources. Two are discharge-based: HCUP Multi-State Emergency Department Databases (from 23 states), HCUP Nationwide Emergency Department Sample pilot database (nationally-representative). Two sources collect data from a sample of EDs: NHAMCS, NEISS. Two sources collect data from a sample of patients: MEPS and NHIS. Finally, counts from the National ED Inventory (NEDI) and American Hospital Association survey are included.

We compare counts across a large number of demographic, geographic, facility, and type of service categories. Comparisons are made using statistical tests (e.g., Chi-squared tests) with a Bonferroni correction for multiple comparisons.

Results/Outcomes

Many data sources concur that there were approximately 115 million ED visits in 2005. Regional reporting revealed that the largest number of visits occurred in the South. Data sources reported the percent of ED visits resulting in an admission as 12-16%.

Conclusions - Comparison of ED data sources reveal the similarities and differences between each source. For example, survey-based methods can produce reliable estimates; however, discharge data sources may be necessary to improve understanding of rare events and to understand the effects of facility characteristics on care delivery.

Learning Objectives:
1. Identify emergency department (ED) visit data sources 2. Compare visit counts from ED data sources 3. Assess the similarities and differences between ED data sources 4. Understand the strengths and potential uses of each ED data source

Keywords: Emergency Department/Room, Data/Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I actively participated in the design, concept, data analysis and writing of the study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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