The Impact of a New Emergency Department on Healthcare Utilization by Delaware Medicaid Clients PDF Download

Author: Kathryn R. Gifford
Publisher:
ISBN: 9781369351477
Category :
Languages : en
Pages : 169

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Book Description
A new Emergency Department (ED) opened in Middletown, Delaware in 2013. This research used two years of data from a balanced panel of Medicaid clients to compare healthcare utilization, including ED use, from one year before and one year after the opening of the new ED. Since out-of-pocket expenses for an ED visit are low, travel time represents one of the Medicaid client's main "costs" and can drive increased ED use, including potential over-use for non-emergent issues. This research sought to answer the following question: What was the impact of a new Emergency Department on healthcare utilization by Delaware Medicaid clients? Methods included geospatial analysis and service area computation in ArcGIS, the application of the NYU ED visit severity algorithm, logistic regression to model the likelihood of having at least one ED visit, and negative binomial regression and seemingly unrelated regression (SUR) to model the count of ED visits. Results showed that a reduction in travel time was associated with significantly increased ED use, and lower diagnosis acuity. Medicaid clients in the vicinity of the new ED, as measured by zip code of residence and drive time calculated in ArcGIS, showed sharply increased likelihood of an ED visit and a lower acuity of the average diagnosis as estimated by the NYU ED visit severity algorithm. Utilization of other physician office visits and hospitalizations were not significantly affected, but a localized decrease in urgent care center use was observed. These results could help public health officials anticipate demand for ED services based on Medicaid clients' geographic distribution.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133769
Category : Medical
Languages : en
Pages : 360

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Book Description
Children represent a special challenge for emergency care providers, because they have unique medical needs in comparison to adults. For decades, policy makers and providers have recognized the special needs of children, but the system has been slow to develop an adequate response to their needs. This is in part due to inadequacies within the broader emergency care system. Emergency Care for Children examines the challenges associated with the provision of emergency services to children and families and evaluates progress since the publication of the Institute of Medicine report Emergency Medical Services for Children (1993), the first comprehensive look at pediatric emergency care in the United States. This new book offers an analysis of: • The role of pediatric emergency services as an integrated component of the overall health system. • System-wide pediatric emergency care planning, preparedness, coordination, and funding. • Pediatric training in professional education. • Research in pediatric emergency care. Emergency Care for Children is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency health care providers, professional organizations, and policy makers looking to address the pediatric deficiencies within their emergency care systems.

Author: National Academies of Sciences Engineering and Medicine
Publisher:
ISBN: 9780309685061
Category :
Languages : en
Pages :

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Book Description
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

Author: Machester Triage Group
Publisher: John Wiley & Sons
ISBN: 0470757280
Category : Medical
Languages : en
Pages : 195

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Book Description
The Manchester Triage System (MTS) is the most widely used triagesystem in the UK, Europe and Australia, with tens of millions ofpatients being processed through hospital emergencydepartments. Emergency Triage is the core text for the MTS which utilises arisk averse system of prioritisation for patients in allunscheduled care settings, and as such it is an essential text forall emergency department staff using the MTS, in particular triagenurses themselves. The second edition has been revised throughout and takes in thechanges in practice introduced into MTS since the book was firstpublished. These include: Redesigned and expanded flow charts Additional charts for allergy and palpitations New practices - such as the possibility of revascularisation forpatients with stroke New discriminators, for example acute neurological deficit andsignificant respiratory history Redefinition of existing discriminators Also new to this edition is the incorporation of sections on theuse of the risk averse system in telephone triage, in settingswhere ‘streaming’ takes place and as an early warningscore for patients in all unscheduled care settings. The tone ofthis edition reflects the more up to date, modified approach totriage while retaining the principles of clinical prioritisation,which in the authors’ words “remains a central plank ofclinical risk management in emergency care”. Emergency Triage is an essential handbook for all cliniciansinvolved in unscheduled care settings such as emergency care, walkin centres, minor injury units, primary care out of hoursservices.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161

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Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Author: American Dental Association
Publisher: American Dental Association
ISBN: 1684470552
Category : Medical
Languages : en
Pages : 186

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Book Description
Get paid faster and keep more detailed patient records with CDT 2020: Dental Procedure Codes. New and revised codes fill in the coding gaps, which leads to quicker reimbursements and more accurate record keeping. CDT 2020 is the most up-to-date coding resource and the only HIPAA-recognized code set for dentistry. 2020 code changes include: 37 new codes, 5 revised codes, and 6 deleted codes. The new and revised codes reinforce the connection between oral health and overall health, help with assessing a patient’s health via measurement of salivary flow, and assist with case management of patients with special healthcare needs. Codes are organized into 12 categories of service with full color charts and diagrams throughout, in spiral bound format for easy searching. Includes a chapter on ICD-10-CM codes. CDT 2020 codes go into effect on January 1, 2020 – don’t risk rejected claims by using outdated codes.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309669820
Category : Social Science
Languages : en
Pages : 369

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Book Description
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309391970
Category : Medical
Languages : en
Pages : 95

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Book Description
The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

Author: National Center for Health Statistics
Publisher: Government Printing Office
ISBN: 9780160939778
Category : Health & Fitness
Languages : en
Pages : 494

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Book Description
This annual overview report of national trends in health statistics contains a Chartbook that assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health-care expenditures. Chapters devoted to population characteristics, prevention, health risk factors, health care resources, personal health care expenditures, health insurance, and trend tables may provide the health/medical statistician, data analyst, biostatistician with additional information to complete experimental studies or provide necessary research for pharmaceutical companies to gain data for modeling and sampling. Undergraduate students engaged in applied mathematics or statistical compilations to graduate students completing biostatistics degree programs to include statistical inference principles, probability, sampling methods and data analysis as well as specialized medical statistics courses relating to epidemiology and other health topics may be interested in this volume. Related products: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports available here: https://bookstore.gpo.gov/products/your-guide-choosing-nursing-home-or-other-long-term-services-supports Health Insurance Coverage in the United States, 2014 available here: https://bookstore.gpo.gov/products/health-insurance-coverage-united-states-2014 "Some System of the Nature Here Proposed": Joseph Lovell's Remarks on the Sick Report, Northern Department, U.S. Army, 1817, and the Rise of the Modern US Army Medical Department can be found here: https://bookstore.gpo.gov/products/some-system-nature-here-proposed-joseph-lovells-remarks-sick-report-northern-department-us Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force (ePub) -Free digital eBook download available at the US Government Online Bookstore here: https://bookstore.gpo.gov/products/guide-clinical-preventive-services-2014-recommendations-us-preventive-services-task-force --Also available for FREE digital eBook download from Apple iBookstore, BarnesandNoble.com (Nook Bookstore), Google Play eBookstore, and Overdrive -Please use ISBN: 9780160926426 to search these commercial platforms.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309144337
Category : Medical
Languages : en
Pages : 852

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Book Description
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.