Despite concerns that safety-net hospitals may be unfairly penalized for not meeting emergency department quality measures, research published in the Journal of the American Medical Association suggests otherwise.
Relying on data from the 2008 National Hospital Ambulatory Medical Care Survey, researchers examined the performance of hospital EDs with respect to length of stay measures for admitted, discharged, transferred and observed patients.
Researchers ultimately included 72.1 percent of visits in the 2008 NHAMCS, which covers 396 hospitals and 34,134 patient records. Of these visits, 42.3 percent were seen in safety-net EDs and 57.7 percent in non-safety net EDs.
Their results suggest outcomes for length of stay were relatively comparable between safety-net EDs and non-safety net EDs. Notable findings from the analysis include the following points:
• Patients treated at safety-net EDs were less likely to need emergency or urgent care in both admitted and discharged populations.
• The median ED length of stay was 269 minutes for safety-net EDs vs. 281 minutes for non-safety-net EDs.
• Critical care admissions accounted for 12.5 percent of all admissions to safety-net EDs and 13.2 percent in non-safety net EDs.
• The median ED length of stay for critical care admissions was 236 minutes at safety-net EDs vs. 248 minutes at non-safety net EDs.
• The median ED length of stay for discharged patients was 156 minutes at safety-net EDs vs. 148 minutes at non-safety net EDs.
• The median ED length of stay for observations was 355 minutes at safety-net EDs vs. 298 minutes at non-safety net EDs.
• The median ED length of stay for transfers was 235 minutes at safety-net EDs vs. 239 minutes at non-safety net EDs.
"Although concerns have been raised that performance measures, particularly those linked to payment, may ultimately penalize safety-net institutions that are already underfunded and that care for a disproportionate volume of patients with poorer health care status, our findings suggest that those concerns about ED length of stay will not penalize safety-net institutions," the authors wrote.
Relying on data from the 2008 National Hospital Ambulatory Medical Care Survey, researchers examined the performance of hospital EDs with respect to length of stay measures for admitted, discharged, transferred and observed patients.
Researchers ultimately included 72.1 percent of visits in the 2008 NHAMCS, which covers 396 hospitals and 34,134 patient records. Of these visits, 42.3 percent were seen in safety-net EDs and 57.7 percent in non-safety net EDs.
Their results suggest outcomes for length of stay were relatively comparable between safety-net EDs and non-safety net EDs. Notable findings from the analysis include the following points:
• Patients treated at safety-net EDs were less likely to need emergency or urgent care in both admitted and discharged populations.
• The median ED length of stay was 269 minutes for safety-net EDs vs. 281 minutes for non-safety-net EDs.
• Critical care admissions accounted for 12.5 percent of all admissions to safety-net EDs and 13.2 percent in non-safety net EDs.
• The median ED length of stay for critical care admissions was 236 minutes at safety-net EDs vs. 248 minutes at non-safety net EDs.
• The median ED length of stay for discharged patients was 156 minutes at safety-net EDs vs. 148 minutes at non-safety net EDs.
• The median ED length of stay for observations was 355 minutes at safety-net EDs vs. 298 minutes at non-safety net EDs.
• The median ED length of stay for transfers was 235 minutes at safety-net EDs vs. 239 minutes at non-safety net EDs.
"Although concerns have been raised that performance measures, particularly those linked to payment, may ultimately penalize safety-net institutions that are already underfunded and that care for a disproportionate volume of patients with poorer health care status, our findings suggest that those concerns about ED length of stay will not penalize safety-net institutions," the authors wrote.
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