Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-26T05:23:52.606Z Has data issue: false hasContentIssue false
  • English
  • Français

Insight Into Health Care Services: A Characterization of Emergency Room Visits and Economic Hazards in the United States

Published online by Cambridge University Press:  08 August 2018

Hanadi Hamadi Open the ORCID record for Hanadi Hamadi [Opens in a new window] ,
Emma Apatu ,
Osayande Osagiede  and
Aaron Spaulding
Hanadi Hamadi*
Affiliation:
Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida
Emma Apatu
Affiliation:
Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida
Osayande Osagiede
Affiliation:
Department of Health Sciences Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo Clinic, Jacksonville, Florida
Aaron Spaulding
Affiliation:
Department of Health Sciences Research, and Division of Health Care Policy and Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida
*
Correspondence and reprint requests to Dr Hanadi Hamadi, Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study explores the impact of economic hazard areas on hospital-based emergency departments to determine whether economically hazardous environments, characterized by the change of population, income per capita, and unemployment rate, experience a higher number of emergency room visits than areas of lower rated economic hazard risk in the United States.

Method

A cross-sectional design was used of a nationally constructed data set of hospital-based emergency departments of over 6,000 hospitals in the United States. We identified our quality outcome measure as the emergency room visits rate within a hospital service area. We created the variable by dividing the number of emergency room visits by the population of the hospital services area in which the emergency room was located.

Results

Results indicate that there is a difference in the incident rate ratio of emergency room visits between environments considered to be experiencing greater amounts of hazard, compared to lower amounts of hazard.

Conclusion

Hospital administrators and health policy-makers need to work in conjunction to focus efforts on public safety as a key objective in the delivery of emergency medical care. One crucial effort that hospital administrators need to focus on is improving emergency room capacity and efficiency as part of the disaster preparedness plan (Disaster Med Public Health Prep. 2019;13:470-475)

Keywords

economic hazardemergency departmentemergency room visitshospital capacityPoisson regression
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 3 , June 2019 , pp. 470 - 475
Copyright
Copyright © 2018 Society for Disaster Medicine and Public Health, Inc. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Di Somma, S, Paladino, L, Vaughan, L, et al. Overcrowding in emergency department: an international issue. Intern Emerg Med. 2015;10(2):171-175.Google Scholar
2. Kellermann, AL. Crisis in the emergency department. N Engl J Med. 2006;355(13):1300-1303.Google Scholar
3. Barish, RA, McGauly, PL, Arnold, TC. Emergency room crowding: a marker of hospital health. Trans Am Clin Climatol Assoc. 2012;123:304-311.Google Scholar
4. U.S. Department of Health and Human Services. A tool for identifying, tracking, and analyzing national hospital statistics. 2016. http://hcupnet.ahrq.gov/HCUPnet.jsp?Id=195EA53627FCF10D&Form=DispTab&JS=Y&Action=Accept. Accessed October 10, 2016.Google Scholar
5. Lucas, R, Farley, H, Twanmoh, J, et al. Measuring the opportunity loss of time spent boarding admitted patients in the emergency department: a multihospital analysis. J Healthc Manag. 2009;54(2):117-124. discussion 124-115.Google Scholar
6. Falvo, T, Grove, L, Stachura, R, et al. The opportunity loss of boarding admitted patients in the emergency department. Acad Emerg Med. 2007;14(4):332-337.Google Scholar
7. Trzeciak, S, Rivers, EP. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J. 2003;20(5):402-405.Google Scholar
8. Hudon, C, Sanche, S, Haggerty, JL. Personal characteristics and experience of primary care predicting frequent use of emergency department: a prospective cohort study. PLoS One. 2016;11(6):e0157489.Google Scholar
9. Kangovi, S, Barg, FK, Carter, T, et al. Understanding why patients of low socioeconomic status prefer hospitals over ambulatory care. Health Affairs. 2013;32(7):1196-1203.Google Scholar
10. Obama, B. United States healthcare reform: progress to date and next steps. JAMA. 2016;316:525-532.Google Scholar
11. Rudowitz, R, Rowland, D, Shartzer, A. Health care in New Orleans before and after Hurricane Katrina. Health Affairs. 2006;25(5):w393-w406.Google Scholar
12. Laska, S, Morrow, BH. Social vulnerabilities and Hurricane Katrina: an unnatural disaster in New Orleans. Mar Technol Soc J. 2006;40(4):16-26.Google Scholar
13. Hartman, C, Squires, GD. There Is No Such Thing as a Natural Disaster: Race, Class, and Hurricane Katrina. New York, Routledge; 2006.Google Scholar
14. Schumacher, I, Strobl, E. Economic development and losses due to natural disasters: the role of hazard exposure. Ecol Econ. 2011;72:97-105.Google Scholar
15. Proag, V. The concept of vulnerability and resilience. Procedia Econ Financ. 2014;18:369-376.Google Scholar
16. Watts, SH, David Bryan, E, Tarwater, PM. Changes in insurance status and emergency department visits after the 2008 economic downturn. Acad Emerg Med. 2015;22(1):73-80.Google Scholar
17. Consortium NSE. Economic hazards. 2014. http://nesec.org/economic-hazards/ Accessed October 12, 2016.Google Scholar
18. Hong, L, Liu, Y, Hottel, TL, et al. Neighborhood socio-economic context and emergency department visits for dental care in a U.S. Midwestern metropolis. Public Health. 2015;129(3):252-257.Google Scholar
19. Suruda, A, Burns, TJ, Knight, S, Dean, JM. Health insurance, neighborhood income, and emergency department usage by Utah children, 1996-1998. BMC Health Serv Res. 2005;5(1):29.Google Scholar
20. Li, G, Grabowski, JG, McCarthy, ML, Kelen, GD. Neighborhood characteristics and emergency department utilization. Acad Emerg Med. 2003;10(8):853-859.Google Scholar
21. Khan, Y, Glazier, RH, Moineddin, R, Schull, MJ. A population-based study of the association between socioeconomic status and emergency department utilization in Ontario, Canada. Acad Emerg Med. 2011;18(8):836-843.Google Scholar
22. American Hospital Association. Hospital statistics. 2014. https://www.aha.org/statistics/2017-01-10-fast-facts-us-hospitals-2017-pdf. Accessed October 11, 2016.Google Scholar
23. Pickle, LW. Atlas of United States Mortality. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services; 1996.Google Scholar
24. Centers for Medicare and Medicaid Services. CMS data navigator. 2012. https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/NonIdentifiableDataFiles/HospitalServiceAreaFile.html. Accessed October 6, 2016.Google Scholar
25. Lemeshow, S, Hosmer, DW. A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol. 1982;115(1):92-106.Google Scholar
26. Warden, G, Griffin, R, Erickson, S, et al. Institute of Medicine. Hospital-based emergency care: at the breaking point. 2007. https://doi.org/10.17226/11621.Google Scholar
27. Driscoll, AK, Bernstein, AB. Health and access to care among employed and unemployed adults: United States, 2009-2010. NCHS Data Brief. 2012;83:1-8.Google Scholar
28. Hughes, DR, Khaliq, AA. The effect of macroeconomic conditions on the care decisions of the employed. Med Care. 2014;52(2):121-127.Google Scholar
29. Tang, N, Stein, J, Hsia, RY, et al. Trends and characteristics of US emergency department visits, 1997-2007. JAMA. 2010;304(6):664-670.Google Scholar
30. Ștefan, SC, Popa, I, Dobrin, CO. Towards a model of sustainable competitiveness of health organizations. Sustainability. 2016;8(5):464.Google Scholar
31. Commission, FT. Improving healthcare. A dose of competition. Dev Health Econ Public Policy. 2005;9:vii.Google Scholar
32. Majerol, M, Newkirk, V, Garfield, R. The uninsured: a primer – key facts about health insurance and the uninsured in America. Kaiser Family Foundation. Published December 2014. https://www.kff.org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-under-the-affordable-care-act/. Accessed September 29, 2016.Google Scholar
33. Bernstein, J. Impact of the economy on health care. Robert Wood Johnson Foundation; 2009. http://hcfo.org/files/hcfo/findings0809_0.pdf Accessed October 10, 2016.Google Scholar