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FSED Research

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31 papers 0 to 25 followers
By Cedric Dark MD, MPH, FACEP, FAAEM
Jesse M Pines, Mark S Zocchi, Bernard S Black
OBJECTIVE: We compare case mix, hospitalization rates, length of stay (LOS), and resource use in independent freestanding emergency departments (FSEDs) and hospital-based emergency departments (H-EDs). METHODS: Data from 74 FSEDs (2013-2015) in Texas and Colorado were compared to H-ED data from the 2013-2014 National Hospital Ambulatory Medical Care Survey. In the unrestricted sample, large differences in visit characteristics (e.g., payer and case mix) were found between patients that use FSEDs compared to H-EDs...
January 30, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Erin L Simon, Cedric Dark, Mitch Kovacs, Sunita Shakya, Craig A Meek
BACKGROUND: Recently, freestanding emergency departments (FSEDs) have grown significantly in number. Critics have expressed concern that FSEDs may increase healthcare costs. OBJECTIVE: We determined whether admission rates for identical diagnoses varied among the same group of physicians according to clinical setting. METHODS: This was a retrospective comparison of adult admission rates (n=3230) for chest pain, chronic obstructive pulmonary disease (COPD), asthma, and congestive heart failure (CHF) between a hospital-based ED (HBED) and two FSEDs throughout 2015...
October 29, 2017: American Journal of Emergency Medicine
John R Dayton, Cedric K Dark, Eric S Cruzen, Erin L Simon
No abstract text is available yet for this article.
January 2018: American Journal of Emergency Medicine
Jeremiah D Schuur, Donald M Yealy, Michael L Callaham
No abstract text is available yet for this article.
December 2017: Annals of Emergency Medicine
Michael L Callaham
No abstract text is available yet for this article.
December 2017: Annals of Emergency Medicine
Cedric Dark, Yingying Xu, Vivian Ho
Freestanding emergency departments (EDs) are a relatively novel phenomenon, and the epicenter of this movement is in Texas. Limited evidence exists about the communities in which freestanding EDs locate or the possible reasons behind location choice. We estimated logistic regressions to determine whether freestanding EDs in 2016 were more likely to be in areas of high demand or in those that could yield high profits. When we compared Public Use Microdata Areas that contained freestanding EDs and those that did not, we found that areas with such EDs had significantly higher household incomes...
October 1, 2017: Health Affairs
Nitish Patidar, Robert Weech-Maldonado, Stephen J O'Connor, Bisakha Sen, Jerry M Trimm, Carlos A Camargo
The number of freestanding emergency departments (FSEDs) is growing rapidly in the United States. Proponents of FSEDs cite potential benefits of FSEDs including lower waiting time and reduced travel distance for needed emergency care. Others have suggested that increased access to emergency care may lead to an increase in the use of emergency departments for lower acuity patients, resulting in higher overall health care expenditures. We examined the relationship between the number of FSEDs in each county and total Medicare expenditures between 2003 and 2009...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Rachel Root, Paul Krogh, Kristi Gullickson, Barbara Hintzen, Martha Christophersen, Steven Kastendieck, Matt Kresl
No abstract text is available yet for this article.
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
Vivian Ho, Leanne Metcalfe, Cedric Dark, Lan Vu, Ellerie Weber, George Shelton, Howard R Underwood
STUDY OBJECTIVE: We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. METHODS: We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type...
December 2017: Annals of Emergency Medicine
Mark E A Escott
No abstract text is available yet for this article.
December 2015: JEMS: a Journal of Emergency Medical Services
Erin L Simon, Gregory Griffin, Kseniya Orlik, Zhenyu Jia, Dave Hayslip, Daniel Kobe, Nicholas Jouriles
BACKGROUND: It has been speculated that freestanding emergency departments (FEDs) draw more affluent, better-insured patients away from urban hospital EDs. It is believed that this leaves urban hospital-based EDs less financially secure. OBJECTIVE: We examined whether the distribution of patients with four types of insurance (self-pay, Medicaid, Medicare, and private) at the main ED changed after opening three affiliated FEDs, and whether the insurance type distribution was different between main ED and FEDs and between individual FEDs...
October 2016: Journal of Emergency Medicine
Robert L Kerner, Kathleen Gallo, Michael Cassara, John D ľAngelo, Anthony Egan, John Galbraith Simmons
Simulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among the entire cohort of 43 experienced emergency physicians, physician assistants, nurses, and patient technicians, most newly hired to the health system, who had never before worked together...
October 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Catherine Gutierrez, Rachel A Lindor, Olesya Baker, David Cutler, Jeremiah D Schuur
Freestanding emergency departments (EDs), which offer emergency medical care at sites separate from hospitals, are a rapidly growing alternative to traditional hospital-based EDs. We evaluated state regulations of freestanding EDs and describe their effect on the EDs' location, staffing, and services. As of December 2015, thirty-two states collectively had 400 freestanding EDs. Twenty-one states had regulations that allowed freestanding EDs, and twenty-nine states did not have regulations that applied specifically to such EDs (one state had hospital regulations that precluded them)...
October 1, 2016: Health Affairs
Jeremiah D Schuur, Olesya Baker, Jaclyn Freshman, Michael Wilson, David M Cutler
STUDY OBJECTIVE: We determine the number and location of freestanding emergency departments (EDs) across the United States and determine the population characteristics of areas where freestanding EDs are located. METHODS: We conducted a systematic inventory of US freestanding EDs. For the 3 states with the highest number of freestanding EDs, we linked demographic, insurance, and health services data, using the 5-digit ZIP code corresponding to the freestanding ED's location...
April 2017: Annals of Emergency Medicine
Nitish Patidar, Robert Weech-Maldonado, Stephen J O'Connor, Bisakha Sen, J M Mickey Trimm, Carlos A Camargo
BACKGROUND: Freestanding emergency departments (FSEDs) are fast growing entities in health care, delivering emergency care outside of hospitals. Hospitals may benefit in several ways by opening FSEDs. PURPOSE: The study used the resource dependence theory as a means to analyze the relationship between market and organizational factors and the likelihood of hospitals to operate FSEDs. METHODOLOGY: All acute care hospitals in 14 states with FSEDs present during the study period from 2002 to 2011...
July 2017: Health Care Management Review
Philip Libassi
No abstract text is available yet for this article.
June 2013: Health Facilities Management
Benjamin J Lawner, Jon Mark Hirshon, Angela C Comer, Jose V Nable, Jeffrey Kelly, Richard L Alcorta, Laura Pimentel, Christina L Tupe, Mary Alice Vanhoy, Brian J Browne
OBJECTIVE: The objective of the study is to examine the effect of the opening of a freestanding emergency department (FED) on the surrounding emergency medical services (EMS) system through an examination of EMS system metrics such as ambulance call volume, ambulance response times, and turnaround times. METHODS: This study is based on data from the county's computer-aided dispatch center, the FED, and the Maryland Health Services Cost Review Commission. The analysis involved a pre/post design, with a 6-month washout period...
August 2016: American Journal of Emergency Medicine
Kseniya Orlik, Christina M Campana, Michael S Beeson, Erin L Simon
No abstract text is available yet for this article.
August 2015: American Journal of Emergency Medicine
Austin S Kilaru, Douglas J Wiebe, David N Karp, Jennifer Love, Michael J Kallan, Brendan G Carr
BACKGROUND: Effective measurement of health care quality, access, and cost for populations requires an accountable geographic unit. Although Hospital Service Areas (HSAs) and Hospital Referral Regions (HRRs) have been extensively used in health services research, it is unknown whether these units accurately describe patterns of hospital use for patients living within them. OBJECTIVES: To evaluate the ability of HSAs, HRRs, and counties to define discrete health care populations...
June 2015: Medical Care
Erin L Simon, Mitch Kovacs, Zhenyu Jia, Dave Hayslip, Kseniya Orlik, Nicholas Jouriles
INTRODUCTION: Freestanding emergency departments (FEDs) have grown in popularity. They often provide emergent care in areas distant from other EDs. Investigations and research to characterize the operation and dynamics of FEDs are needed. This study characterizes the severity of illness seen at FEDs and compares it with a hospital-based urban tertiary care ED using the emergency severity index (ESI), a quantification of patient acuity. METHODS: Patient ESI levels were analyzed retrospectively over 1 year for a single hospital system with 1 main urban hospital-based ED and 3 FEDs...
April 2015: American Journal of Emergency Medicine
2015-11-17 22:09:26
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