MEDICAL MONDAYS: ED UTILIZATION FOR MEDICAID RECIPIENTS DEPENDS ON THE DAY OF THE WEEK, SEASON, AND HOLIDAYS
MEDICAL MONDAYS: ED UTILIZATION FOR MEDICAID RECIPIENTS DEPENDS ON THE DAY OF THE WEEK, SEASON, AND HOLIDAYS
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DOI：
10.1016/j.jen.2015.12.010
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发表时间：
2016-07-01
影响因子：
1.7
通讯作者：
Hewner, Sharon
中科院分区：
文献类型：
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作者：
Castner, Jessica;Yin, Yong;Hewner, Sharon
前言：本研究的目的是描述和解释低收入人群ED使用的时间和季节性趋势。方法：采用自回归移动平均（ARMA）时间序列分析方法，对2009年纽约西部2个县66,487份ED医疗保险索赔进行回顾性分析。结果：最终的ARMA（2,0）模型显示了一个自回归结构，最多滞后2天。ED在周末的交易量低于工作日，周一的交易量最高。夏季和秋季表现出较高的产量，而较低的产量异常值与假日有关。讨论：一周中的哪一天是低收入人群ED使用的一个有影响的预测因子。季节和节假日也是ED使用的预测因子。这些基于日历的模式支持当前和未来应急领导人在重新设计社区保健系统方面进行合作的需求，以满足低收入者获得卫生保健的需求。
Introduction: The purpose of this study is to describe and explain the temporal and seasonal trends in ED utilization for a low-income population.Methods: A retrospective analysis of 66,487 ED Medicaid-insured health care claims in 2009 was conducted for 2 Western New York Counties using time-series analysis with autoregressive moving average (ARMA) models.Results: The final ARMA (2,0) model indicated an autoregressive structure with up to a 2-day lag. ED volume is lower on weekends than on weekdays, and the highest volumes are on Mondays. Summer and fall seasons demonstrated higher volumes, whereas lower volume outliers were associated with holidays.Discussion: Day of the week was an influential predictor of ED utilization in low-income persons. Season and holidays are also predictors of ED utilization. These calendar-based patterns support the need for ongoing and future emergency leaders' collaborations in community-based care system redesign to meet the health care access needs of low-income persons.