Cost variation and revisit rate for adult patients with asthma presenting to the emergency department.
Cost variation and revisit rate for adult patients with asthma presenting to the emergency department.
复制标题
DOI：
10.1016/j.ajem.2022.09.021
复制
发表时间：
2022-11
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
哮喘很常见，每年有5300万人次到急诊科就诊。关于ED哮喘护理的成本和质量的差异，人们知之甚少。我们试图描述急诊室间哮喘护理费用和7天急诊室复诊率的差异。我们的主要目标是测试ED费用与7天内再次发作哮喘的可能性之间的关系。我们使用2014年佛罗里达州急诊部数据库对出院的18岁初步诊断为哮喘的患者进行了一项≥急诊室就诊的观察性研究。我们比较了有和没有7天复诊的患者和医院出院指数ED的特征，然后测试了ED复诊和ED指数费用之间的关联。多水平回归用于解释医院水平的聚集性。2014年，有54,060名成人急诊科因哮喘而出院，其中1,667人(3%)在7天内因哮喘相关的急诊科再次就诊。一次ED哮喘护理的中位数成本为597美元，四分位数范围为371-980美元。在调整了患者和医院的特征后，缺乏保险与较高的再就诊几率相关(OR 1.42，95%可信区间1.18-1.71)，而私人保险、女性和年龄与较低的再就诊几率相关。住院费用与急诊复诊无关(OR=1.00；95%CI为1.00~1.00)。与急性期哮喘就诊相关的医院费用各不相同，但与急性期再次就诊的几率无关。
Asthma is common, resulting in 53 million emergency department (ED) visits annually. Little is known about variation in cost and quality of ED asthma care. We sought to describe variation in costs and 7-day ED revisit rates for asthma care across EDs. Our primary objective was to test for an association between ED costs and the likelihood of a 7-day revisit for another asthma exacerbation. We used the 2014 Florida State Emergency Department Database to perform an observational study of ED visits by patients ≥18 years old with a primary diagnosis of asthma that were discharged home. We compared patient and hospital characteristics of index ED discharges with and without 7-day revisits, then tested the association between ED revisits and index ED costs. Multilevel regression was performed to account for hospital-level clustering. In 2014, there were 54,060 adult ED visits for asthma resulting in discharge, and 1,667 (3%) were associated with an asthma-related ED revisit within 7 days. Median cost for an episode of ED asthma care was $597 with an interquartile range of $371–980. After adjusting for both patient and hospital characteristics, lack of insurance was associated with higher odds of revisit (OR 1.42, 95% CI 1.18–1.71), while private insurance, female gender, and older age were associated with lower odds of revisit. Hospital costs were not associated with ED revisits (OR = 1.00; 95% CI 1.00–1.00). Hospital costs associated with ED asthma visits vary but are not associated with odds of ED revisit.
登录
查看更多内容
影响因子：
39.2
作者：
Hussey PS;Wertheimer S;Mehrotra A
通讯作者：
Mehrotra A
影响因子：
39.2
作者：
Duseja, Reena;Bardach, Naomi S.;Dudley, R. Adams
通讯作者：
Dudley, R. Adams
影响因子：
8.3
作者：
Nurmagambetov, Tursynbek;Kuwahara, Robin;Garbe, Paul
通讯作者：
Garbe, Paul
影响因子：
8
作者：
Guttmann, Astrid;Zagorski, Brandon;Anderson, Geoff
通讯作者：
Anderson, Geoff
影响因子：
2.8
作者：
Banerjee S;Paasche-Orlow MK;McCormick D;Lin MY;Hanchate AD
通讯作者：
Hanchate AD