Impact of a statewide Emergency Department Information Exchange on health care use and expenditures.
Impact of a statewide Emergency Department Information Exchange on health care use and expenditures.
复制标题
全州范围内的急诊科信息交换对医疗保健使用和支出的影响。
DOI：
10.1111/1475-6773.13963
复制
发表时间：
2022
影响因子：
3.4
通讯作者：
Basu,Anirban
中科院分区：
文献类型：
--
作者：
Sabbatini,AmberK;McConnell,KJohn;Parrish,Canada;Frogner,BiancaK;Reddy,Ashok;Zatzick,DouglasF;Kreuter,William;Basu,Anirban
目的评估一项计划的影响，该计划要求全州采用急诊科信息交换（EDIE）对医疗保健利用和医疗补助登记者在华盛顿state.Data Source医疗补助索赔和管理式护理遭遇从华盛顿卫生保健管理局。研究设计一个差异中差异分析与趋势被用来比较变化艾德访问，住院，初级保健访问，和支出之间的频繁艾德用户（≥5艾德访问在过去的一年），以那些不频繁的用户通过第二年华盛顿的program.Data ExtractionThe研究人群包括成人医疗补助登记与艾德访问之间的2010年1月和2014年10月。华盛顿的项目与EDIE强制实施后第一年每位登记者每年-0.70艾德就诊率的微小但统计学显著差异变化相关（95% CI：-1.24，-0.16），或频繁使用者基线艾德就诊率的8.2%。然而，实施的第二年，这些影响艾德使用不再显着，也没有任何可衡量的影响住院，初级保健的使用，或在任何periodsConclusionsStateswide实施EDIE是与一个小的减少经常使用者之间的艾德在第一年的计划，但没有改变整体支出或其他利用成果。
ObjectiveTo assess the effects of a program mandating the statewide adoption of an Emergency Department Information Exchange (EDIE) on health care utilization and spending among Medicaid enrollees in Washington state.Data SourceMedicaid claims and managed care encounters from the Washington Health Care Authority.Study DesignA difference‐in‐differences analysis with trends was used to compare changes in ED visits, inpatient admissions, primary care visits, and expenditures among frequent ED users (≥5 ED visits in past year) to those of infrequent users through the second year Washington's program.Data ExtractionThe study population included adult Medicaid enrollees with ED visits between January 2010 and October 2014.Principal FindingsThere were 505,667 ED visits among 153,543 unique enrollees included in the analysis. Washington's program was associated with a small, but statistically significant differential change of −0.70 ED visits per enrollee per year (95% CI: −1.24, −0.16) in the first year after EDIE was mandated, or 8.2% of the baseline ED visit rate among frequent users. However, by the second year of implementation, these effects on ED use were no longer significant, nor were there any measurable effects on inpatient admissions, primary care use, or expenditures in any period.ConclusionsStatewide implementation of EDIE was associated with a small reduction in ED use among frequent users in the first year of the program but did not change overall spending or other utilization outcomes.