PA-20-070 Identifying Predictors of Hospital Admission from the ED Among the Elderly
PA-20-070 Identifying Predictors of Hospital Admission from the ED Among the Elderly
批准号:
10175813
负责人:
Bruce E. Landon
金额:
$39.88万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2017
资助国家:
美国
项目状态:
已结题
起止时间:
2017-09-30 至 2022-08-31
中文摘要
项目总结:
英文摘要
Project Summary:
The ongoing COVID-19 pandemic has had a dramatic impact on emergency care. Reports from around
the country suggest that ED visits for non-COVID related conditions such as acute myocardial infarction and
stroke have plummeted by 30-50%, and anecdotal data suggests that overall visit volume for non-COVID
related conditions has also decreased. Conditional on presenting to the ED, the pandemic also is changing
how ED providers approach the decision to admit a patient to the hospital. There may be a number of
motivations involved in this decision-making, some related to system-level factors such as capacity constraints
and some related to changes in assessments of the risks and benefits of hospitalization for individual patients.
The emergency department (ED) is the primary source for hospital admissions in the US. Over 70% of
hospital admissions among Medicare patients originate from the ED at an extraordinary cost to Medicare.1
Rates of hospital admission from the ED vary widely across regions, hospitals, and even across physicians
within hospitals. A critical need exists to determine the extent to which factors related to the COVID-19
pandemic have altered provider decision-making in the ED and whether these decisions are associated with
greater harm for patients. Lessons learned from these analyses will be vital to guiding ED providers in
approaching the decision to admit during future phases of this pandemic as well as under similar
circumstances that might arise. Moreover, there is a possibility that for some non-COVID related conditions
hospitalization rates pre-COVID-19 were too high (low-value admissions), and that admission rates are now
more optimal. Thus, there could be longer term improvements in the efficiency of the health care delivery
system that can be gained by optimizing the use of inpatient hospital care, its most expensive component.
The proposed study will utilize data on Medicare beneficiaries and their care providers to accomplish three
key aims. Using nationally representative data from the Medicare program aim 1 will examine the extent to
which the COVID-19 pandemic has impacted ED visit rates for specific diagnoses in parts of the country more
and less effected by the pandemic. The second aim will then examine how admission decisions from the ED
have been impacted. Finally, aim 3 will examine the impact of changes in admission on patient outcomes
including 30-day mortality and ED revisits. The second and third aims will use rigorous quasi-experimental
methods to compare changes in the outcomes of interest in areas of the country more and less impacted by
the COVID-19 pandemic. Our central hypotheses are that the rate of admission will be decreased (across a
broad array of non-COVID-19 related conditions) during the time of the pandemic, that greater decreases in
admission will be seen for areas that were particularly impacted by COVID-19, and that these decreases in
admission rates will be associated with worse clinical outcomes.
期刊论文(4)
专著(0)
科研奖励(0)
会议论文
Weak correlations in health services research: Weak relationships or common error?
卫生服务研究中的弱相关性:弱关系还是常见错误?
DOI:
10.1111/1475-6773.13882
发表时间:
2022
期刊:
Health services research
影响因子:
3.4
作者:
[O'Malley,AlistairJames, Landon,BruceE, Zaborski,LawrenceA, Roberts,EricT, Khidir,HazarH, Smulowitz,PeterB, McWilliams,JohnMichael]
通讯作者:
McWilliams,JohnMichael
Association of Functional Status, Cognition, Social Support, and Geriatric Syndrome With Admission From the Emergency Department.
功能状态、认知、社会支持和老年综合症与急诊科入院的关联。
DOI:
10.1001/jamainternmed.2023.2149
发表时间:
2023
期刊:
JAMA internal medicine
影响因子:
39
作者:
[Smulowitz,PeterB, Weinreb,Gabe, McWilliams,JMichael, O'Malley,AJames, Landon,BruceE]
通讯作者:
Landon,BruceE
DOI:
10.1377/hlthaff.2020.00670
发表时间:
2021-02-01
期刊:
HEALTH AFFAIRS
影响因子:
9.7
作者:
[Smulowitz, Peter B., O'Malley, A. James, Landon, Bruce E.]
通讯作者:
Landon, Bruce E.
Risk Aversion, Fear of Malpractice, and Medical Decision Making in the Emergency Department
-
批准号:10474364
-
项目类别:
-
资助金额:$38.36万
-
财政年份:2019
-
负责人:Bruce E. Landon
-
依托单位:
Comparing Targeted and Non-Targeted Approaches to Improving the Value of Cancer Care Services
-
批准号:9895590
-
项目类别:
-
资助金额:$37.18万
-
财政年份:2019
-
负责人:Bruce E. Landon
-
依托单位:
Risk Aversion, Fear of Malpractice, and Medical Decision Making in the Emergency Department
-
批准号:10242666
-
项目类别:
-
资助金额:$39.03万
-
财政年份:2019
-
负责人:Bruce E. Landon
-
依托单位:
Comparing Targeted and Non-Targeted Approaches to Improving the Value of Cancer Care Services
-
批准号:10374837
-
项目类别:
-
资助金额:$40.0万
-
财政年份:2019
-
负责人:Bruce E. Landon
-
依托单位:
Identifying Predictors of Hospital Admission from the ED Among the Elderly
-
批准号:9365351
-
项目类别:
-
资助金额:$36.0万
-
财政年份:2017
-
负责人:Bruce E. Landon
-
依托单位:
Identifying Predictors of Hospital Admission from the ED Among the Elderly
-
批准号:10015296
-
项目类别:
-
资助金额:$36.0万
-
财政年份:2017
-
负责人:Bruce E. Landon
-
依托单位:
Long Term Outcomes of Open Versus Endovascular AAA Repair
-
批准号:8205001
-
项目类别:
-
资助金额:$62.27万
-
财政年份:2010
-
负责人:Bruce E. Landon
-
依托单位:
Long Term Outcomes of Open Versus Endovascular AAA Repair
-
批准号:8536355
-
项目类别:
-
资助金额:$60.16万
-
财政年份:2010
-
负责人:Bruce E. Landon
-
依托单位:
Long Term Outcomes of Open Versus Endovascular AAA Repair
-
批准号:8020566
-
项目类别:
-
资助金额:$73.35万
-
财政年份:2010
-
负责人:Bruce E. Landon
-
依托单位:
Improving Medicare in an Era of Change: Deaths in Long-Term Care Facilities During the COVID-19 Era
-
批准号:10288393
-
项目类别:
-
资助金额:$45.01万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Looking Under the Hood of MA
-
批准号:10379883
-
项目类别:
-
资助金额:$30.6万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Administrative Core
-
批准号:10379880
-
项目类别:
-
资助金额:$12.45万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Improving Medicare in an Era of Change: Impact of Private Equity Acquisitions of Hospitals and Physicians on the Care of Medicare Beneficiaries with ADRD
-
批准号:10714444
-
项目类别:
-
资助金额:$42.29万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Administrative Core
-
批准号:10616693
-
项目类别:
-
资助金额:$13.33万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Administrative Core
-
批准号:10196899
-
项目类别:
-
资助金额:$12.78万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Improving Medicare in an Era of Change: Post-Acute Use and Outcomes During the Pandemic for Patients with Dementia
-
批准号:10288010
-
项目类别:
-
资助金额:$43.37万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Medicare in a Restructured Delivery System
-
批准号:9756126
-
项目类别:
-
资助金额:$176.84万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Administrative Core
-
批准号:10379887
-
项目类别:
-
资助金额:$43.67万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
Improving Medicare in an Era of Change
-
批准号:10196897
-
项目类别:
-
资助金额:$181.22万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
A Research Agenda for the Patient Centered Medical Home
-
批准号:7645339
-
项目类别:
-
资助金额:$4.6万
-
财政年份:2009
-
负责人:Bruce E. Landon
-
依托单位:
国内基金
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