Amber K Sabbatini1, K John McConnell2, Canada Parrish1, Bianca K Frogner3, Ashok Reddy4, Douglas F Zatzick5, William Kreuter6, Anirban Basu7. 1. Department of Emergency Medicine, University of Washington, Seattle, Washington, USA. 2. Department of Emergency Medicine, Oregon Health and Sciences University, Portland, Oregon, USA. 3. Department of Family Medicine, University of Washington, Seattle, Washington, USA. 4. Division of General Internal Medicine, University of Washington, Seattle, Washington, USA. 5. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA. 6. Department of Pharmacy, University of Washington, Seattle, Washington, USA. 7. Comparative Health Outcomes, Policy and Economics (CHOICE) Institute in Department of Pharmacy, University of Washington, Seattle, Washington, USA.
Abstract
OBJECTIVE: To 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 SOURCE: Medicaid claims and managed care encounters from the Washington Health Care Authority. STUDY DESIGN: A 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 EXTRACTION: The study population included adult Medicaid enrollees with ED visits between January 2010 and October 2014. PRINCIPAL FINDINGS: There 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. CONCLUSIONS: Statewide 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.
OBJECTIVE: To 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 SOURCE: Medicaid claims and managed care encounters from the Washington Health Care Authority. STUDY DESIGN: A 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 EXTRACTION: The study population included adult Medicaid enrollees with ED visits between January 2010 and October 2014. PRINCIPAL FINDINGS: There 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. CONCLUSIONS: Statewide 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.
Authors: Malcolm B Doupe; Wes Palatnick; Suzanne Day; Dan Chateau; Ruth-Ann Soodeen; Charles Burchill; Shelley Derksen Journal: Ann Emerg Med Date: 2012-02-02 Impact factor: 5.721
Authors: Fabrice Althaus; Sophie Paroz; Olivier Hugli; William A Ghali; Jean-Bernard Daeppen; Isabelle Peytremann-Bridevaux; Patrick Bodenmann Journal: Ann Emerg Med Date: 2011-07 Impact factor: 5.721
Authors: Robert S Rudin; Courtney A Gidengil; Zachary Predmore; Eric C Schneider; James Sorace; Rachel Hornstein Journal: Rand Health Q Date: 2017-06-19
Authors: Jessica Moe; Scott W Kirkland; Erin Rawe; Maria B Ospina; Ben Vandermeer; Sandy Campbell; Brian H Rowe Journal: Acad Emerg Med Date: 2017-01 Impact factor: 3.451
Authors: Amber K Sabbatini; K John McConnell; Canada Parrish; Bianca K Frogner; Ashok Reddy; Douglas F Zatzick; William Kreuter; Anirban Basu Journal: Health Serv Res Date: 2022-03-13 Impact factor: 3.734
Authors: Susan L Hayes; Claudia A Salzberg; Douglas McCarthy; David C Radley; Melinda K Abrams; Tanya Shah; Gerard F Anderson Journal: Issue Brief (Commonw Fund) Date: 2016-08
Authors: Benjamin C Sun; Christina J Charlesworth; Nicoleta Lupulescu-Mann; Jenny I Young; Hyunjee Kim; Daniel M Hartung; Richard A Deyo; K John McConnell Journal: Ann Emerg Med Date: 2017-12-13 Impact factor: 5.721
Authors: Amber K Sabbatini; K John McConnell; Canada Parrish; Bianca K Frogner; Ashok Reddy; Douglas F Zatzick; William Kreuter; Anirban Basu Journal: Health Serv Res Date: 2022-03-13 Impact factor: 3.734