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2016 ; 6
(8
): e011739
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Validation of an algorithm to determine the primary care treatability of
emergency department visits
#MMPMID27566637
Jeffery MM
; Bellolio MF
; Wolfson J
; Abraham JM
; Dowd BE
; Kane RL
BMJ Open
2016[Aug]; 6
(8
): e011739
PMID27566637
show ga
OBJECTIVES: We propose a new claims-computable measure of the primary care
treatability of emergency department (ED) visits and validate it using a
nationally representative sample of Medicare data. STUDY DESIGN AND SETTING: This
is a validation study using 2011-2012 Medicare claims data for a nationally
representative 5% sample of fee-for-service beneficiaries to compare the new
measure's performance to the Ballard variant of the Billings algorithm in
predicting hospitalisation and death following an ED visit. OUTCOMES:
Hospitalisation within 1?day or 1?week of an ED visit; death within 1?week or
1?month of an ED visit. RESULTS: The Minnesota algorithm is a strong predictor of
hospitalisations and deaths, with performance similar to or better than the most
commonly used existing algorithm to assess the severity of ED visits. The
Billings/Ballard algorithm is a better predictor of death within 1?week of an ED
visit; this finding is entirely driven by a small number of ED visits where
patients appear to have been dead on arrival. CONCLUSIONS: The procedure-based
approach of the Minnesota algorithm allows researchers to use the clinical
judgement of the ED physician, who saw the patient to determine the likely
severity of each visit. The Minnesota algorithm may thus provide a useful tool
for investigating ED use in Medicare beneficiaries.
|*Algorithms
[MESH]
|*Emergency Service, Hospital
[MESH]
|*Hospital Mortality
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Fee-for-Service Plans
[MESH]
|Female
[MESH]
|Hospitalization/*statistics & numerical data
[MESH]