Emergency department and inpatient hospital use by Medicare beneficiaries in patient-centered medical homes.


STUDY OBJECTIVE:Patient-centered medical homes are primary care practices that focus on coordinating acute and preventive care. Such practices can obtain patient-centered medical home recognition from the National Committee for Quality Assurance. We compare growth rates for emergency department (ED) use and costs of ED visits and hospitalizations (all-cause and ambulatory-care-sensitive conditions) between patient-centered medical homes recognized in 2009 or 2010 and practices without recognition. METHODS:We studied a sample of US primary care practices and federally qualified health centers: 308 with and 1,906 without patient-centered medical home recognition, using fiscal year 2008 to 2010 Medicare fee-for-service data. We assessed average annual practice-level payments per beneficiary for ED visits and hospitalizations and rates of ED visits and hospitalizations (overall and ambulatory-care-sensitive condition) per 100 beneficiaries before and after patient-centered medical home recognition, using a difference-in-differences regression model comparing patient-centered medical homes and propensity-matched non-patient-centered medical homes. RESULTS:Comparing patient-centered medical home with non-patient-centered medical home practices, the rate of growth in ED payments per beneficiary was $54 less for 2009 patient-centered medical homes and $48 less for 2010 patient-centered medical homes relative to non-patient-centered medical home practices. The rate of growth in all-cause and ambulatory-care-sensitive condition ED visits per 100 beneficiaries was 13 and 8 visits fewer for 2009 patient-centered medical homes and 12 and 7 visits fewer for 2010 patient-centered medical homes, respectively. There was no hospitalization effect. CONCLUSION:From 2008 to 2010, outpatient ED visits increased more slowly for Medicare patients being treated by patient-centered medical home practices than comparison non-patient-centered medical homes. The reduction was in visits for both ambulatory-care-sensitive and non-ambulatory-care-sensitive conditions, suggesting that steps taken by practices to attain patient-centered medical home recognition such as improving care access may decrease some of the demand for outpatient ED care.


Ann Emerg Med


Pines JM,Keyes V,van Hasselt M,McCall N




Has Abstract


2015-06-01 00:00:00














  • Beer potomania: an unusual cause of symptomatic hyponatremia.

    abstract::A 43-year-old woman presented to the emergency department with acute agitation, confusion, and tonic seizures. She had a history of drug abuse, most notably beer, which constituted her major dietary intake. The patient's seizures were at first thought to be factitious in association with an acute psychosis; however, h...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Joyce SM,Potter R

    更新日期:1986-06-01 00:00:00

  • External transcutaneous pacemakers in interhospital transport of cardiac patients.

    abstract::From October 1985 to April 1988, 297 patients with presumed unstable angina, acute myocardial infarction, or permanent pacemaker failure were transferred by helicopter from community hospitals to our medical center for tertiary care. Fifty-six patients (19%) experienced treatable bradycardia (heart rate of less than 5...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Vukov LF,Johnson DQ

    更新日期:1989-07-01 00:00:00

  • Use of Out-of-Hospital Ethanol Administration to Improve Outcome in Mass Methanol Outbreaks.

    abstract:STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Zakharov S,Pelclova D,Urban P,Navratil T,Nurieva O,Kotikova K,Diblik P,Kurcova I,Belacek J,Komarc M,Eddleston M,Hovda KE

    更新日期:2016-07-01 00:00:00

  • Varicella pneumonia in adults: a spectrum of disease.

    abstract::Varicella (Chicken pox) is a contagious disease common in childhood but uncommon in adulthood. Pneumonia, however, is a relatively common complication of the disease in adults. Recognition of the potential for this complication in adult patients with varicella is essential for the emergency physician. Three cases of v...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Hockberger RS,Rothstein RJ

    更新日期:1986-08-01 00:00:00

  • Methanol poisoning as a result of inhalational solvent abuse.

    abstract::We report an unusual presentation of solvent abuse. A 17-year-old boy was brought to the emergency department after he inhaled fumes from a rag soaked with a carburetor cleaner containing toluene, methylene chloride, and methanol. Considered to be intoxicated from the acute effects of sniffing toluene or methylene chl...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: McCormick MJ,Mogabgab E,Adams SL

    更新日期:1990-06-01 00:00:00

  • Comparison of gastric lavage and thoracic cavity lavage in the treatment of severe hypothermia in dogs.

    abstract::A study was undertaken to compare warm gastric (Group 1) and closed thoracic cavity (Group 2) lavage for rewarming severely hypothermic dogs. Adult mongrel dogs were monitored by intra-arterial catheter, central venous catheter, and ECG, and by central venous, esophageal, and rectal temperature probes. Animals were ex...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Brunette DD,Sterner S,Robinson EP,Ruiz E

    更新日期:1987-11-01 00:00:00

  • Studying injuries with case-control methods in the emergency department.

    abstract::To study factors that cause or prevent injuries, it can be efficient to use a case-control study design and select both cases and controls from patients seen in the ED. Bias in case ascertainment can be reduced by studying exposures that, aside from their influence on the risk of injury, are unrelated to the use of em...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审


    authors: Cummings P,Koepsell TD,Weiss NS

    更新日期:1998-01-01 00:00:00

  • Serum levels of myoglobin, creatine phosphokinase, and smooth muscle heavy-chain myosin in patients with ectopic pregnancy.

    abstract:STUDY OBJECTIVE:Serum markers of smooth muscle destruction have been shown to be elevated in ectopic pregnancy, but they remain of questionable clinical utility. Our goal was to determine the clinical utility of 3 markers of smooth muscle destruction: creatine phosphokinase (CPK), smooth muscle heavy-chain myosin (SMHC...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Birkhahn RH,Gaeta TJ,Paraschiv D,Bove JJ,Suzuki T,Katoh H,Nagai R

    更新日期:2001-12-01 00:00:00

  • Antibody titers to hepatitis B surface antigen among vaccinated emergency physicians: three years' experience with a wellness booth.

    abstract:STUDY OBJECTIVE:To determine antibody titers to hepatitis B surface antigen (anti-HBsAg) among previously vaccinated emergency physicians and to assess the degree of compliance with Centers for Disease Control and Prevention (CDC) postvaccination guidelines. METHODS:A descriptive analysis was performed of anti-HBsAg t...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Goldberg R,Thomas H,Kuhn G,Moradzadeh D,Mody T,Boss RW,Goodman E

    更新日期:1999-02-01 00:00:00

  • Conference attendance: do we meet the new residency review committee requirements?

    abstract:STUDY OBJECTIVES:To characterize the attendance at and presenters of conferences given to emergency medicine residents and to determine the ability of emergency medicine residents to attend conferences while working in the emergency department and on off-service rotations. DESIGN:Descriptive study of an anonymous mail...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Austin PE,Brown CK,Dunn KA

    更新日期:1995-03-01 00:00:00

  • Medicolegal documentation of prehospital triage.

    abstract::Patients evaluated by paramedics but not transported to the hospital account for 50% to 90% of emergency medical services lawsuits. We reviewed 2,698 consecutive paramedic run reports to examine documentation in these cases. Documentation criteria for prehospital patient release were history, physical examination, vit...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Selden BS,Schnitzer PG,Nolan FX

    更新日期:1990-05-01 00:00:00

  • American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2017-2018).

    abstract::The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine-sponsored residency and fellowship programs, as well as the residents and fellows training in those programs. We present the 2018 annual report on the status of US emergency medicine training programs. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Nelson LS,Keim SM,Baren JM,Beeson MS,Carius ML,Chudnofsky CR,Gausche-Hill M,Goyal DG,Kowalenko T,Marco CA,Muelleman RL,Research Committee, American Board of Emergency Medicine.,Johnston MM,Joldersma KB,American Board of Emerg

    更新日期:2018-05-01 00:00:00

  • National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries.

    abstract:STUDY OBJECTIVE:We compare the association between barriers to timely primary care and emergency department (ED) utilization among adults with Medicaid versus private insurance. METHODS:We analyzed 230,258 adult participants of the 1999 to 2009 National Health Interview Survey. We evaluated the association between 5 s...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Cheung PT,Wiler JL,Lowe RA,Ginde AA

    更新日期:2012-07-01 00:00:00

  • Emergency department management and 1-year outcomes of patients with atrial flutter.

    abstract:STUDY OBJECTIVE:Atrial flutter is a common arrhythmia seen in the emergency department (ED), yet there is little research describing its management and outcomes. We analyze the success and safety of treatment of ED patients with atrial flutter. METHODS:This was a retrospective cohort study obtained by searching the ED...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Scheuermeyer FX,Grafstein E,Heilbron B,Innes G

    更新日期:2011-06-01 00:00:00

  • Single-dose ceftriaxone treatment of urinary tract infections.

    abstract::Single-dose antibiotic therapy for urinary tract infections in which no underlying structural or neurologic lesions are present holds the promise of greater patient compliance and convenience. We present the results of a study comparing a single intramuscular dose of a long-acting, third-generation cephalosporin, ceft...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Rosenberg JM,Levy RC,Cicmanec JF,Hedges JR,Burke BM

    更新日期:1985-10-01 00:00:00

  • Primary varicella in adults: pneumonia, pregnancy, and hospital admission.

    abstract:STUDY OBJECTIVE:To define the rate of complications of adult varicella, including pneumonia, and to determine the association of such complications with pregnancy. METHODS:Retrospective, descriptive case series of consecutive adult emergency department patients with primary varicella seen over a 31-month period in an ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Baren JM,Henneman PL,Lewis RJ

    更新日期:1996-08-01 00:00:00

  • N-acetylcysteine reduces methemoglobin in vitro.

    abstract:STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Wright RO,Magnani B,Shannon MW,Woolf AD

    更新日期:1996-11-01 00:00:00

  • Fatal pulmonary edema following intravenous "freebase" cocaine use.

    abstract::A 36-year-old man developed extreme shortness of breath after injecting "freebase" cocaine intravenously. Clinical and radiographic evaluation confirmed acute pulmonary edema, and blood gas studies substantiated acute respiratory failure. Despite vigorous therapy, the patient died three hours after admission. When coc...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Allred RJ,Ewer S

    更新日期:1981-08-01 00:00:00

  • Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS): development and application of computer modeling to selected National Planning Scenarios for high-consequence events.

    abstract::Few tools exist that are sufficiently robust to allow manipulation of key input variables to produce casualty estimates resulting from high-consequence events reflecting local or specific regions of concern. This article describes the design and utility of a computerized modeling simulation tool, Electronic Mass Casua...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Scheulen JJ,Thanner MH,Hsu EB,Latimer CK,Brown J,Kelen GD

    更新日期:2009-02-01 00:00:00

  • Allergic reaction to sulfiting agents.

    abstract::Sodium metabisulfite (MBS) is a commonly used food and drug preservative. We report the case of a 32-year-old man with a documented history of allergy to MBS who developed an anaphylactic reaction after ingestion of MBS-treated foods. The patient had a prolonged clinical course requiring two emergency department visit...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Riggs BS,Harchelroad FP Jr,Poole C

    更新日期:1986-01-01 00:00:00

  • Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children.

    abstract:STUDY OBJECTIVE:Epinephrine autoinjector use for anaphylaxis is increasing. There are reports of digit injections because of incorrect autoinjector use, but no previous reports of lacerations, to our knowledge. We report complications of epinephrine autoinjector use in children and discuss features of these devices, an...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Brown JC,Tuuri RE,Akhter S,Guerra LD,Goodman IS,Myers SR,Nozicka C,Manzi S,Long K,Turner T,Conners GP,Thompson RW,Park E

    更新日期:2016-03-01 00:00:00

  • Small-bowel obstruction secondary to activated charcoal and adhesions.

    abstract::Gastrointestinal obstruction is a rare complication of multiple-dose administration of activated charcoal. Previous reports deal only with obstruction after ingestion of drugs that impair gastrointestinal motility. This patient developed a small-bowel obstruction associated with the administration of multiple doses of...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Goulbourne KB,Cisek JE

    更新日期:1994-07-01 00:00:00

  • Emergency physicians' perspectives on their use of health information exchange.

    abstract:STUDY OBJECTIVE:We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. METHODS:A qualitative study using grounded theory principles was conducted in 4 urban emergency departments that had health informa...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究


    authors: Thorn SA,Carter MA,Bailey JE

    更新日期:2014-03-01 00:00:00

  • Report of the Task Force on Residency Training Information (1999-2000), American Board of Emergency Medicine.

    abstract::The American Board of Emergency Medicine gathers extensive background information on emergency medicine residents and the programs in which they train. We present the third annual report on the status of US emergency medicine residency programs. [American Board of Emergency Medicine. Report of the Task Force on Reside...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Hoffman GL,Bock BF,Gallagher EJ,Markovchick VJ,Ham HP,Munger BS

    更新日期:2000-05-01 00:00:00

  • Feasibility study of the use of bilevel positive airway pressure for respiratory support in the emergency department.

    abstract:STUDY OBJECTIVE:To determine the feasibility of bilevel positive airway pressure (BiPAP) support for acute respiratory distress (ARD) in the emergency department. METHODS:A convenience sample of patients in ARD as a result of any nontraumatic cause was recruited for a prospective, noncontrolled clinical trial in the E...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章


    authors: Pollack C Jr,Torres MT,Alexander L

    更新日期:1996-02-01 00:00:00

  • The validity of self-reported primary adherence among Medicaid patients discharged from the emergency department with a prescription medication.

    abstract:STUDY OBJECTIVE:We determine the validity of self-reported prescription filling among emergency department (ED) patients. METHODS:We analyzed a subgroup of 1,026 patients enrolled in a randomized controlled trial who were prescribed at least 1 medication at ED discharge, were covered by Medicaid insurance, and complet...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验


    authors: Ding R,Zeger SL,Steinwachs DM,Ortmann MJ,McCarthy ML

    更新日期:2013-09-01 00:00:00

  • Characteristics of patient care management problems identified in emergency department morbidity and mortality investigations during 15 years.

    abstract:STUDY OBJECTIVE:We describe cases referred for physician review because of concern about quality of patient care and identify factors that contributed to patient care management problems. METHODS:We performed a retrospective review of 636 cases investigated by an emergency department physician review committee at an u...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Cosby KS,Roberts R,Palivos L,Ross C,Schaider J,Sherman S,Nasr I,Couture E,Lee M,Schabowski S,Ahmad I,Scott RD 2nd

    更新日期:2008-03-01 00:00:00

  • Olfactory and gustatory hallucinations presenting as partial status epilepticus because of glioblastoma multiforme.

    abstract::Olfactory and gustatory hallucinations are not often encountered in the acute care setting but may represent the subtle presenting features of a significant underlying disease process. We describe a patient whose most striking presenting symptoms were of olfactory and gustatory hallucinations and in whom the diagnosis...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Capampangan DJ,Hoerth MT,Drazkowski JF,Lipinski CA

    更新日期:2010-10-01 00:00:00

  • Managed care and emergency medicine: conflicts, federal law, and California legislation.

    abstract::The traditional use of the American ED, one of unrestricted access by patients and payment for services by insurers, is being questioned in this era of health care reform. Both primary care physicians and managed care organizations have questioned the use of the ED by patients without obvious problems of an emergency ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Derlet RW,Young GP

    更新日期:1997-09-01 00:00:00

  • EMS agenda for the future: where we are ... where we want to be. EMS Agenda for the Future Steering Committee.

    abstract::During the past 30 years, emergency medical services (EMS) in the United States have experienced explosive growth. The American health care system is now transforming, providing an opportune time to examine what we have learned over the past three decades in order to create a vision for the future of EMS. Over the cou...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审


    authors: Delbridge TR,Bailey B,Chew JL Jr,Conn AK,Krakeel JJ,Manz D,Miller DR,O'Malley PJ,Ryan SD,Spaite DW,Stewart RD,Suter RE,Wilson EM

    更新日期:1998-02-01 00:00:00