当前位置： SCI文献检索 > ANNALS OF EMERGENCY MEDICINE期刊下所有文献 > Risk-Adjusted Variation of Publicly Reported Emergency Department Timeliness Measures.

Risk-Adjusted Variation of Publicly Reported Emergency Department Timeliness Measures.

Abstract：

STUDY OBJECTIVE:The Centers for Medicare & Medicaid Services (CMS) recently published emergency department (ED) timeliness measures. These data show substantial variation in hospital performance and suggest the need for process improvement initiatives. However, the CMS measures are not risk adjusted and may provide misleading information about hospital performance and variation. We hypothesize that substantial hospital-level variation will persist after risk adjustment. METHODS:This cross-sectional study included hospitals that participated in the Emergency Department Benchmarking Alliance and CMS ED measure reporting in 2012. Outcomes included the CMS measures corresponding to median annual boarding time, length of stay of admitted patients, length of stay of discharged patients, and waiting time of discharged patients. Covariates included hospital structural characteristics and case-mix information from the American Hospital Association Survey, CMS cost reports, and the Emergency Department Benchmarking Alliance. We used a γ regression with a log link to model the skewed outcomes. We used indirect standardization to create risk-adjusted measures. We defined "substantial" variation as coefficient of variation greater than 0.15. RESULTS:The study cohort included 723 hospitals. Risk-adjusted performance on the CMS measures varied substantially across hospitals, with coefficient of variation greater than 0.15 for all measures. Ratios between the 10th and 90th percentiles of performance ranged from 1.5-fold for length of stay of discharged patients to 3-fold for waiting time of discharged patients. CONCLUSION:Policy-relevant variations in publicly reported CMS ED timeliness measures persist after risk adjustment for nonmodifiable hospital and case-mix characteristics. Future "positive deviance" studies should identify modifiable process measures associated with high performance.

journal_name

Ann Emerg Med

journal_title

Annals of emergency medicine

authors

Sun BC,Laurie A,Prewitt L,Fu R,Chang AM,Augustine J,Reese C 4th,McConnell KJ

doi

10.1016/j.annemergmed.2015.05.029

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

509-516.e7

issue

4

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(15)00476-X

journal_volume

67

pub_type

杂志文章

相关文献

ANNALS OF EMERGENCY MEDICINE文献大全
  • The spectrum of informed consent in emergency psychiatric research.

    abstract：STUDY OBJECTIVE:I evaluate the variation in requirements for informed consent in studies evaluating chemical tranquilization of agitated patients. METHODS:A computer-assisted literature search of the National Library of Medicine was performed. Additional use of the references listed in the articles identified with the...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2005.08.025

    authors： Brown J

    更新日期：2006-01-01 00:00:00

  • The Efficacy of Antivenin Latrodectus (Black Widow) Equine Immune F(ab')2 Versus Placebo in the Treatment of Latrodectism: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial.

    abstract：STUDY OBJECTIVE:The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,多中心研究,随机对照试验

    doi：10.1016/j.annemergmed.2019.02.007

    authors： Dart RC,Bush SP,Heard K,Arnold TC,Sutter M,Campagne D,Holstege CP,Seifert SA,Lo JCY,Quan D,Borron S,Meurer DA,Burnham RI,McNally J,Garcia-Ubbelohde W,Anderson VE

    更新日期：2019-09-01 00:00:00

  • Can broad-range 16S ribosomal ribonucleic acid gene polymerase chain reactions improve the diagnosis of bacterial meningitis? A systematic review and meta-analysis.

    abstract：STUDY OBJECTIVE:We aim to evaluate the accuracy of the broad-range 16S polymerase chain reaction test in the diagnosis of bacterial meningitis through a systematic review and meta-analysis. METHODS:We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Registry, using the Medical Subject Headings terms "polym...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,meta分析,评审

    doi：10.1016/j.annemergmed.2012.05.040

    authors： Srinivasan L,Pisapia JM,Shah SS,Halpern CH,Harris MC

    更新日期：2012-11-01 00:00:00

  • Conventional and right precordial ECGs, creatine kinase, and radionuclide angiography in post-traumatic ventricular dysfunction.

    abstract：:Right ventricular infarction due to ischemic heart disease can be diagnosed by a right precordial electrogram or by first-pass radionuclide angiography (FPRNA). Prior FPRNA studies have shown that cardiac dysfunction after blunt chest trauma (myocardial contusion) is most often due to right ventricular dysfunction. We...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(88)80665-6

    authors： Mooney R,Niemann JT,Bessen HA,Mena I,French S,Laks MM

    更新日期：1988-09-01 00:00:00

  • Acute otitis media in children: are decongestants or antihistamines necessary?

    abstract：:This study was designed to investigate the efficacy of a decongestant-antihistamine preparation in combination with antibiotic treatment of acute otitis media. The effectiveness of a new Dimetapp (DIM) preparation was assessed in comparison with each of its components (brompheniramine maleate [BPM] and phenylephrine h...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(83)80125-5

    authors： Bhambhani K,Foulds DM,Swamy KN,Eldis FE,Fischel JE

    更新日期：1983-01-01 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

    doi：10.1016/s0196-0644(98)70289-6

    authors： Cummings P,Koepsell TD,Weiss NS

    更新日期：1998-01-01 00:00:00

  • Do emergency physicians attribute drug-related emergency department visits to medication-related problems?

    abstract：STUDY OBJECTIVE:Adverse drug events represent the most common cause of preventable nonsurgical adverse events in medicine but may remain undetected. Our objective is to determine the proportion of drug-related visits emergency physicians attribute to medication-related problems. METHODS:This prospective observational ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2009.10.008

    authors： Hohl CM,Zed PJ,Brubacher JR,Abu-Laban RB,Loewen PS,Purssell RA

    更新日期：2010-06-01 00:00:00

  • Shift Change.

    abstract：:[Parkhurst DC: Shift change. Ann Emerg Med June 1998;31:785-788.]. ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：

    authors： Parkhurst DC

    更新日期：1998-06-01 00:00:00

  • Outcome of patients experiencing cardiac arrest with carbon monoxide poisoning treated with hyperbaric oxygen.

    abstract：STUDY OBJECTIVE:We sought to examine the outcome of a subgroup of patients with extreme carbon monoxide (CO) poisoning, specifically those discovered in cardiac arrest, resuscitated, and subsequently treated with hyperbaric oxygen (HBO(2)). Opinions of hyperbaric medicine physicians regarding the treatment of such pati...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1067/mem.2001.115532

    authors： Hampson NB,Zmaeff JL

    更新日期：2001-07-01 00:00:00

  • Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey.

    abstract：STUDY OBJECTIVE:Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. METHODS:The Trans PULSE Pr...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2013.09.027

    authors： Bauer GR,Scheim AI,Deutsch MB,Massarella C

    更新日期：2014-06-01 00:00:00

  • Experience with the use of tPA in the treatment of acute myocardial infarction.

    abstract：:Early experience with the use of tissue plasminogen activator (tPA) in acute myocardial infarction is reviewed, including comparisons with other thrombolytic agents, a summary of hemorrhagic complications associated with its use, and the rationale for adjunctive therapeutic strategies. The use of tPA has been associat...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,评审

    doi：10.1016/s0196-0644(88)80064-7

    authors： Califf RM,Mantell S,Westawski C,Bride W,Honan MB,Bellinger RL,Wall TC

    更新日期：1988-11-01 00:00:00

  • One-week and 3-month outcomes after an emergency department visit for undifferentiated musculoskeletal low back pain.

    abstract：STUDY OBJECTIVE:Nearly 3 million patients present to US emergency departments (EDs) annually with undifferentiated musculoskeletal low back pain. Little is known about short- and longer-term outcomes in this group. We seek to describe the pain and functional outcomes 1 week and 3 months after discharge in a sample of E...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2011.09.012

    authors： Friedman BW,O'Mahony S,Mulvey L,Davitt M,Choi H,Xia S,Esses D,Bijur PE,Gallagher EJ

    更新日期：2012-02-01 00:00:00

  • Accuracy of Emergency Department Clinical Findings for Diagnosis of Coronavirus Disease 2019.

    abstract：STUDY OBJECTIVE:We seek to describe the medical history and clinical findings of patients attending the emergency department (ED) with suspected coronavirus disease 2019 (COVID-19) and estimate the diagnostic accuracy of patients' characteristics for predicting COVID-19. METHODS:We prospectively enrolled all patients ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2020.05.022

    authors： Peyrony O,Marbeuf-Gueye C,Truong V,Giroud M,Rivière C,Khenissi K,Legay L,Simonetta M,Elezi A,Principe A,Taboulet P,Ogereau C,Tourdjman M,Ellouze S,Fontaine JP

    更新日期：2020-10-01 00:00:00

  • Hurricane-related emergency department visits in an inland area: an analysis of the public health impact of Hurricane Hugo in North Carolina.

    abstract：STUDY OBJECTIVE:To evaluate the public health impact of a hurricane on an inland area. DESIGN:Descriptive study. SETTING:Seven hospital emergency departments. PARTICIPANTS:Patients who were treated from September 22 to October 6, 1989, for an injury or illness related to Hurricane Hugo. INTERVENTION:None. MEASUREM...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(94)70307-8

    authors： Brewer RD,Morris PD,Cole TB

    更新日期：1994-04-01 00:00:00

  • Idiopathic priapism treated with inhalation of amyl nitrite.

    abstract：:Presented is a case of idiopathic priapism that was successfully treated with inhalation of amyl nitrite. Routine treatment measures had failed. The same patient presented on several other occasions in a similar fashion. Each time amyl nitrite was successful. An investigation for diseases known to be associated with p...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(83)80602-7

    authors： Parrillo SJ,Manfrey S

    更新日期：1983-04-01 00:00:00

  • Use of a bilingual medical history questionnaire in the emergency department.

    abstract：STUDY OBJECTIVE:To demonstrate that a complete and rapid clinical history can be obtained using a self-administered, bilingual questionnaire. DESIGN:A post-test experimental design was used to evaluate time spent obtaining the history and information completeness for the two groups. SETTING:Urban county emergency dep...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(05)80799-1

    authors： Nasr I,Cordero M,Houmes B,Fagan J,Rydman R,Green C

    更新日期：1993-05-01 00:00:00

  • Rupture of the right hemidiaphragm due to blunt trauma.

    abstract：:Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan w...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(83)80464-8

    authors： Leaman PL

    更新日期：1983-06-01 00:00:00

  • High-dose hydrocortisone hemisuccinate in scorpion envenomation.

    abstract：STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(97)70105-7

    authors： Abroug F,Nouira S,Haguiga H,Elatrous S,Belghith M,Boujdaria R,Touzi N,Bouchoucha S

    更新日期：1997-07-01 00:00:00

  • Determination of cerebral cortical blood flow: a thermal technique.

    abstract：:A mathematical model for tissue thermodilution was developed to study cerebral cortical perfusion before and after controlled perfusion arrest. Cerebral cortical perfusion rates are readily determined by this method. A thermistor was introduced into the subdural space and secured in direct contact with the frontal cor...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(83)80123-1

    authors： Hoehner PJ,Krause GS,White BC,Gadzinski DS

    更新日期：1983-01-01 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

    doi：10.1016/s0196-0644(95)70288-1

    authors： Austin PE,Brown CK,Dunn KA

    更新日期：1995-03-01 00:00:00

  • A trial of povidone-iodine in the prevention of infection in sutured lacerations.

    abstract：:A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scr...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(87)80008-2

    authors： Gravett A,Sterner S,Clinton JE,Ruiz E

    更新日期：1987-02-01 00:00:00

  • Outcome of Immediate Versus Early Antibiotics in Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis.

    abstract：STUDY OBJECTIVE:Debate exists about the mortality benefit of administering antibiotics within either 1 or 3 hours of sepsis onset. We performed this meta-analysis to analyze the effect of immediate (0 to 1 hour after onset) versus early (1 to 3 hours after onset) antibiotics on mortality in patients with severe sepsis ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,meta分析

    doi：10.1016/j.annemergmed.2020.04.042

    authors： Rothrock SG,Cassidy DD,Barneck M,Schinkel M,Guetschow B,Myburgh C,Nguyen L,Earwood R,Nanayakkara PWB,Nannan Panday RS,Briscoe JG

    更新日期：2020-10-01 00:00:00

  • Vertex epidural hematoma: a diagnostic challenge.

    abstract：:We present the case of a 27-year-old man who sustained a minor head injury and presented with complaints of headache and vomiting. The diagnosis of vertex epidural hematoma is discussed. ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(94)70145-8

    authors： Plotkin FR,Burke TF

    更新日期：1994-08-01 00:00:00

  • Foodborne botulism in a six-month-old infant caused by home-canned baby food.

    abstract：:Previously reported cases of botulism in infants have been diagnosed as infant botulism; that is, botulism caused by intestinal colonization by Clostridium botulinum with intraluminal production and absorption of toxin. Foodborne botulism is caused by ingestion of preformed toxin. We describe an unusual case of foodbo...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1067/mem.2003.259

    authors： Armada M,Love S,Barrett E,Monroe J,Peery D,Sobel J

    更新日期：2003-08-01 00:00:00

  • Severe metabolic acidosis after acute naproxen sodium ingestion.

    abstract：:Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is a propionic acid derivative that possesses analgesic and antipyretic properties through inhibition of prostaglandin synthesis. The propionic acids have been considered the least toxic of the NSAIDs, and one, ibuprofen, is currently available as an over-the-co...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(89)80939-4

    authors： Martinez R,Smith DW,Frankel LR

    更新日期：1989-10-01 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

    doi：10.1016/s0196-0644(86)80679-5

    authors： Hockberger RS,Rothstein RJ

    更新日期：1986-08-01 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

    doi：10.1016/s0196-0644(89)80006-x

    authors： Vukov LF,Johnson DQ

    更新日期：1989-07-01 00:00:00

  • The gay bowel syndrome: a common problem of homosexual patients in the emergency department.

    abstract：:Sexually transmitted bowel and rectal diseases are common in gay men and are caused by a wide variety of infectious agents. Each of the entities implicated in the gay bowel syndrome is considered separately and epidemiologic considerations responsible for the appearance of such a syndrome are examined. The emergency p...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(80)80310-6

    authors： Heller M

    更新日期：1980-09-01 00:00:00

  • Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup.

    abstract：STUDY OBJECTIVE:Salicylate poisoning is a challenging clinical entity associated with substantial morbidity and mortality. The indications for extracorporeal treatments such as hemodialysis are poorly defined. We present a systematic review of the literature along with evidence- and consensus-based recommendations on t...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,评审

    doi：10.1016/j.annemergmed.2015.03.031

    authors： Juurlink DN,Gosselin S,Kielstein JT,Ghannoum M,Lavergne V,Nolin TD,Hoffman RS,EXTRIP Workgroup.

    更新日期：2015-08-01 00:00:00

  • Comparison of intramuscular analgesic activity of butorphanol and morphine in patients with sickle cell disease.

    abstract：:This double-blind study compared the analgesic effects of morphine with those of butorphanol in patients who presented with pain because of sickle cell crisis. Patients were placed at bed rest, administered IV hydration, and randomly assigned on each visit to receive either 2 mg IM butorphanol or 6 mg IM morphine ever...

    journal_title：Annals of emergency medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0196-0644(88)80554-7

    authors： Gonzalez ER,Ornato JP,Ware D,Bull D,Evens RP

    更新日期：1988-08-01 00:00:00