Abstract:
STUDY OBJECTIVE:Single-payer health care is supported by most Americans, but the effect of single payer on any particular sector of the health care market has not been well explored. We examine the effect of 2 potential single-payer designs, Medicare for All and an alternative including Medicare and Medicaid, on total payments and out-of-pocket spending for treat-and-release emergency care (patients discharged after an emergency department [ED] visit). METHODS:We used the 2013 to 2016 Medical Expenditure Panel Survey to determine estimates of payments made for ED visits by insurance type, and the 2015 National Hospital Ambulatory Medical Care Survey to estimate the proportion of ED visits covered by each insurance type. RESULTS:We found that total payments were predicted to increase from $85.5 billion to $89.0 billion (range $81.3 to $99.8 billion) in the Medicare-only scenario and decrease to $79.4 billion (range $71.6 to $87.2 billion) under Medicare/Medicaid, whereas out-of-pocket costs were predicted to decrease from $116 per visit to $45 with Medicare and to $36 with Medicare/Medicaid. CONCLUSION:In this study of ED treat-and-release patients, a transition to a Medicare for All system may increase ED reimbursement and reduce consumer out-of-pocket costs, whereas a system that maintains Medicaid in addition to Medicare could reduce total payments for emergency care.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Pomerantz A,Burke R,Friedman A,Burke L,Wolfe R,Smulowitz Pdoi
10.1016/j.annemergmed.2020.03.003subject
Has Abstractpub_date
2020-10-01 00:00:00pages
454-458issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(20)30174-8journal_volume
76pub_type
杂志文章abstract:STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70238-1
更新日期:1994-12-01 00:00:00
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
更新日期:2012-11-01 00:00:00
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
更新日期:2001-07-01 00:00:00
abstract::We investigated the compliance of emergency department health care workers with barrier precaution policies adapted from the Centers for Disease Control's "Recommendations for Prevention of HIV Transmission in Health-Care Settings." One hundred sixty-nine health care worker encounters with 97 patients were observed. O...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80522-0
更新日期:1989-06-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the effectiveness and safety of an outpatient clinical care pathway for the initial treatment of acute proximal lower-extremity deep venous thrombosis (DVT) with low molecular weight heparin (LMWH) managed by the emergency department of 2 affiliated community hospitals. METHODS:This observa...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1067/mem.2001.113703
更新日期:2001-03-01 00:00:00
abstract::A 31-year-old white man with a core temperature of 60.8 F (16 C) and ventricular fibrillation was successfullly resuscitated using active core and external rewarming techniques. Rectal temperature at the time of reestablished electromechanical cardiac activity was 68 F (20 C), a temperature previously thought to be in...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80339-8
更新日期:1980-02-01 00:00:00
abstract:STUDY OBJECTIVE:We examine whether using public National Hospital Ambulatory Medical Care Survey (NHAMCS) data with masked design variables produces different estimates, standard errors, and confidence intervals (CIs) for the temporal trend of overall and injury-related emergency department (ED) visits compared with us...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.12.025
更新日期:2011-06-01 00:00:00
abstract::Communication at discharge is an important part of high-quality emergency department (ED) care. This review describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2011.10.023
更新日期:2012-08-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to develop and validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. METHODS:Using a modified Delphi process, a 17-member multidisciplinary physician panel developed expl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.107003
更新日期:2000-07-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the spectrum of electrical injuries and develop guidelines for management. DESIGN:Retrospective review of charts compiled during a 6-year period (1988 through 1993). SETTING:Pediatric emergency department. PARTICIPANTS:Seventy-eight patients seen for electrical injuries. RESULTS:Fifty-fou...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70012-9
更新日期:1995-11-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the sensitivity, specificity, and clinical utility of the Gram's stain of peritoneal fluid in patients undergoing paracentesis. METHODS:We conducted a retrospective chart review of all peritoneal fluid analyses in a 3-year period in an urban 3-hospital system. Peritoneal dialysis and diagn...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.12.020
更新日期:2009-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the presence of cocaethylene, an active metabolite of the combination of cocaine and ethanol, among trauma patients who test positive for cocaine. METHODS:We assembled a case series of 416 consecutive urban trauma center patients with major trauma. Urine was tested for the presence of the ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70266-4
更新日期:1996-03-01 00:00:00
abstract::During the evaluation of a victim of a motor vehicle accident, routine radiographs of the patient's cervical spine, chest, and pelvis revealed multiple radiopaque foreign bodies along his posterior neck, chest, abdomen, and pelvis. Repeat examination of the patient disclosed no evidence of foreign bodies. Further ques...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82986-5
更新日期:1991-09-01 00:00:00
abstract::Ultrasonography in the emergency department is being used for many purposes, including the evaluation of patients with cardiac arrest. Ultrasound testing has been shown to be useful in such patients in determining the presence of true electromechanical dissociation and pericardial effusions. We report a case of ventri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70372-0
更新日期:1999-03-01 00:00:00
abstract::First-responding emergency medical technicians (EMTs) trained to defibrillate have been shown to increase survival from prehospital ventricular fibrillation (VF) almost fourfold in Washington's King County. Using Nebraska ambulance rescue run data from 1982 and published information relating ambulance response time to...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80331-5
更新日期:1984-12-01 00:00:00
abstract::Numerous interventions have been used to protect organ systems and cellular viability from the lethal injury accompanying hypoperfusion and ischemia. Some measures have been directed toward improving perfusion, while others have attempted to enhance the metabolic processes. Our work has focused for the most part on au...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80946-5
更新日期:1986-12-01 00:00:00
abstract:STUDY HYPOTHESIS:The clinical features of children treated with oral antibiotics before the diagnosis of bacterial meningitis differ from those who receive no antibiotics. DESIGN:Retrospective case series. SETTING:University medical center. PARTICIPANTS:Two hundred fifty-eight children 24 months old or younger with ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80149-0
更新日期:1992-02-01 00:00:00
abstract::We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80462-7
更新日期:1989-09-01 00:00:00
abstract:STUDY OBJECTIVE:Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS:We completed a video-based, case-control study (1:3...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.09.005
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVE:To document prehospital and inhospital time intervals from stroke onset to emergency department evaluation and to identify factors associated with presentation to the ED within 3 hours of symptom onset, the current time window for thrombolytic therapy. METHODS:Patients admitted through the ED with a di...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70431-2
更新日期:1999-01-01 00:00:00
abstract::Electrolytes, BUN, and creatinine are some of the most frequently ordered laboratory tests. The use of these tests in emergency practice has not been studied critically, and few investigations of their use in other disciplines have been performed. A review of the available literature and an analysis of medical problem...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(86)80586-8
更新日期:1986-03-01 00:00:00
abstract::The traditional use of the throat culture to guide treatment of potential streptococcal pharyngitis recently has been questioned because of the following facts: antibiotic therapy within the first 48 hours of illness reduces the severity and symptoms of streptococcal pharyngitis; more rapid treatment of streptococcal ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80573-x
更新日期:1986-03-01 00:00:00
abstract::Nine dogs were hemorrhaged to approximately 40% of their blood volume and then were resuscitated with a crystalloid solution (Normosol) at various flow rates. Three study groups with three dogs in each group were resuscitated at 15 mL/min/kg (Group 1), 6 mL/min/kg (Group 2), and 4 mL/min/kg (Group 3). Central venous p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80091-3
更新日期:1985-04-01 00:00:00
abstract:STUDY OBJECTIVE:Immobility predisposes to venous thromboembolism, but this risk may vary, depending on the underlying cause of immobility. METHODS:This was a prospective, longitudinal outcome study of self-presenting emergency department (ED) patients who were from 12 hospitals and had suspected venous thromboembolism...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2008.10.033
更新日期:2009-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether pediatric patients with acute, mild to moderate acetaminophen exposures, treated with home monitoring alone, develop systemic signs of hepatic injury. METHODS:A prospective, observational study of calls to a regional poison center over a 25-month period was performed. Patients were...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(00)70074-6
更新日期:2000-03-01 00:00:00
abstract::This article provides information supporting the need for new outcome measures in emergency care. It also addresses the use of outcome measures in emergency care, the impact of emergency care, identification of at-risk groups, new approaches to measuring patient satisfaction, quality of life and cost-effectiveness, an...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract:STUDY OBJECTIVE:Emergency department records are an important source of injury surveillance data. However, documentation regarding intentional assault has not been studied and may be suboptimal. The purpose of this study was to analyze physician documentation of assailant, site, and object used in intentional assault. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70096-x
更新日期:1999-12-01 00:00:00
abstract::Verapamil is considered by many investigators to be the drug of choice for the acute management of uncomplicated PSVT. Several clinical investigators have demonstrated termination of PSVT in more than 90% of their patients within minutes following IV drug administration. The incidence of reported severe adverse reacti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(81)80013-3
更新日期:1981-10-01 00:00:00
abstract::The Advanced Trauma Life Support (ATLS) course is sponsored by the American College of Surgeons Committee on Trauma. This course was developed to provide a consistent method of care for the resuscitation and evaluation of the injured patient. The ATLS course provides an easily remembered method for evaluating and trea...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70238-6
更新日期:1999-08-01 00:00:00
abstract:STUDY OBJECTIVE:This study tests the effect of a brief intervention with emergency department (ED) patients to reduce at-risk drinking. METHODS:We enrolled patients aged 18 years or older who screened positive for at-risk drinking in an urban academic ED and used alternative allocation to assign them to control or int...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2004.10.014
更新日期:2005-07-01 00:00:00