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Hospital‐level variation in risk‐standardized admission rates for emergency care–sensitive conditions among older and younger Veterans

Hospital‐level variation in risk‐standardized admission rates for emergency care–sensitive... INTRODUCTIONUnexplained variations in health care utilization present seminal opportunities to improve value in health care delivery.1,2 As health care expenditures in the United States (U.S.) continue to rise, policymakers are increasingly scrutinizing utilization of care of marginal health benefit.3 The National Academy of Medicine suggests that 20%–30% of health expenditures are misused—spanning overutilization to underutilization—relative to evidence of effectiveness.4 Studies suggest that this has, in part, derived from a lack of consensus surrounding the value of certain health care services.5 This may be particularly germane for hospital admissions, which represent one of the costliest health care decisions and one for which explicit clinical practice guidelines are limited and decision making is impacted by a multitude of medical, social, and systems‐based considerations with known variation across health care providers and settings.5–21Given that the emergency department (ED) is the primary source of hospital admissions, researchers have focused on this setting when seeking to understand modifiable drivers of admission practices.22,23 Variation in hospital admissions has been demonstrated at the patient, condition, provider, and hospital levels as targets for performance benchmarks and interventions to improve the value of health care delivery.5–9,16 Research surrounding variations in ED admission practices within the Department of Veterans http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Academic Emergency Medicine Wiley

Hospital‐level variation in risk‐standardized admission rates for emergency care–sensitive conditions among older and younger Veterans

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References (81)

Publisher
Wiley
Copyright
Copyright © 2023 Society for Academic Emergency Medicine
ISSN
1069-6563
eISSN
1553-2712
DOI
10.1111/acem.14691
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONUnexplained variations in health care utilization present seminal opportunities to improve value in health care delivery.1,2 As health care expenditures in the United States (U.S.) continue to rise, policymakers are increasingly scrutinizing utilization of care of marginal health benefit.3 The National Academy of Medicine suggests that 20%–30% of health expenditures are misused—spanning overutilization to underutilization—relative to evidence of effectiveness.4 Studies suggest that this has, in part, derived from a lack of consensus surrounding the value of certain health care services.5 This may be particularly germane for hospital admissions, which represent one of the costliest health care decisions and one for which explicit clinical practice guidelines are limited and decision making is impacted by a multitude of medical, social, and systems‐based considerations with known variation across health care providers and settings.5–21Given that the emergency department (ED) is the primary source of hospital admissions, researchers have focused on this setting when seeking to understand modifiable drivers of admission practices.22,23 Variation in hospital admissions has been demonstrated at the patient, condition, provider, and hospital levels as targets for performance benchmarks and interventions to improve the value of health care delivery.5–9,16 Research surrounding variations in ED admission practices within the Department of Veterans

Journal

Academic Emergency Medicine – Wiley

Published: Apr 1, 2023

Keywords: Department of Veterans Affairs; efficiency measurement; emergency department; health care quality; hospital admission; value‐based care; Veterans

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