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Response to “Rising high‐acuity emergency care services independently billed by advanced practice providers, 2013 to 2019”

Response to “Rising high‐acuity emergency care services independently billed by advanced practice... To the editor:We read with great interest “Rising high‐acuity emergency care services independently billed by advanced practice providers, 2013 to 2019” by Gettel et al. This is a vital topic as we study the emergency medicine workforce amid raised concerns regarding advanced practice providers (APP) in the emergency department. Studies, such as this, can help stimulate evidence‐based discussions, instead of individual anecdotes. We would like to share a few comments and questions for the authors regarding their article.APPs in emergency medicine typically refer to physician assistants (PAs) and nurse practitioners (NPs). In this study, the authors define APPs as PAs, NPs, certified nurse midwives, and certified registered nurse anesthetists (CRNA). In our experience, CRNAs and midwives do not routinely provide care in the emergency department. Can the authors explain the reason for their inclusion in a study regarding emergency departments? Does the inclusion of these two categories potentially skew the data? Does the public use file distinguish between different APP types or is it preselected?Does the demonstrated increase in billing correlate with an overall increase in emergency department volume or increase in patient acuity? For example, in 2013, immediate/emergent ED visits were 7.9% of all visits.1 In 2019, immediate/emergent http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Academic Emergency Medicine Wiley

Response to “Rising high‐acuity emergency care services independently billed by advanced practice providers, 2013 to 2019”

Wu, Fred; Darracq, Michael A.
Academic Emergency Medicine , Volume Early View – Mar 4, 2023
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Publisher
Wiley
Copyright
© 2023 Society for Academic Emergency Medicine
ISSN
1069-6563
eISSN
1553-2712
DOI
10.1111/acem.14713
Publisher site
See Article on Publisher Site

Abstract

To the editor:We read with great interest “Rising high‐acuity emergency care services independently billed by advanced practice providers, 2013 to 2019” by Gettel et al. This is a vital topic as we study the emergency medicine workforce amid raised concerns regarding advanced practice providers (APP) in the emergency department. Studies, such as this, can help stimulate evidence‐based discussions, instead of individual anecdotes. We would like to share a few comments and questions for the authors regarding their article.APPs in emergency medicine typically refer to physician assistants (PAs) and nurse practitioners (NPs). In this study, the authors define APPs as PAs, NPs, certified nurse midwives, and certified registered nurse anesthetists (CRNA). In our experience, CRNAs and midwives do not routinely provide care in the emergency department. Can the authors explain the reason for their inclusion in a study regarding emergency departments? Does the inclusion of these two categories potentially skew the data? Does the public use file distinguish between different APP types or is it preselected?Does the demonstrated increase in billing correlate with an overall increase in emergency department volume or increase in patient acuity? For example, in 2013, immediate/emergent ED visits were 7.9% of all visits.1 In 2019, immediate/emergent

Journal

Academic Emergency Medicine – Wiley

Published: Mar 4, 2023

References

  • National study of the emergency physician workforce, 2020
    Bennett, CL; Sullivan, AF; Ginde, AA
  • Physician assistant and nurse practitioner utilization in U.S. emergency departments, 2010 to 2017
    Wu, F; Darracq, MA