David J. Wallace, MD, MPH, Deepika Mohan, MD, Derek C

Slides:

Advertisements

Similar presentations

Young Woman With Abdominal Pain David Jones, MD Annals of Emergency Medicine Volume 64, Issue 4, (October 2014) DOI: /j.annemergmed

Advertisements

An Early Look at Performance on the Emergency Care Measures Included in Medicare's Hospital Inpatient Value-Based Purchasing Program Megan McHugh, PhD,

Colorado Cannabis Legalization and Its Effect on Emergency Care

Electrocardiographic Criteria for Detecting Acute Myocardial Infarction in Patients With Left Bundle Branch Block: A Meta-analysis Jeffrey A. Tabas,

Annals of Emergency Medicine

The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD,

Emergency Physician Ultrasonography for Evaluating Patients at Risk for Ectopic Pregnancy: A Meta-Analysis John C. Stein, MD, Ralph Wang, MD, Naomi Adler,

Annals of Emergency Medicine

Female With Right Lower Quadrant Abdominal Pain

Volume 146, Issue 6, Pages (December 2014)

Vulvar Lesions Annals of Emergency Medicine

Pacemaker Extrusion Annals of Emergency Medicine

The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD,

No SIRS; Quick SOFA Instead

Alan E. Jones, MD, Michael A. Puskarich, MD

Emergency Department and Inpatient Hospital Use by Medicare Beneficiaries in Patient- Centered Medical Homes Jesse M. Pines, MD, MBA, Vincent Keyes, MA,

Man With Back Pain and Rash

The Secret Life of America's Poison Centers

Annals of Emergency Medicine

Validation of the Simplified Motor Score in the Out-of-Hospital Setting for the Prediction of Outcomes After Traumatic Brain Injury David O. Thompson,

Clinical Policy: Use of Intravenous tPA for the Management of Acute Ischemic Stroke in the Emergency Department Annals of Emergency Medicine Volume.

Procedural Sedation: Is Two Better Than One?

Maria C. Raven, MD, MPH, Margot Kushel, MD, Michelle J

Managing Nontraumatic Acute Back Pain

HIV Care Continuum for HIV-Infected Emergency Department Patients in an Inner-City Academic Emergency Department Yu-Hsiang Hsieh, PhD, Gabor D. Kelen,

Fatal Cerebral Edema After Moderate Valproic Acid Overdose

A Population-Based Analysis of Outcomes in Patients With a Primary Diagnosis of Hypertension in the Emergency Department Sameer Masood, MD, Peter C.

A Woman With a Click in Her Throat

Selective Use of Computed Tomography Compared With Routine Whole Body Imaging in Patients With Blunt Trauma Malkeet Gupta, MD, MS, David L. Schriger,

Observers in the Medical Setting

An Emergency Medicine–Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine Margaret B. Greenwood-Ericksen,

Steven M. Green, MD, Mark G. Roback, MD, Robert M

Global Emergency Medicine Journal Club: Social Media Responses to the March 2014 Annals of Emergency Medicine Journal Club on Targeted Temperature Management∗

Michael A. LaMantia, MD, MPH, Frank C. Messina, MD, Cherri D

Man With Acute Respiratory Distress

Middle-Aged Man With Rash

Comparison of Electronic Pharmacy Prescription Records With Manually Collected Medication Histories in an Emergency Department Kin Wah Fung, MD, MS,

An Infant With Fever and Rash

Andrea W. Thorp, MD, David L. Schriger, MD, MPH

Sangeeta Lamba, MD, Tammie E. Quest, MD Annals of Emergency Medicine

Elderly Man With Dark Urine

Lee Cearnal Annals of Emergency Medicine

Female With Right Lower Quadrant Abdominal Pain

Clinical Features From the History and Physical Examination That Predict the Presence or Absence of Pulmonary Embolism in Symptomatic Emergency Department.

Nupur Garg, MD, Michael Gottlieb, MD Annals of Emergency Medicine

Measuring and Explaining Computed Tomography Use in the United States and Canada: A Consideration of Health Economics and Use Versus Appropriateness,

Images in Emergency Medicine

Emergency Department Planning and Resource Guidelines

Characteristics of Frequent Users of Emergency Departments

Anthony Eidelman, MD, Jocelyn M. Weiss, MPH, Joseph Lau, MD, Daniel B

Young Woman With Abdominal Pain

Eric Berger Annals of Emergency Medicine

Worms and Flesh-Eating Bacteria? The Worst Day of Your Life

Abscess Incision and Drainage With or Without Ultrasonography: A Randomized Controlled Trial Romolo J. Gaspari, MD, PhD, Alexandra Sanseverino, MD, Timothy.

Rapid HIV Testing in a Southeastern Emergency Department Serving a Semiurban- Semirural Adolescent and Adult Population Richard W. Sattin, MD, James A.

Kuo-Chen Cheng, MD Annals of Emergency Medicine

Images in Emergency Medicine

Penetrating Neck Injury: What’s In and What’s Out?

Images in Emergency Medicine

Continuing Care for Patients Choosing the Emergency Department as a Site for Primary Care: Feasibility, Benefits, and EMTALA Considerations David L.

Woman With Unresponsiveness

Lean Thinking in Emergency Departments: A Critical Review

Vulvar Lesions Annals of Emergency Medicine

Critical Care Management ofVerapamil and Diltiazem Overdose With a Focus on Vasopressors: A 25-Year Experience at a Single Center Michael Levine, MD,

Young Boy With Shedding Nails

Global Emergency Medicine Journal Club: A Social Media Discussion About the Lack of Association Between Press Ganey Scores and Emergency Department Analgesia

Elderly Woman With Chest Pain and Cough

D. Stevenson, T. Long, J.P. Green, J. Rose

Young Man with Foreign-Body Sensation in the Right Eye

Subclavian Vein Thrombosis

Presentation transcript:

Referral Regions for Time-Sensitive Acute Care Conditions in the United States David J. Wallace, MD, MPH, Deepika Mohan, MD, Derek C. Angus, MD, MPH, Julia R. Driessen, PhD, Christopher M. Seymour, MD, MSc, Donald M. Yealy, MD, Mark M. Roberts, MD, MPP, Kristen S. Kurland, BA, Jeremy M. Kahn, MD, MSc Annals of Emergency Medicine Volume 72, Issue 2, Pages 147-155 (August 2018) DOI: 10.1016/j.annemergmed.2018.02.018 Copyright © 2018 American College of Emergency Physicians Terms and Conditions

Figure 1 Measures of spatial accuracy. Geographic accuracy measures: localization index (A), market share index (B), and net patient flow (C). These measures evaluate the accuracy of region constructions, as they relate to where patients live and receive their acute care. Annals of Emergency Medicine 2018 72, 147-155DOI: (10.1016/j.annemergmed.2018.02.018) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

Figure 2 Political boundary preservation by referral region type. A and B, Lack of state boundary preservation in Dartmouth Atlas hospital referral regions. A, Referral region 293 (red hash marks) is shown crossing into Utah, Arizona, Colorado, and New Mexico. B, Referral region 2 (red hash marks) is shown crossing into Alabama, Florida, and Georgia. Overall, state boundaries are crossed by 43.1% (n=132) of Dartmouth Atlas hospital referral regions. Black lines show state borders and red lines show referral region boundaries. C and D, Corresponding areas for the Pittsburgh Atlas, which preserves state boundaries. Black lines show state borders and blue lines show referral region boundaries. All panels are shown at 1:2,000,000 scale in Equal Area Albers projection. Annals of Emergency Medicine 2018 72, 147-155DOI: (10.1016/j.annemergmed.2018.02.018) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

Figure E1 Accessibility map showing regions without referral centers for acute myocardial infraction. Light blue areas show Pittsburgh Atlas referral regions without an acute myocardial infarction referral hospital, yellow areas show Dartmouth Atlas hospital referral regions without an acute myocardial infarction referral hospital, and dark blue areas show geographies identified by both sets of regions as not having an acute myocardial infarction referral hospital. Overlapping regions (dark blue) are included to show areas where the Pittsburgh Atlas and the Dartmouth Atlas identify similar potentially at-risk populations. Annals of Emergency Medicine 2018 72, 147-155DOI: (10.1016/j.annemergmed.2018.02.018) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

Figure E2 Accessibility map showing regions without referral centers for stroke. Light blue areas show Pittsburgh Atlas referral regions without a stroke referral hospital, yellow areas show Dartmouth Atlas hospital referral regions without a stroke referral hospital, and dark blue areas show geographies identified by both sets of regions as not having a stroke referral hospital. Overlapping regions (dark blue) are included to show areas where the Pittsburgh Atlas and the Dartmouth Atlas identify similar potentially at-risk populations. Annals of Emergency Medicine 2018 72, 147-155DOI: (10.1016/j.annemergmed.2018.02.018) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

Figure E3 Accessibility map showing regions without referral centers for trauma. Light blue areas show Pittsburgh Atlas referral regions without a Level I or II trauma referral hospital, yellow areas show Dartmouth Atlas hospital referral regions without a Level I or II trauma referral hospital, and dark blue areas show geographies identified by both sets of regions as not having a Level I or II trauma referral hospital. Overlapping regions (dark blue) are included to show areas where the Pittsburgh Atlas and the Dartmouth Atlas identify similar potentially at-risk populations. Annals of Emergency Medicine 2018 72, 147-155DOI: (10.1016/j.annemergmed.2018.02.018) Copyright © 2018 American College of Emergency Physicians Terms and Conditions