First study of emergency care for an entire state finds care isn't always local

December 20, 2011 in Health

The first study to examine patterns of emergency care for an entire state has found that 40 percent of emergency department visits in Indiana over a three-year period were by patients who visited more than one emergency department. This finding challenges conventional wisdom that patients are tightly bound to health care systems and tend to repeatedly visit local facilities.

The Regenstrief Institute study, "All Health Care Is Not Local: An Evaluation of the Distribution of Care Delivered in Indiana" has been honored with a 2011 Distinguished Paper award at the AMIA Annual Symposium and has been published in the Proceedings of the AMIA 2011 Annual Symposium. AMIA is a professional society of , informatics researchers and thought leaders in biomedicine, health care, and science.

The Regenstrief study reports that nearly all emergency departments in Indiana shared patients with nearly every other emergency department. The high degree of connectedness between emergency departments had not been previously recognized at this scale, according to the researchers.

"Our findings provide critical, previously unrealized information to policy makers as well as those, like ourselves, who are designing strategies and technology to link medical information electronically. These numbers challenge premises upon which policy and technology have been based," said the senior study author, Regenstrief Institute investigator Shaun Grannis, M.D., M.S., associate professor of at the Indiana University School of Medicine.

"Since EDs can't predict when patients will appear or know in what other places they have been seen, all EDs need instant access to information from wide swaths of geographic areas and actually the entire nation," said Dr. Grannis, who directs the Indiana in Public , one of only four Centers for Disease Control-funded public health informatics centers in the nation. Data from the Indiana Public Health Emergency Surveillance System was used in the study to determine where emergency department visits were occurring.

As patients in the emergency department often forget key details or are too ill or injured to provide relevant medical history, medications or allergy information, immediate access to their complete medical records is critical to providing appropriate care.

"What may appear to be a simple problem is no longer simple when someone comes in for a second or third ED visit for the same issue. You are no longer thinking earache, you are thinking possible bone infection. Knowing that a patient who comes to the ED with chest pain had a recent clear cardiac scan will make a difference in treatment," said Regenstrief Institute investigator John T. Finnell, M.D., M.S., associate professor of emergency medicine at the IU School of Medicine, who is an author of the new study. He is an emergency medicine physician.

The researchers were not surprised by the large volume of visits to departments across the state. Approximately 2.8 million patients generated 7.4 million visits over three years. But the wide range of the number of visits per patient — from one to 385 — was unexpected.

"Although our findings were specific to Indiana, ED use in other states is likely to be quite similar because there is nothing particularly unique about delivery in Indiana," Dr. Finnell said.

Provided by Indiana University School of Medicine

5 /5 (1 vote)  

Rank 5 /5 (1 vote)
Relevant PhysicsForums posts

More news stories

New research identifies risks, interventions for children's GI health

An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).

Health created 16 minutes ago | popularity not rated yet | comments 0 | with audio podcast

Youth who have their first drink during puberty have higher levels of later drinking

Research shows that the earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems. Thus, age at first drink (AFD) is generally considered a powerful predictor of ...

Health created 17 hours ago | popularity not rated yet | comments 0

British MPs concerned about parliamentary boozing

One quarter of British lawmakers believe there is an "unhealthy" drinking culture in the Houses of Parliament, according to a survey published on Friday.

Health created 23 hours ago | popularity not rated yet | comments 0

Patient openness to research can depend on race and sex of study personnel

Researchers at the University of Cincinnati (UC) have found that the race and sex of study personnel can influence a patient's decision on whether or not to participate in clinical research.

Health created 23 hours ago | popularity not rated yet | comments 0

Clinical support for patient self-management is rhetoric rather than reality

The processes to allow people to self-manage their own illness are not being used appropriately by health professionals to the benefit of their patients, new research suggests.

Health created May 17, 2013 | popularity not rated yet | comments 0


New colonoscope provides ground-breaking view of colon

A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...

AIDS science at 30: 'Cure' now part of lexicon

Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.

For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests

Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...

Melon focus headband turns to Kickstarter for rollout plans

(Medical Xpress)—What if the quality of your work depends more on your focus on the piano keys or canvas or laptop than your musical or painting or computing skills? If target users can be convinced, they ...

Temporal processing in the olfactory system

The neural machinery underlying our olfactory sense continues to be an enigma for neuroscience. A recent review in Neuron seeks to expand traditional ideas about how neurons in the olfactory bulb might encode information about ...

Now we know why old scizophrenia medicine works on antibiotics-resistant bacteria

In 2008 researchers from the University of Southern Denmark showed that the drug thioridazine, which has previously been used to treat schizophrenia, is also a powerful weapon against antibiotic-resistant bacteria such as ...