LEADER 04307oam 2200601 450 001 9910220152003321 005 20190911100038.0 010 $a0-8330-8080-6 010 $a0-8330-8082-2 035 $a(OCoLC)857923165 035 $a(MiFhGG)GVRL6SHE 035 $a(EXLCZ)992670000000417953 100 $a20130515d2013 uy 0 101 0 $aeng 135 $aurun|---uuuua 181 $ctxt 182 $cc 183 $acr 200 04$aThe evolving role of emergency departments in the United States /$fKristy Gonzalez Morganti [and eight others] 210 $aSanta Monica, CA $cRand Corporation$d2013 210 1$aSanta Monica, CA :$cRAND Health,$d2013. 215 $a1 online resource (xi, 63, 43 pages) $cillustrations (some color) 225 1 $aResearch report 225 0 $aGale eBooks 300 $a"RAND Health." 300 $a"Sponsored by the Emergency Medicine Action Fund." 311 $a0-8330-8079-2 320 $aIncludes bibliographical references (p. 57-63). 327 $aCover; Title Page; Copyright; Preface; Table of Contents; Figures; Tables; Executive Summary; Acknowledgements; Abbreviations; 1. Introduction; Trends Affecting the Evolution of Hospital EDs; Overall Growth in Health Care Spending; Growing Use of Hospital EDs; The Rising Cost of ED Care; Efforts to Discourage Non-Urgent Use of EDs; EDs as Entry Points to Inpatient Care; Aims of the RAND Study; Organization of This Report; 2. Conceptual Model of ED Use; 3. Methods; Quantitative Data Sources; Analytical Approach; Qualitative Data Sources; Emergency Physician Focus Groups 327 $aHospital Physician Focus Group Individual Interviews with Primary Care Providers; Review of Qualitative Data; 4. Findings; What are the most important sources of inpatient admissions and how have they changed?; What are the sources driving growth of non-elective inpatient admissions?; Why are primary care physicians admitting fewer patients to hospitals?; Why are patients using EDs for non-urgent care?; Does a patient's insurance coverage influence likelihood of admission and his/her portal of entry to inpatient care? 327 $aDoes a patient's source of primary health insurance influence his/her probability of hospitalization from the ED?Does a patient's type of insurance influence a primary care physician's decision to send the patient to the ED?; Do plans that offer care coordination have lower rates of inpatient admission from EDs than fee-for-service plans?; Are EDs playing a role in reducing preventable hospital admissions?; 5. Discussion; Assessing the Value of Emergency Department Care; The Evolving Relationship Between EDs and Primary Care Providers; Emergency Departments as Diagnostic Centers 327 $aDo Emergency Departments Prevent Costly Inpatient Admissions?Study Limitations; 6. Conclusions; Implications for Policy; References; Appendix A. Additional Quantitative Results; Appendix B. Focus Groups and Interviews 330 $aThis report explores the evolving role that hospital emergency departments play in the U.S. health care system. EDs evaluate and manage complex and high-acuity patients, are the major point of entry to inpatient care, and serve as ""the safety net of the safety net"" for patients who cannot get care elsewhere. The report examines the role that EDs may come to play in either contributing to or reducing the rising costs of health care. 410 0$aResearch report (Rand Corporation) 606 $aEmergency Service, Hospital$xtrends$zUnited States 606 $aEmergency Service, Hospital$xeconomics$zUnited States 606 $aHospitals$xEmergency services$zUnited States 606 $aEmergency medicine$zUnited States 615 12$aEmergency Service, Hospital$xtrends 615 22$aEmergency Service, Hospital$xeconomics 615 0$aHospitals$xEmergency services 615 0$aEmergency medicine 676 $a362.18 700 $aMorganti$b Kristy Gonzalez$01039942 702 $aMorganti$b Kristy Gonzalez 712 02$aRand Corporation. 712 02$aEmergency Medicine Action Fund. 801 0$bMiFhGG 801 1$bMiFhGG 906 $aBOOK 912 $a9910220152003321 996 $aThe evolving role of emergency departments in the United States$92462423 997 $aUNINA