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Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department ( ED ) Visits: The ED Prevention Quality Indicators for General Health Conditions
Author(s) -
Davies Sheryl,
Schultz Ellen,
Raven Maria,
Wang Nancy Ewen,
Stocks Carol L.,
Delgado Mucio Kit,
McDonald Kathryn M.
Publication year - 2017
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12687
Subject(s) - emergency department , medicaid , medicine , health care , environmental health , delphi method , healthcare cost and utilization project , population , poverty , health department , public health , agency (philosophy) , medical emergency , family medicine , nursing , statistics , philosophy , mathematics , epistemology , economics , economic growth
Objective To develop and validate rates of potentially preventable emergency department ( ED ) visits as indicators of community health. Data Sources Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008–2010 State Inpatient Databases and State Emergency Department Databases. Study Design Empirical analyses and structured panel reviews. Methods Panels of 14–17 clinicians and end users evaluated a set of ED Prevention Quality Indicators ( PQI s) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county‐level poverty, uninsurance, and density of primary care physicians ( PCP s). Principal Findings ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county‐level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end‐user panel separately rated the indicators as having strong face validity for most uses evaluated. Conclusions The ED PQI s have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research.