Emergency department use and subsequent hospitalizations among members of a high-deductible health plan

JAMA

Volumn 297, Issue 10, 2007, Pages 1093-1102

  Wharam, J Frank ^a   Landon, Bruce E ^a,b   Galbraith, Alison A ^a   Kleinman, Ken P ^a   Soumerai, Stephen B ^a   Ross Degnan, Dennis ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CHILD; CONTROLLED STUDY; COST OF ILLNESS; DISEASE SEVERITY; EMERGENCY CARE; EMERGENCY WARD; FEMALE; FOLLOW UP; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE UTILIZATION; HEALTH MAINTENANCE ORGANIZATION; HOSPITAL ADMISSION; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RISK ASSESSMENT;

EID: 33947271823     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.297.10.1093     Document Type: Article

References (52)

1. Baker LC, Baker LS. Excess cost of emergency department visits for nonurgent care. Health Aff (Millwood). 1994;13:162-171.
2. Bamezai A, Melnick G, Nawathe A. The cost of an emergency department visit and its relationship to emergency department volume. Ann Emerg Med. 2005;45:483-490.
3. O'Grady KF, Manning WG, Newhouse JP, Brook RH. The impact of cost sharing on emergency department use. N Engl J Med. 1985;313:484-490.
4. Selby JV, Fireman BH, Swain BE. Effect of a copayment on use of the emergency department in a health maintenance organization. N Engl J Med. 1996;334:635-641.
5. Billings J, Parikh N, Mijanovich T. Emergency department use: the New York story. Issue Brief (Commonw Fund). November 2000;(434):1-12.
6. Derlet RW, Richards JR. Overcrowding in the nation's emergency departments: complex causes and disturbing effects. Ann Emerg Med. 2000;35:63-68.
7. Billings J, Parikh N, Mijanovich T. Emergency department use in New York City: a substitute for primary care? Issue Brief (Commonw Fund). November 2000;(433):1-5.
8. Institute of Medicine Committee on the Future of Emergency Care in the United States Health System. The Future of Emergency Care: Key Findings and Recommendations. http://www.iom.edu/Object.File/Master/35/040/ Emergency%20Care%20Findings%20and%20Recs.pdf. Accessed January 28, 2007.
9. Sprivulis PC, Da Silva JA, Jacobs IG, Frazer AR, Jelinek GA. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust. 2006;184:208-212.
10. Trzeciak S, Rivers EP. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J. 2003;20:402-405.
11. Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust. 2006;184:213-216.
12. Bindman AB, Grumbach K, Keane D, Rauch L, Luce JM. Consequences of queuing for care at a public hospital emergency department. JAMA. 1991;266:1091-1096.
13. Cogan JF, Hubbard RG, Kessler DP. Making markets work: five steps to a better health care system. Health Aff (Millwood). 2005;24:1447-1457.
14. Herzlinger RE. Let's put consumers in charge of health care. Harv Bus Rev. 2002;80:44-50, 52-45, 123.
15. Cannon MF. Health savings accounts: do the critics have a point? https://www.cato.org/pub_display.php?pub_id=6395. Accessed July 7, 2006.
16. Bush GW. The president's proposal for health security in the world's best health care system. http://www.whitehouse.gov/infocus/medicare/health-care/ health-accts.html. Accessed February 21, 2007.
17. Landa AS. Medicaid to offer HSA pilot program. http://www.ama-assn.org/ amednews/2006/03/13/gvsa0313.htm. Accessed July 7, 2006.
18. Yoo H, Chovan T. January census shows 3.2 million people covered by HSA plans. http://www.ahipresearch.org/pdfs/HSAHDHPReportJanuary2006.pdf. Accessed July 7, 2006.
19. Centers for Medicare and Medicaid Services. Fact sheet on 2007 Medicare medical savings account plans. http://www.cms.hhs.gov/MedicareAdvantageApps/ Downloads/MSA_Hill_Fact_Sheet.9.29.06.pdf. Accessed February 10, 2007.
20. Kaiser Family Foundation and Health Research and Educational Trust. Employer health benefits 2006 annual survey. http://www.kff.org/insurance/7527/ upload/7527.pdf. Accessed January 28, 2007.
21. Palmisano DJ, Emmons DW, Wozniak GD. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform. JAMA. 2004;291:2237-2242.
22. Davis K. Will consumer-directed health care improve system performance? Issue Brief (Commonw Fund). August 2004;(773):1-4.
23. Ginsburg PB. Controlling health care costs. N Engl J Med. 2004;351:1591-1593.
24. Shearer G. Defined contribution health plans: attracting the healthy and well-off. Health Serv Res. 2004;39:1159-1166.
25. Lee TH, Zapert K. Do high-deductible health plans threaten quality of care? N Engl J Med. 2005;353:1202-1204.
26. Rassell ME. Cost sharing in health insurance - a reexamination. N Engl J Med. 1995;332:1164-1168.
27. Newhouse JP. Free for All? Lessons From the RANDHealth Insurance Experiment. Cambridge, Mass: Harvard University Press; 1996.
28. Roblin DW, Platt R, Goodman MJ, et al. Effect of increased cost-sharing on oral hypoglycemic use in five managed care organizations: how much is too much? Med Care. 2005;43:951-959.
29. Tamblyn R, Laprise R, Hanley JA, et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA. 2001;285:421-429.
30. Blustein J. Medicare coverage, supplemental insurance, and the use of mammography by older women. N Engl J Med. 1995;332:1138-1143.
31. Soumerai SB, Ross-Degnan D, Avorn J, McLaughlin T, Choodnovskiy I. Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. N Engl J Med. 1991;325:1072-1077.
32. Magid DJ, Koepsell TD, Every NR, et al. Absence of association between insurance copayments and delays in seeking emergency care among patients with myocardial infarction. N Engl J Med. 1997;336:1722-1729.
33. Hsu J, Price M, Brand R, et al. Cost-sharing for emergency care and unfavorable clinical events: findings from the Safety and Financial Ramifications of ED Copayments Study. Health Serv Res. 2006;41:1801-1820.
34. Buntin MB, Damberg C, Haviland A, et al. Consumer-directed health care: early evidence about effects on cost and quality. Health Aff (Millwood). 2006;25:w516-w530.
35. Cowen ME, Dusseau DJ, Toth BG, Guisinger C, Zodet MW, Shyr Y. Casemix adjustment of managed care claims data using the clinical classification for health policy research method. Med Care. 1998;36:1108-1113.
36. Ash AS, Posner MA, Speckman J, Franco S, Yacht AC, Bramwell L. Using claims data to examine mortality trends following hospitalization for heart attack in Medicare. Health Serv Res. 2003;38:1253-1262.
37. Cowen ME, Strawderman RL. Quantifying the physician contribution to managed care pharmacy expenses: a random effects approach. Med Care. 2002;40:650-661.
38. Yu W, Ravelo A, Wagner TH, Barnett PG. The relationships among age, chronic conditions, and healthcare costs. Am J Manag Care. 2004;10:909-916.
39. Travers DA, Haas SW, Waller AE, Tintinalli JE. Diagnosis clusters for emergency medicine. Acad Emerg Med. 2003;10:1337-1344.
40. Wuerz RC, Meador SA. Effects of prehospital medications on mortality and length of stay in congestive heart failure. Ann Emerg Med. 1992;21:669-674.
41. Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA. 2003;290:1868-1874.
42. Schneeweiss S, Seeger JD, Maclure M, Wang PS, Avorn J, Glynn RJ. Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. Am J Epidemiol. 2001;154:854-864.
43. Clark DO, Von Korff M, Saunders K, Baluch WM, Simon GE. A chronic disease score with empirically derived weights. Med Care. 1995;33:783-795.
44. Fishman PA, Shay DK. Development and estimation of a pediatric chronic disease score using automated pharmacy data. Med Care. 1999;37:874-883.
45. Johnson RE, Hornbrook MC, Nichols GA. Replicating the Chronic Disease Score (CDS) from automated pharmacy data. J Clin Epidemiol. 1994;47:1191-1199.
46. US Bureau of the Census. Geographical Areas Reference Manual. Washington, DC: US Bureau of the Census; 1994.
47. Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramanian SV. Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures - the public health disparities geocoding project. Am J Public Health. 2003;93:1655-1671.
48. Koenker R, Bassett GW. Regression quantiles. Econometrica. 1978;46:33-50.
49. Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13-22.
50. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121-130.
51. Ruger JP, Richter CJ, Lewis LM. Association between insurance status and admission rate for patients evaluated in the emergency department. Acad Emerg Med. 2003;10:1285-1288.
52. Sox CM, Burstin HR, Edwards RA, O'Neil AC, Brennan TA. Hospital admissions through the emergency department: does insurance status matter? Am J Med. 1998;105:506-512.