Geography of ED Use and Population Health

Statewide Analysis of Emergency Department Use for Determining Geographic Patterns of Emergency Care Use, Hospital Choice and Measures of Population Health.

The goal of this study is to create predictive models of emergency care and metrics for population health that can be used to analyze how events like hospital closures or disasters like Hurricane Sandy affect health care utilization by patients in specific populations or geographic regions. Additionally, it will allow the development of metrics for population health that can act as surveillance mechanisms to measure disease prevalence and identify patterns in emergency department use that can be used to identify specific geographic regions where health care is either optimized to promote health or needs to be improve so that population health can be improved.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus; Emergencies
• Intervention / Treatment: Other: Statewide Planning and Research Cooperative System Database

Detailed Description

The purpose of this study is to analyze the geographic patterns of emergency department utilization. This study will look at the relationship that geographic proximity and local population factors have on patient use of emergency departments. Geographic proximity of alternative hospitals and elicit other patient and hospital specific factors, such as demographic, insurance type, diagnosis, and socioeconomic factors that lead patients to choose specific hospitals for emergency care or generally lead to patients accessing emergency care will be compared.

Patterns of emergency department utilization by patients will be identified in specific geographies such as Census tracts to determine clusters of high and low emergency department use. We also analyze the patterns of emergency care use based on specific disease conditions.Investigators will analyze the rate of emergency department use for patients with diabetes to determine population prevalence of diseases using emergency department data. Studying the pattern of use by specific geographies or disease conditions will also allow us to understand how emergency department use varies among populations by geographies and the socioeconomic and health care factors local to those regions.

• Study Type: Observational
• Enrollment (Actual): 100

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10016
      • New York University School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 120 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Includes all patients visiting an emergency department in New York State

Description

Inclusion Criteria:

• Patients visiting an emergency department in New York State

Exclusion Criteria:

• Depending on the population analyzed, may exclude some subpopulations such as children (in order study adults), prisoners or patients transferred from other healthcare facilities (in order to study non-institutionalized individuals).

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Patients visiting an emergency department in New York State

Other: Statewide Planning and Research Cooperative System Database; The Statewide Planning and Research Cooperative System (SPARCS) is a comprehensive data reporting system created to collect information on discharges from hospitals. SPARCS currently collects patient level detail on patient characteristics, diagnoses and treatments, services, and charges for every hospital discharge, ambulatory surgery patient, and emergency department admission in New York State.; Other Names: SPARCS

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emergency Deparrtment (ED) visit by a patient	In order to identify repeat ED visits by the same individual, unique identifiers within SPARCS match visits by the same individual throughout the study period	1 Day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Surveillance of Disease Prevalence	Proportion of individuals who recieve a given diagnosis like diabetes during any emergency department visit including emergency inpatient admissions.	1 Day
Extension to Other Disease Conditions and Geographies	Analysis of how disease prevalence can be measured at the level of the entire state. Populations will be stratified based on geography.	1 Day
Hospital Selection	Identification of the selection of a given hospital by patients based on facility codes contained within the SPARCS database.	1 Day

Collaborators and Investigators

• Sponsor: NYU Langone Health
• Investigators: Principal Investigator: David Lee, MD, NYU Langone Health

Study record dates

Study Major Dates

• Study Start (Actual): August 20, 2014
• Primary Completion (Actual): December 31, 2020
• Study Completion (Actual): December 31, 2020

Study Registration Dates

• First Submitted: August 16, 2017
• First Submitted That Met QC Criteria: August 16, 2017
• First Posted (Actual): August 18, 2017

Study Record Updates

• Last Update Posted (Actual): February 8, 2021
• Last Update Submitted That Met QC Criteria: February 4, 2021
• Last Verified: February 1, 2021

More Information

Terms related to this study

• Keywords: Epidemiology Research
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 14-01408

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No