2024
End‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study
Gettel C, Kitchen C, Rothenberg C, Song Y, Hastings S, Kennedy M, Ouchi K, Haimovich A, Hwang U, Venkatesh A. End‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study. Journal Of The American Geriatrics Society 2024 PMID: 39311623, DOI: 10.1111/jgs.19199.Peer-Reviewed Original ResearchEnd-of-lifeOut-of-pocket spendingED visitsTotal healthcare spendingMedicare beneficiariesHealthcare spendingEmergency departmentOlder adultsMedicare Current Beneficiary Survey dataAnalysis of Medicare beneficiariesPooled cross-sectional analysisEmergency department usePrimary outcomeDecreased likelihoodDiagnosis of dementiaOut-of-pocket costsNationally representative studyNationally representative sampleAdult decedentsHospice statusDepartment useED useED servicesHealth careHealthcare expendituresTotal and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage
Gettel C, Salah W, Rothenberg C, Liang Y, Schwartz H, Scott K, Hwang U, Hastings S, Venkatesh A. Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage. Annals Of Emergency Medicine 2024, 84: 285-294. PMID: 38864783, PMCID: PMC11343654, DOI: 10.1016/j.annemergmed.2024.04.023.Peer-Reviewed Original ResearchOut-of-pocketED visitsTraditional MedicareOlder adultsEmergency departmentMedicare AdvantageMedicare Advantage plan enrolleesMedicare Current Beneficiary SurveyEmergency department careTreat-and-releaseOut-of-pocket expensesOut-of-pocket health care spendingHealth care spendingCross-sectional analysisProportion of costsMedian totalEmergency careTreat-and-release emergency departmentBeneficiary SurveyMedian total costProportion of expensesCare spendingPlan enrolleesMedicareVisitsEstimating the size and scope of the academic emergency physician workforce
Gettel C, Camargo C, Bennett C, Courtney D, Kaji A, Fermann G, Gallahue F, Nelson L, Hebbard C, Rothenberg C, Raja A, Venkatesh A. Estimating the size and scope of the academic emergency physician workforce. Academic Emergency Medicine 2024, 31: 732-738. PMID: 38769602, DOI: 10.1111/acem.14931.Peer-Reviewed Original ResearchProportion of emergency physiciansAccreditation Council for Graduate Medical EducationClinical training sitesED visitsEM residency programsAcademic emergency departmentEmergency physiciansEmergency departmentEM workforceEmergency medicineACGME-accredited EM residency programsAcademic sitesProportion of emergency departmentCenters for Medicare & Medicaid ServicesEmergency physician workforceResidency programsProportion of ED visitsDepartment of Veterans AffairsAccredited EM residency programsTraining of resident physiciansAmerican Hospital AssociationTraining sitesNational proportionsAcademic Emergency MedicineGraduate Medical EducationImpact of the geriatric emergency medicine specialist intervention on final emergency department disposition
Cohen I, Sangal R, Taylor R, Crawford A, Lai J, Martin P, Palleschi S, Rothenberg C, Tomasino D, Hwang U. Impact of the geriatric emergency medicine specialist intervention on final emergency department disposition. Journal Of The American Geriatrics Society 2024, 72: 2017-2026. PMID: 38667266, DOI: 10.1111/jgs.18908.Peer-Reviewed Original ResearchED length of stayED lengthLength of stayObservation admissionsED dispositionInpatient admissionsEmergency departmentOdds of inpatient admissionRate of hospital admissionsAdvanced practice providersGeriatric ED patientsEmergency medicine specialistsTarget trial emulation frameworkHospital admission ratesOdds of dischargeRegional healthcare systemEmergency department dispositionIncreased odds of dischargeCare planningPractice providersED sitesED visitsOlder adultsSpecialist interventionAdmission rates
2023
Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department
Hawk K, Weiner S, Rothenberg C, Bernstein E, D'Onofrio G, Herring A, Hoppe J, Ketcham E, LaPietra A, Nelson L, Perrone J, Ranney M, Samuels E, Strayer R, Sharma D, Goyal P, Schuur J, Venkatesh A. Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 225-234. PMID: 37831040, DOI: 10.1016/j.annemergmed.2023.08.490.Peer-Reviewed Original ResearchAtraumatic back painCommunity EDED visitsBack painOpioid prescribing practicesFirst-line treatmentEmergency department patientsOpioid use disorderQuality improvement projectEvidence-based resourcesOpioid administrationOpioid prescriptionsDental painSafe analgesiaDepartment patientsOpioid pillsPrescribing practicesEmergency departmentAmerican CollegeUse disordersMedication safety educationPainOpioidsImprovement projectVisitsAn Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments
Gettel C, Hwang U, Janke A, Rothenberg C, Tomasino D, Schneider S, Goyal P, Venkatesh A. An Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments. Annals Of Emergency Medicine 2023, 82: 681-689. PMID: 37389490, PMCID: PMC10756927, DOI: 10.1016/j.annemergmed.2023.05.013.Peer-Reviewed Original ResearchConceptsGeriatric EDDiagnosis rateED lengthEmergency departmentMedian discharge rateAmerican CollegeRevisit ratesOlder adultsUrinary tract infectionAge categoriesGeriatric Emergency DepartmentHigher diagnosis ratesED visitsTract infectionsMental statusObservational studyDelirium/Outcome comparisonsData registryED statusProcess outcomesED sitesStayAnalytic sampleAdultsEstimated reimbursement impact of COVID‐19 on emergency physicians
Venkatesh A, Janke A, Koski‐Vacirca R, Rothenberg C, Parwani V, Granovsky M, Burke L, Li S, Pines J. Estimated reimbursement impact of COVID‐19 on emergency physicians. Academic Emergency Medicine 2023, 30: 636-643. PMID: 36820470, DOI: 10.1111/acem.14700.Peer-Reviewed Original ResearchConceptsNationwide Emergency Department SampleED visitsEmergency physiciansSecondary analysisCOVID-19Acute care utilizationEmergency Department SampleEmergency Department registryCOVID-19 pandemicHealth care servicesEmergency department sitesReimbursement impactCare utilizationBilling codesInsurance payerDepartment registryPrimary analysisCare servicesPhysiciansReimbursement lossHealth careStudy sampleVisitsPandemic-related lossReimbursementReal-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications
Sangal R, Rothenberg C, Hawk K, D'Onofrio G, Hsiao A, Solad Y, Venkatesh A. Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications. The Joint Commission Journal On Quality And Patient Safety 2023, 49: 239-246. PMID: 36914528, DOI: 10.1016/j.jcjq.2023.01.013.Peer-Reviewed Original ResearchConceptsOpioid prescribingED visitsElectronic health recordsOpioid prescriptionsEmergency department opioid prescriptionsAnalgesia prescriptionOpioid stewardshipOpioid medicationsSecondary outcomesPrimary outcomePreintervention periodInterruptive alertsCommon interventionPrescribingAlert fatigueElectronic prescribingPrevious interventionsHospital systemObservational evaluationHealth recordsVisitsStewardship policiesInterventionOutcomesPrescription
2022
Emergency department utilization for substance use disorders and mental health conditions during COVID-19
Venkatesh AK, Janke AT, Kinsman J, Rothenberg C, Goyal P, Malicki C, D’Onofrio G, Taylor A, Hawk K. Emergency department utilization for substance use disorders and mental health conditions during COVID-19. PLOS ONE 2022, 17: e0262136. PMID: 35025921, PMCID: PMC8757912, DOI: 10.1371/journal.pone.0262136.Peer-Reviewed Original ResearchConceptsOpioid use disorderOverall ED visitsED visitsEmergency departmentMental health conditionsAlcohol use disorderED visitationUse disordersED utilizationHospital-based emergency departmentsHealth conditionsEmergency department utilizationPublic health surveillance toolSite of careClinical quality registryEarly pandemic periodVisit countsSubstance use disordersCOVID-19COVID-19 pandemicED visit countsDiagnosis codesOutpatient treatmentMedicines RegistryQuality registry
2021
National trends in emergency department closures, mergers, and utilization, 2005-2015
Venkatesh AK, Janke A, Rothenberg C, Chan E, Becher RD. National trends in emergency department closures, mergers, and utilization, 2005-2015. PLOS ONE 2021, 16: e0251729. PMID: 34015007, PMCID: PMC8136839, DOI: 10.1371/journal.pone.0251729.Peer-Reviewed Original ResearchConceptsHospital-based EDsEmergency department closureED visitsHospital admissionHospital bedsED closureYearly ED visitsLarge health systemAmerican Hospital Association Annual SurveyInpatient bed capacityPrimary outcomeSecondary outcomesMore patientsEmergency departmentRelative increaseInpatient bedsPatient volumeRural areasHealth systemAdmissionVisitsNational trendsBed capacityEDObservational analysisEmergency Department Utilization for Emergency Conditions During COVID-19
Venkatesh AK, Janke AT, Shu-Xia L, Rothenberg C, Goyal P, Terry A, Lin M. Emergency Department Utilization for Emergency Conditions During COVID-19. Annals Of Emergency Medicine 2021, 78: 84-91. PMID: 33840512, PMCID: PMC7805390, DOI: 10.1016/j.annemergmed.2021.01.011.Peer-Reviewed Original ResearchConceptsED visitsED visit countsVisit countsClinical Modification codesEmergency department utilizationAcute myocardial infarctionEmergency Department registryCoronavirus disease 2019 (COVID-19) outbreakCoronavirus disease 2019Emergency department (ED) visitationEmergency medical conditionsClinical quality registryTotal visit countsDisease 2019 outbreakCerebrovascular diseaseMyocardial infarctionQuality registryTenth RevisionDisease 2019Medical conditionsEmergency conditionsInternational ClassificationEmergency carePrepandemic levelsDepartment registry
2020
Unscheduled Care Access in the United States-A Tale of Two Emergency Departments
Venkatesh AK, Greenwood-Ericksen MB, Mei H, Rothenberg C, Lin Z, Krumholz HM. Unscheduled Care Access in the United States-A Tale of Two Emergency Departments. The American Journal Of Emergency Medicine 2020, 45: 374-377. PMID: 33143957, PMCID: PMC8076339, DOI: 10.1016/j.ajem.2020.08.095.Peer-Reviewed Original ResearchConceptsHospital referral regionsED visit ratesEmergency departmentCare ratesVisit ratesMedicare Chronic Conditions WarehouseHospital-based emergency departmentsRole of EDsChronic Conditions WarehouseProportion of beneficiariesDartmouth Atlas hospital referral regionHealthcare delivery systemED utilizationED visitsED useUnscheduled careReferral regionsUrban zip codesCare accessMedicare beneficiariesCare needsCare deliveryOffice settingCare capabilitiesDisproportionate barriersNational Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare Survey
2019
Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency
Coughlin RF, Peaper D, Rothenberg C, Golden M, Landry ML, Cotton J, Parwani V, Shapiro M, Ulrich A, Venkatesh AK. Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency. American Journal Of Medical Quality 2019, 35: 252-257. PMID: 31296024, DOI: 10.1177/1062860619861947.Peer-Reviewed Original ResearchConceptsUrine culture ordersUrine culture testingED visitsUrine cultureEmergency departmentDiagnostic yieldCulture ordersCulture testingUrine culture utilizationClinical decision support toolElectronic health recordsSecondary outcomesPrimary outcomeTest utilizationHealth recordsSignificant decreaseDiagnostic efficiencyMean numberVisitsCulture utilizationOutcomesTesting algorithm
2018
Patient centered medical homes did not improve access to timely follow-up after ED visit
Chou SC, Rothenberg C, Agnoli A, Wiechers I, Lott J, Voorhees J, Bernstein SL, Venkatesh AK. Patient centered medical homes did not improve access to timely follow-up after ED visit. The American Journal Of Emergency Medicine 2018, 36: 854-858. PMID: 29452920, DOI: 10.1016/j.ajem.2018.01.070.Peer-Reviewed Original ResearchConceptsPrimary care followPrimary care practicesPCMH designationCare followAffordable Care ActAppointment availabilityCare practicesEmergency department dischargeGreater New HavenED visitsED patientsTimely followInsurance statusOutpatient practiceInsurance typeHours appointmentED diagnosisMedical homeLocal cliniciansPractice characteristicsSignificant associationPatientsFollowStandardized scriptPractice improvementTrends and Variation in the Utilization and Diagnostic Yield of Chest Imaging for Medicare Patients With Suspected Pulmonary Embolism in the Emergency Department.
Venkatesh AK, Agha L, Abaluck J, Rothenberg C, Kabrhel C, Raja AS. Trends and Variation in the Utilization and Diagnostic Yield of Chest Imaging for Medicare Patients With Suspected Pulmonary Embolism in the Emergency Department. American Journal Of Roentgenology 2018, 210: 572-577. PMID: 29364724, DOI: 10.2214/ajr.17.18586.Peer-Reviewed Original ResearchConceptsChest CT utilizationPulmonary embolismCT utilizationEmergency departmentDiagnostic yieldMedicare beneficiariesEmergency medicine board certificationAmerican Medical Association Physician MasterfileChest CT useSample of feeHospital referral regionsAmerican Hospital Association Annual SurveyED visitsChest CTHospital characteristicsCT useAnalytic FilesMedicare patientsChest imagingProvider characteristicsReferral regionsPhysician identificationPhysician useService beneficiariesPhysician Masterfile
2017
Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications
Venkatesh AK, Mei H, Kocher KE, Granovsky M, Obermeyer Z, Spatz E, Rothenberg C, Krumholz H, Lin Z. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications. Academic Emergency Medicine 2017, 24: 422-431. PMID: 27864915, PMCID: PMC5905698, DOI: 10.1111/acem.13140.Peer-Reviewed Original ResearchConceptsED visitsEmergency department visitsClaims-based definitionED visitationAdministrative claimsDepartment visitsClaims dataAdministrative claims data setsHealthcare resource utilizationMore ED visitsAcute care practiceAdministrative claims dataQuality improvement interventionsEmergency care researchMedicare administrative claimsClaims data setsED useCritical careED servicesMedicare feeMedicare dataCare practicesService beneficiariesImprovement interventionsProvider definitionsReducing Unnecessary Blood Chemistry Testing in the Emergency Department: Implementation of Choosing Wisely
Venkatesh AK, Hajdasz D, Rothenberg C, Dashevsky M, Parwani V, Sevilla M, Shapiro M, Schwartz I. Reducing Unnecessary Blood Chemistry Testing in the Emergency Department: Implementation of Choosing Wisely. American Journal Of Medical Quality 2017, 33: 81-85. PMID: 28693330, DOI: 10.1177/1062860617691842.Peer-Reviewed Original ResearchConceptsBlood chemistry testingMultimodal interventionChemistry testingFormal laboratory testingMultimodal quality improvement interventionQuality improvement interventionsChemistry testsCare laboratory testingEmergency department throughputPre-post analysisAutoregressive integrated moving-average modelsED visitsPrimary outcomeUrban EDEmergency departmentProvider educationLaboratory testingImprovement interventionsVisitsInterventionDaily numberEDTesting