2023
Emergency medicine physician workforce attrition differences by age and gender
Gettel C, Courtney D, Agrawal P, Madsen T, Rothenberg C, Mills A, Lall M, Keim S, Kraus C, Ranney M, Venkatesh A. Emergency medicine physician workforce attrition differences by age and gender. Academic Emergency Medicine 2023, 30: 1092-1100. PMID: 37313983, PMCID: PMC10973949, DOI: 10.1111/acem.14764.Peer-Reviewed Original ResearchConceptsFemale emergency physiciansEmergency physiciansMedian ageMultivariate logistic regression modelMale emergency physiciansResidency graduationRepeated cross-sectional analysisCharacteristics of physiciansWorkforce attritionCross-sectional analysisLogistic regression modelsStudy time frameDate of birthPrimary outcomeFemale genderMale physiciansClinical practiceFemale physiciansClinical servicesPhysiciansEmergency medicineAgeNumber of yearsRecent dataWorkforce concernsEstimated 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 ResearchMeSH KeywordsCOVID-19Emergency Medical ServicesEmergency Service, HospitalHumansPandemicsPhysiciansUnited StatesConceptsNationwide 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 lossReimbursement
2022
Patient cost consciousness in the emergency department
Gaylor JM, Chan E, Parwani V, Ulrich A, Rothenberg C, Venkatesh A. Patient cost consciousness in the emergency department. The American Journal Of Emergency Medicine 2022, 61: 61-63. PMID: 36054987, DOI: 10.1016/j.ajem.2022.08.039.Peer-Reviewed Original ResearchMeSH KeywordsConsciousnessEmergency Service, HospitalFees and ChargesHumansMedically UninsuredMedicareUnited StatesConceptsEmergency departmentPocket costsED patientsLarge academic hospital systemAcademic hospital systemCertain patient demographicsEmergency department settingPerceptions of patientsCost of careMedicare/MedicaidPatient demographicsED careUnscheduled careUninsured patientsDepartment settingPatients' estimatesPatient's abilityEmergency careHigh school educationPatientsPrivate insuranceFinal analysisHospital systemCareConvenience sampleImproving Sepsis Management Through the Emergency Quality Network Sepsis Initiative
Rodos A, Aaronson E, Rothenberg C, Goyal P, Sharma D, Slesinger T, Schuur J, Venkatesh A. Improving Sepsis Management Through the Emergency Quality Network Sepsis Initiative. The Joint Commission Journal On Quality And Patient Safety 2022, 48: 572-580. PMID: 36137885, DOI: 10.1016/j.jcjq.2022.08.002.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesEmergency Service, HospitalHospitalsHumansMedicareSepsisUnited StatesConceptsSepsis casesQI activitiesSEP-1 performanceEmergency department patientsQI effortsTime-sensitive conditionsSignificant correlationCross-sectional analysisSepsis careDepartment patientsSepsis managementAmerican CollegeED sitesScoresPublic reportingReal-time quality improvementHospital performanceEDQuality improvementImplementation dataOverall hospital performanceQI dataPatientsInpatientsED performanceThe 2013 to 2019 Emergency Medicine Workforce: Clinician Entry and Attrition Across the US Geography
Gettel CJ, Courtney DM, Janke AT, Rothenberg C, Mills AM, Sun W, Venkatesh AK. The 2013 to 2019 Emergency Medicine Workforce: Clinician Entry and Attrition Across the US Geography. Annals Of Emergency Medicine 2022, 80: 260-271. PMID: 35717274, PMCID: PMC9398978, DOI: 10.1016/j.annemergmed.2022.04.031.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesEmergency MedicineGeographyHumansMedicareUnited StatesWorkforceConceptsAdvanced practice providersEmergency physiciansPractice providersNonemergency physiciansEmergency cliniciansRural designationUrban emergency physiciansRepeated cross-sectional analysisEmergency medicine workforceCross-sectional analysisUnique cliniciansMedicare Part BStudy yearsCliniciansPhysiciansProvider UtilizationPhysician attritionSubstantial state-level variationResidency trainingLongitudinal trendsManagement servicesAttrition ratesState-level changesState-level variationTotal proportion
2021
Universal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay
Sangal RB, Peaper DR, Rothenberg C, Landry ML, Sussman LS, Martinello RA, Ulrich A, Venkatesh AK. Universal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay. Annals Of Emergency Medicine 2021, 79: 182-186. PMID: 34756452, PMCID: PMC8424016, DOI: 10.1016/j.annemergmed.2021.09.005.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19COVID-19 TestingEmergency Service, HospitalHumansLength of StayPandemicsSARS-CoV-2United StatesConceptsSARS-CoV-2 testingUniversal SARS-CoV-2 testingEmergency department lengthAdmission lengthED admissionPositivity rateSARS-CoV-2 testAcademic health systemCOVID-19 prevalenceSecondary outcomesED lengthPrevention needsED boardingPatientsStayPositive casesClinical costsHealth systemAdmissionTesting policiesContainment effortsTestingPrevalenceTesting changesPositivityNational 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 ResearchMeSH KeywordsEmergency Service, HospitalHospitalizationHospitalsHumansInpatientsPatient AdmissionUnited StatesConceptsHospital-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 analysisAnalysis of Hospital Resource Availability and COVID‐19 Mortality Across the United States
Janke AT, Mei H, Rothenberg C, Becher RD, Lin Z, Venkatesh AK. Analysis of Hospital Resource Availability and COVID‐19 Mortality Across the United States. Journal Of Hospital Medicine 2021, 16: 211-214. PMID: 33496664, PMCID: PMC8025594, DOI: 10.12788/jhm.3539.Peer-Reviewed Original ResearchConceptsCOVID-19 casesHospital resourcesIntensive care unit bedsHospital referral regionsCOVID-19 mortalityAmerican Hospital Association dataCOVID-19 deathsHospital resource availabilityDeath countsIncidence rateSurgical bedCare modelReferral regionsUnit bedsCOVID-19MortalityDeathUnited StatesLittle assessmentCOVID-19 dataCountGeographic areasNursesFair Play: Application of Normalized Scoring to Emergency Department Throughput Quality Measures in a National Registry
Venkatesh A, Ravi S, Rothenberg C, Kinsman J, Sun J, Goyal P, Augustine J, Epstein SK. Fair Play: Application of Normalized Scoring to Emergency Department Throughput Quality Measures in a National Registry. Annals Of Emergency Medicine 2021, 77: 501-510. PMID: 33455841, PMCID: PMC9103009, DOI: 10.1016/j.annemergmed.2020.10.021.Peer-Reviewed Original ResearchConceptsED groupMultiple EDsNational registryPatient-centered quality measuresED visit volumeHigh-volume EDsEmergency department throughputRegistry data setsSingle EDAmerican CollegeVisit volumeED typeRegistryStandardized approachPerformance scoresIdentification numberVisitsEDAcceptable methodStandardized scoresGroup-level analysisQuality measuresGroupScoresPerformance programsEmergency 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 SurveyWhere Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionCross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries
Venkatesh AK, Mei H, Shuling L, D’Onofrio G, Rothenberg C, Lin Z, Krumholz HM. Cross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries. Academic Emergency Medicine 2020, 27: 570-579. PMID: 32302034, DOI: 10.1111/acem.13971.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsEmergency departmentUnscheduled careMedicare beneficiariesCross-sectional analysisVisit ratesCare servicesHighest ED visit ratesNumber of EDVulnerable subpopulationsSkilled nursing facility useAmbulatory office settingNon-ED settingsUnscheduled care servicesAcute care utilizationED visit ratesOffice-based visitsAcute care servicesClaims-based definitionNursing facility useMedicare beneficiaries age 65Dual-eligible beneficiariesOlder adult populationBeneficiaries age 65Care visitsNational Assessment of Surprise Coverage Gaps Provided to Simulated Patients Seeking Emergency Care
Parwani V, Ulrich A, Rothenberg C, Kinsman J, Duhaime M, Thomas M, Venkatesh A. National Assessment of Surprise Coverage Gaps Provided to Simulated Patients Seeking Emergency Care. JAMA Network Open 2020, 3: e206868. PMID: 32412634, PMCID: PMC7229522, DOI: 10.1001/jamanetworkopen.2020.6868.Peer-Reviewed Original ResearchChoosing wisely in emergency medicine: Early results and insights from the ACEP emergency quality network (E-QUAL)
Venkatesh AK, Scofi JE, Rothenberg C, Berdahl CT, Tarrant N, Sharma D, Goyal P, Pilgrim R, Klauer K, Schuur JD. Choosing wisely in emergency medicine: Early results and insights from the ACEP emergency quality network (E-QUAL). The American Journal Of Emergency Medicine 2020, 39: 102-108. PMID: 32014376, PMCID: PMC7365747, DOI: 10.1016/j.ajem.2020.01.029.Peer-Reviewed Original ResearchConceptsCT utilization ratesMinor head injuryLow back painBack painHead injuryED sitesAtraumatic back painChoosing Wisely recommendationsQuality improvement dataLow-value careWisely recommendationsEmergency physiciansObservational studyQI interventionsAmerican CollegeClinical targetsPainSyncopeQI practicesInjuryEmergency medicineSignificant decreasePractice improvementImprovement dataMRI
2018
Urban and Rural Emergency Department Performance on National Quality Metrics for Sepsis Care in the United States
Greenwood‐Ericksen M, Rothenberg C, Mohr N, Andrea SD, Slesinger T, Osborn T, Whittle J, Goyal P, Tarrant N, Schuur JD, Yealy DM, Venkatesh A. Urban and Rural Emergency Department Performance on National Quality Metrics for Sepsis Care in the United States. The Journal Of Rural Health 2018, 35: 490-497. PMID: 30488590, DOI: 10.1111/jrh.12339.Peer-Reviewed Original ResearchConceptsSepsis careUrban EDRural EDsHospital-based EDsNational quality measuresManual chart reviewNational quality metricsEmergency department performanceBundle adherenceChart reviewFluid administrationPatient chartsBlood culturesPatient levelEmergency physiciansAmerican CollegeHospital levelRural hospitalsCare qualityCMS measuresMedicaid ServicesCareCMS definitionsManual reviewEDEmergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service
Lord K, Parwani V, Ulrich A, Finn EB, Rothenberg C, Emerson B, Rosenberg A, Venkatesh AK. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal Of Emergency Medicine 2018, 36: 1246-1248. PMID: 29605480, DOI: 10.1016/j.ajem.2018.03.043.Peer-Reviewed Original ResearchConceptsAdverse hospitalization outcomesRapid response team activationGeneral medical servicesHospitalization outcomesEmergency departmentED boardingComposite outcomeCare escalationPrimary outcomeAdverse outcomesRRT activationPatient encountersConsecutive patient encountersGeneral medicine serviceInpatient hospital stayMedical servicesEmergency department boardingED departureHospital mortalityHospital deathHospital stayED admissionPatient demographicsHospital admissionIntensive carePatient 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