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 expenditures“What Matters” in the Emergency Department
Chera T, Tinetti M, Travers J, Galske J, Venkatesh A, Southerland L, Dresden S, McQuown C, Gettel C. “What Matters” in the Emergency Department. Medical Care 2024, 62: s50-s56. PMID: 39514495, PMCID: PMC11548826, DOI: 10.1097/mlr.0000000000002053.Peer-Reviewed Original ResearchConceptsOlder adultsEmergency departmentEmergency careED visitsAssociated with meetingAssociated with older adultsEnd-of-lifeFollow-upPatient characteristicsMultivariate logistic regression modelCare of oneselfLogistic regression modelsFollow-up interviewsMulticenter prospective observational studyHealthcare settingsED encountersFunctional independenceProspective observational studySecondary analysisSymptom identificationAssess concernsSecondary outcomesPrimary outcomeCareObservational studyTotal 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 EducationReliability of a Measure of Admission Intensity for Emergency Physicians
Janke A, Oskvarek J, Zocchi M, Cai A, Litvak O, Pines J, Venkatesh A. Reliability of a Measure of Admission Intensity for Emergency Physicians. Annals Of Emergency Medicine 2024, 84: 295-304. PMID: 38430082, DOI: 10.1016/j.annemergmed.2024.02.002.Peer-Reviewed Original ResearchED admission ratesIntraclass correlation coefficientAdmission ratesEmergency departmentAverage admission rateMeasures of emergency departmentValue-based care programsInternational Classification of DiseasesClassification of DiseasesLinear probability modelsMultilevel linear probability modelsCare programED visitsInternational ClassificationEmergency physiciansDiagnosis codesCorrelation coefficientPhysiciansIdentifying high-Reduce variationIntraclassStandard deviationAdmissionClinical conditionsAssess stabilityPatient‐reported outcome measure use among older adults after emergency department care: A systematic review
Gettel C, Galske J, Sather A, Haidous A, Hwang U, Brackett A, Venkatesh A, Rising K, Goldberg E, van Oppen J, Conroy S, Carpenter C. Patient‐reported outcome measure use among older adults after emergency department care: A systematic review. Academic Emergency Medicine 2024, 31: 273-287. PMID: 38366698, DOI: 10.1111/acem.14850.Peer-Reviewed Original ResearchPatient-reported outcome measuresActivities of daily livingED visitsOlder adultsPhysical functionPatient-reported outcome measure useInstrumental activities of daily livingKatz activities of daily livingOlder adult ED patientsPatient-reported outcome measure assessmentSystematic reviewOutcome measure useEmergency department carePatient symptom burdenFull-text screeningAdult ED patientsRisk of biasQuality of lifeStudy inclusion criteriaWeb of Science-Core CollectionKatz ActivitiesEmergency careDaily livingPROM assessmentBarthel Index
2023
Inequities among patient placement in emergency department hallway treatment spaces
Tuffuor K, Su H, Meng L, Pinker E, Tarabar A, Van Tonder R, Chmura C, Parwani V, Venkatesh A, Sangal R. Inequities among patient placement in emergency department hallway treatment spaces. The American Journal Of Emergency Medicine 2023, 76: 70-74. PMID: 38006634, DOI: 10.1016/j.ajem.2023.11.013.Peer-Reviewed Original ResearchEscalation of careAdjusted odds ratioED revisitsHallway bedsEmergency departmentHigher oddsPatient placementPatient insurance coverageSocial risk factorsPatient social factorsDischarge AMAED visitsSecondary outcomesPatient agePatient demographicsPrimary outcomeMale sexPatient sexTreatment spaceED censusFemale sexRisk factorsOdds ratioED staffingObservational studyRace and Ethnicity and Emergency Department Discharge Against Medical Advice
Tsai J, Janke A, Krumholz H, Khidir H, Venkatesh A. Race and Ethnicity and Emergency Department Discharge Against Medical Advice. JAMA Network Open 2023, 6: e2345437. PMID: 38015503, PMCID: PMC10685883, DOI: 10.1001/jamanetworkopen.2023.45437.Peer-Reviewed Original ResearchConceptsWhite patientsHispanic patientsEmergency departmentCross-sectional studyED visitsBlack patientsDAMA rateMedical adviceMAIN OUTCOMEEthnic disparitiesNationwide Emergency Department SampleNational cross-sectional studyHospital ED visitsEmergency department dischargeHospital-level variationEmergency Department SampleMetropolitan teaching hospitalHealth care resourcesMedian ageGreater morbidityHospital variationUnadjusted analysesTeaching hospitalAdditional adjustmentLower oddsLeveraging 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 projectVisitsSociodemographic Disparities in Queue Jumping for Emergency Department Care
Sangal R, Su H, Khidir H, Parwani V, Liebhardt B, Pinker E, Meng L, Venkatesh A, Ulrich A. Sociodemographic Disparities in Queue Jumping for Emergency Department Care. JAMA Network Open 2023, 6: e2326338. PMID: 37505495, PMCID: PMC10383013, DOI: 10.1001/jamanetworkopen.2023.26338.Peer-Reviewed Original ResearchConceptsCross-sectional studyHigh acuityPatient demographicsSame acuityLatino ethnicityNon-Hispanic raceEmergency department careBed placementTime of triageNon-Hispanic blacksNon-Hispanic whitesED visitsPrimary outcomeED arrivalED patientsMedicaid insuranceMean ageTriage acuityStudy visitAcuity patientsSociodemographic disparitiesED outcomesHigher oddsMAIN OUTCOMECare accessAn 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 sampleAdultsThe Cost Shifting Economics of United States Emergency Department Professional Services (2016–2019)
Pines J, Zocchi M, Black B, Carr B, Celedon P, Janke A, Moghtaderi A, Oskvarek J, Venkatesh A, Venkat A, Group A. The Cost Shifting Economics of United States Emergency Department Professional Services (2016–2019). Annals Of Emergency Medicine 2023, 82: 637-646. PMID: 37330720, DOI: 10.1016/j.annemergmed.2023.04.026.Peer-Reviewed Original ResearchConceptsNationwide Emergency Department SampleED visitsCommercial insuranceUninsured ED visitsEmergency Department SampleHealth Care Cost InstituteUnreimbursed careED cliniciansMedicaid visitsPatientsInsurance sourceMedicare visitsVisitsMedicaidHealth insuranceLongstanding effectsMedicareCliniciansProfessional servicesInsuranceEstimated 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 policiesInterventionOutcomesPrescriptionChoice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering
Sangal R, Venkatesh A, Cahill J, Pettker C, Peaper D. Choice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering. The Journal Of Applied Laboratory Medicine 2023, 8: 98-105. PMID: 36610419, DOI: 10.1093/jalm/jfac104.Peer-Reviewed Original ResearchConceptsRSV testingSymptomatic visitsED visitsSARS-CoV-2 nucleic acid amplification testsCOVID-19Respiratory syncytial virus testingNucleic acid amplification testsElectronic health record ordersSystems-based interventionsSARS-CoV-2Symptomatic patientsPrimary outcomeInfluenza testingClinical guidelinesClinician educationClinician practiceVirus testingAmplification testsPatientsTest orderingInstitutional guidelinesClinical needHospital systemVisitsTesting patterns
2022
Psychotropic Medication Use in United States Pediatric Emergency Department Visits
Nash K, Olfson M, Rothenberg C, Anderson B, Pincus H, Venkatesh A. Psychotropic Medication Use in United States Pediatric Emergency Department Visits. Academic Pediatrics 2022, 23: 971-979. PMID: 36494030, PMCID: PMC10241984, DOI: 10.1016/j.acap.2022.11.016.Peer-Reviewed Original ResearchConceptsPsychotropic medication useNon-Hispanic patientsMedication useED visitsEmergency departmentPsychotropic medicationsMedication administrationBlack non-Hispanic patientsWhite non-Hispanic patientsSurvey-weighted logistic regressionBehavioral health visitsAppropriate medication usePediatric emergency departmentProportion of visitsCross-sectional analysisBehavioral health carePsychotropic polypharmacyHealth visitsMedication typeEquitable careMedicationsLogistic regressionPrivate insuranceAnxiety disordersVisitsTrends In Treat-And-Release Emergency Care Visits With High-Intensity Billing In The US, 2006–19
Janke A, Gettel C, Koski-Vacirca R, Lin M, Kocher K, Venkatesh A. Trends In Treat-And-Release Emergency Care Visits With High-Intensity Billing In The US, 2006–19. Health Affairs 2022, 41: 1772-1780. PMID: 36469824, DOI: 10.1377/hlthaff.2022.00484.Peer-Reviewed Original ResearchConceptsRelease ED visitsEmergency departmentED visitsNationwide Emergency Department SampleEmergency care visitsEmergency Department SampleProportion of visitsHealth care systemMore comorbiditiesCare visitsOlder patientsED careBilling practicesSerious diagnosisObservational studyUndifferentiated patientsPatient complexityCare servicesHealth statusCare systemVisitsPatientsEvolving roleReimbursement reformTreatEMS Non-Transport of Low-Risk COVID-19 Patients
Couturier K, Nelson AR, Burns K, Cone DC, Rollins M, Venkatesh AK, Ulrich A, Shapiro M, Joseph D. EMS Non-Transport of Low-Risk COVID-19 Patients. Prehospital Emergency Care 2022, 27: 310-314. PMID: 35639643, DOI: 10.1080/10903127.2022.2083278.Peer-Reviewed Original ResearchConceptsEMS cliniciansLow-risk COVID-19 patientsSuburban EMS systemLow-risk patientsED visit ratesEMS systemCOVID-19 patientsCOVID-19 infectionCOVID-19ED visitsRetrospective reviewEmergency departmentCOVID-19 casesProtocol violationsCommon reasonConnecticut OfficeHospital resourcesPatientsSmall studyVisit ratesVital signsHealth systemSymptomsReasonable adherenceCliniciansEmergency 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
Design and Implementation of an Agitation Code Response Team in the Emergency Department
Wong AH, Ray JM, Cramer LD, Brashear TK, Eixenberger C, McVaney C, Haggan J, Sevilla M, Costa DS, Parwani V, Ulrich A, Dziura JD, Bernstein SL, Venkatesh AK. Design and Implementation of an Agitation Code Response Team in the Emergency Department. Annals Of Emergency Medicine 2021, 79: 453-464. PMID: 34863528, PMCID: PMC9038629, DOI: 10.1016/j.annemergmed.2021.10.013.Peer-Reviewed Original ResearchConceptsResponse team interventionPhysical restraint useInterrupted time series analysisRestraint useEmergency departmentTeam interventionRates of physical restraint useTeam-based interventionAdministrative supportQuality improvement studyResponse teamBehavioral health systemManagement of agitated patientsInterprofessional collaborationRestraint ordersExcessive psychomotor activityRestraint ratesHealth systemED visitsImprovement studyPhysical restraintCompare trendsPrimary outcomeTime series analysisAgitated patients