Beyond Administrative Data: Characterizing Cardiorespiratory Disease Episodes Among Patients Visiting the Emergency Department

Stieb, David M.; Beveridge, Robert; Smith‐Doiron, Marc; Burnett, Richard T.; Judek, Stan; Dales, Robert; Anis, Aslam H.

doi:10.1007/bf03404921

Cited by 10 publications

(12 citation statements)

References 27 publications

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“…The higher valuation of avoiding cardiac compared to respiratory disease episodes is driven mainly by the much higher proportion of cardiac conditions requiring admission to hospital, critical care, and invasive procedures [29]. Valuation for emergency department visits for both types of conditions includes cost of treatment related to hospital admission for those patients who were ultimately admitted.…”

Section: Discussionmentioning

confidence: 99%

“…Response rates to the emergency department follow-up survey were greater than 80% for individuals with asthma and respiratory infections, but only 50% and 67% for those with COPD and cardiac conditions respectively. Those with cardiac conditions who completed follow-up interviews were younger (and possibly healthier) than those who did not [29]. Cost of treatment estimates may therefore be conservative relative to a fully representative population of patients of all degrees of severity.…”

Section: Discussionmentioning

confidence: 99%

“…In the second study, data were collected prospectively on individuals visiting emergency departments for cardiorespiratory conditions, as part of an epidemiological study of air pollution in Saint John, Canada between 1992 and 1996 [29,33]. A random sample of those agreeing to follow-up was contacted two weeks after their visit and asked to complete a structured telephone interview, in which information was collected on the duration of the disease episode which prompted their visit, disposition of their visit (whether they were admitted or discharged), and the occurrence of various outcomes including restricted activity days, days of missed work for the patient, parent, or other care giver, health care utilization and illness-related expenses, from the onset of their earliest symptoms until the follow-up interview.…”

Section: Methodsmentioning

confidence: 99%

“…Mapping of symptoms and levels of activity restrictions to a given outcome was derived from empirical data from our own emergency department study [29], and from a population-based survey in Strasbourg, France on the prevalence of minor respiratory symptoms [38]. Adjustments were made, where applicable, to shift the distribution towards the mild end of the spectrum to reflect those individuals who do not visit the emergency department and whose symptoms are presumably less severe on average.…”

Section: Methodsmentioning

confidence: 99%

“…All inputs to our estimates pertaining to the duration of time in and out of hospital and of lost work days, and the probability of requiring inpatient care at the ward or critical care level (Table 3), were derived from Stieb et al [29]. Based on data from the U.S. National Health Interview Survey, it was determined that work loss days comprise 21 percent of restricted activity days (standard error = 1.07%) [39] and we applied this factor in estimating lost productivity costs associated with restricted activity days.…”

Section: Methodsmentioning

confidence: 99%

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Costs of Cardiorespiratory Disease Episodes in a Study of Emergency Department Use

Anis

Guh

Stieb

et al. 2000

Can J Public Health

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The first point of contact for individuals with urgent health problems is often the emergency department (ED). We recently completed a study of ED use due to cardiorespiratory conditions as part of a larger study on the health effects of air quality 1 which was motivated by the recent public health concerns over this issue. [2][3][4][5][6] Several studies have documented an association between air quality and ED visits for respiratory diseases. [7][8][9][10][11][12][13][14][15][16] Thus the emergency department served as a useful reference point from which to capture the potential health costs of cardiorespiratory disease episodes. In this paper, we describe the cost methodology used to estimate the average per person direct cost of illness for four cardiorespiratory conditions and discuss the results. METHODS Data collectionThe study design and data collection are described in detail in the companion paper. 1 Briefly, data were collected prospectively between September 1, 1994 and August 31, 1995 at the two hospital emergency departments in Saint John, New Brunswick for emergency visits that were assigned a diagnosis of asthma, chronic obstructive pulmonary disease (COPD), respiratory infections, or cardiac conditions. Follow-up was conducted using a structured telephone interview in which consenting patients were asked about the occurrence of various outcomes from the onset of their earliest symptoms until the follow-up interview. Estimates of out-of-hospital costs were based on these data.Estimates of costs for hospitalization episodes were based on inpatient utilization data abstracted from clinical records for a sample of 393 patients. These inpatient records were selected randomly after stratification for the four diagnosis groups considered. Types of utilization data captured in the record abstracts included medication, procedures, investigations, physician care and length of stay. Cost calculationThe direct cost of cardiorespiratory disease episodes included six cost categories: hospital utilization, emergency department visits, physicians visits, concomitant medication use, equipment and out-of-pocket expenses. The methodology used to calculate each cost category is as outlined below. All costs were deflated by the Price Index for all products 17 and are in 1997 Canadian dollars.Emergency Visits: The cost of emergency visits included the initial visit by the patient and any subsequent visits prior to the telephone interview. A fully allocated cost including that for all hospital-based resources and physician time was estimated.Physicians Visits: Each physician clinic visit was assumed to be a "minor assessment" and valued according to the allowed reimbursement rate as specified by BC Medical Services Agreement.

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A study on the short-term effect of particulate matter pollution on hospital visits for asthma in children in Shanghai, China

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Environ Geochem Health

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Beyond Administrative Data: Characterizing Cardiorespiratory Disease Episodes Among Patients Visiting the Emergency Department

Cited by 10 publications

References 27 publications

Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution

Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution

The Costs of Cardiorespiratory Disease Episodes in a Study of Emergency Department Use

A study on the short-term effect of particulate matter pollution on hospital visits for asthma in children in Shanghai, China

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