The Financial Impact of Ambulance Diversions and Patient Elopements

Falvo, Thomas; Grove, Lance; Stachura, Ruth; Zirkin, William

doi:10.1197/j.aem.2006.06.056

Cited by 34 publications

(24 citation statements)

References 16 publications

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“…Here, we fix N 1 = N 2 = 10, µ 1 = µ 2 = 1 and total arrival rate λ Σ = λ 1 + λ 2 = 18. We then split the total arrival rate between the two EDs into different combinations of λ 1 and λ 2 so that the pair of (no-diversion) utilizations combinations, we fix λ a i = 0.25λ i in accordance with empirical evidence [Falvo et al 2007]. As expected, the waiting time under all scenarios increases with ρ.…”

Section: Choice Of Parametersmentioning

confidence: 94%

Centralized vs. Decentralized Ambulance Diversion: A Network Perspective

Deo

Gurvich²

2011

SSRN Journal

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Section: Choice Of Parametersmentioning

confidence: 94%

Centralized vs. Decentralized Ambulance Diversion: A Network Perspective

Deo

Gurvich²

2011

SSRN Journal

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“…4,5 Despite recent expansion of health insurance coverage, ED visit volumes are expected to grow, exacerbating ED crowding and LWBS rates. 6 The financial effect of crowding on the costs of ED visits has been previously estimated, [7][8][9][10] but has been limited to hospital (i.e., facility) reimbursement 9,11,12 or patients with disease-specific conditions (e.g., chest pain 13 ) or has considered only the revenue opportunity loss from ambulance diversion. 12,14,15 Few studies have attempted to estimate the lost revenue opportunity from patients who LWBS.…”

mentioning

confidence: 99%

“…12,14,15 Few studies have attempted to estimate the lost revenue opportunity from patients who LWBS. 12 All services provided by physicians to patients during an ED visit, including procedures and ''cognitive work,'' are described by common procedural terminology (CPT) codes. 16 These codes are translated by coders into total professional (physician) charges for the visit, which are then billed to the patient or insurance company.…”

mentioning

confidence: 99%

Emergency Severity Index Triage System Correlation with Emergency Department Evaluation and Management Billing Codes and Total Professional Charges

Wiler

Poirier

Farley

et al. 2011

Academic Emergency Medicine

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Objectives: All services provided by physicians to patients during an emergency department (ED) visit, including procedures and ''cognitive work,'' are described by common procedural terminology (CPT) codes that are translated by coders into total professional (physician) charges for the visit. These charges do not include the technical (facility) charges. The objectives of this study were to characterize associations between Emergency Severity Index (ESI) acuity level, ED Evaluation and Management (E&M) billing codes 99281-99285 and 99291, and total ED provider charges (sum of total procedure and E&M professional charges). Secondary objectives were to identify factors that might affect these associations and to evaluate the performance of ESI and identified variables to predict E&M code and average total professional charges. Methods:The authors reviewed 276,824 patient records for calendar year 2007, of which 193,952 adult ED visits from three different ED types (community, university-based academic, and non-universitybased academic) met inclusion criteria. Correlations between 1) ESI level and E&M billing code per visit by institution and 2) ESI and total professional charges were analyzed using Spearman rank correlation. Linear regression analysis was performed to identify variables that significantly affected these correlations.Results: ESI level and E&M codes were moderately correlated (Spearman r = 0.51). ESI levels corresponded proportionately to higher E&M codes. ESI 1, 2, and 3 most frequently corresponded with E&M level 5 (50, 62, and 45%, respectively), and ESI 4 and 5 most frequently corresponded with E&M level 3 (56 and 67%, respectively). Only age by decade significantly affected the association between ESI level and E&M billing code. The mean total professional charge for all patient encounters was $421 (SD ± $204) with increasing mean charges per patient by increasing ESI acuity. Race and E&M code significantly affected the relationship between ESI level and total ED professional charges per patient (adjusted r 2 = 0.66).Conclusions: A moderate, nonlinear correlation exists between ESI acuity levels and ED E&M billing codes. Increasing age affects this correlation. Race and E&M code affect the correlation between ESI level and total professional charges. As such, basic triage data can be used to estimate E&M code and total professional charges. Future studies are needed to validate these findings across other institutional settings.

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“…This phenomenon is manifested by a lack of human and material resources (mainly admission beds) in front of an urgent demand for care [6]. This leads to the dissatisfaction of patients [7] [8] not finding the required care quality [9] [10] and a tired and overwhelmed staff [11], without neglecting the substantial financial losses [12] and the risk of mortality which is the most serious issue [13] [14] [15]. The overcrowding phenomenon occurs when the demand exceeds supply.…”

Section: Overcrowding Phenomenon In the Pediatric Emergency Departmentmentioning

confidence: 99%

A Multi-criteria Optimization Approach to Health Care Tasks Scheduling Under Resources Constraints

Othman¹,

Hammadi²

2017

IJCIS

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We are interested in this paper in studying and developing a decision support tool for multi-skill health care tasks scheduling in the Pediatric Emergency Department. We use an evolutionary algorithm and we propose the use of fuzzy logic to formulate an adapted fitness function. We consider the potential performance of the system and we set up a set of lower bounds characterizing criteria limits allowing to calculate the minimum waiting time for incoming patients and the corresponding latest ending time.

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The Financial Impact of Ambulance Diversions and Patient Elopements

Abstract: Significant revenue may be foregone as a result of throughput delays that prevent the ED from utilizing its existing bed capacity for additional patient visits.

Cited by 34 publications

References 16 publications

Centralized vs. Decentralized Ambulance Diversion: A Network Perspective

Centralized vs. Decentralized Ambulance Diversion: A Network Perspective

Emergency Severity Index Triage System Correlation with Emergency Department Evaluation and Management Billing Codes and Total Professional Charges

A Multi-criteria Optimization Approach to Health Care Tasks Scheduling Under Resources Constraints

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