Geography of ED Use and Population Health

Study Overview
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Brief Summary
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The goal of this study is to create predictive models of emergency care and metrics for population health that can be used to analyze how events like hospital closures or disasters like Hurricane Sandy affect health care utilization by patients in specific populations or geographic regions. Additionally, it will allow the development of metrics for population health that can act as surveillance mechanisms to measure disease prevalence and identify patterns in emergency department use that can be used to identify specific geographic regions where health care is either optimized to promote health or needs to be improve so that population health can be improved.

Detailed Description
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The purpose of this study is to analyze the geographic patterns of emergency department utilization. This study will look at the relationship that geographic proximity and local population factors have on patient use of emergency departments. Geographic proximity of alternative hospitals and elicit other patient and hospital specific factors, such as demographic, insurance type, diagnosis, and socioeconomic factors that lead patients to choose specific hospitals for emergency care or generally lead to patients accessing emergency care will be compared. Patterns of emergency department utilization by patients will be identified in specific geographies such as Census tracts to determine clusters of high and low emergency department use. We also analyze the patterns of emergency care use based on specific disease conditions.Investigators will analyze the rate of emergency department use for patients with diabetes to determine population prevalence of diseases using emergency department data. Studying the pattern of use by specific geographies or disease conditions will also allow us to understand how emergency department use varies among populations by geographies and the socioeconomic and health care factors local to those regions.

Official Title
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Statewide Analysis of Emergency Department Use for Determining Geographic Patterns of Emergency Care Use, Hospital Choice and Measures of Population Health.

Conditions
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Emergencies, Diabetes Mellitus

Intervention / Treatment
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* Other: Statewide Planning and Research Cooperative System Database


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients visiting an emergency department in New York State Exclusion Criteria: Depending on the population analyzed, may exclude some subpopulations such as children (in order study adults), prisoners or patients transferred from other healthcare facilities (in order to study non-institutionalized individuals).

Ages Eligible for Study
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Maximum Age: 120 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients visiting an emergency department in New York State<br> | Other: Statewide Planning and Research Cooperative System Database<br>* The Statewide Planning and Research Cooperative System (SPARCS) is a comprehensive data reporting system created to collect information on discharges from hospitals. SPARCS currently collects patient level detail on patient characteristics, diagnoses and treatments, services, and charges for every hospital discharge, ambulatory surgery patient, and emergency department admission in New York State.<br>* Other names: SPARCS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emergency Deparrtment (ED) visit by a patient | In order to identify repeat ED visits by the same individual, unique identifiers within SPARCS match visits by the same individual throughout the study period | 1 Day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Surveillance of Disease Prevalence | Proportion of individuals who recieve a given diagnosis like diabetes during any emergency department visit including emergency inpatient admissions. | 1 Day | 
| Extension to Other Disease Conditions and Geographies | Analysis of how disease prevalence can be measured at the level of the entire state. Populations will be stratified based on geography. | 1 Day | 
| Hospital Selection | Identification of the selection of a given hospital by patients based on facility codes contained within the SPARCS database. | 1 Day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Epidemiology Research