Clinical trial NCT03254524: Geography of ED Use and Population Health
Official title: Statewide Analysis of Emergency Department Use for Determining Geographic Patterns of Emergency Care Use, Hospital Choice and Measures of Population Health.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Emergencies
Diabetes Mellitus
Keywords: Epidemiology Research
Lead sponsor: NYU Langone Health
Sponsor class: OTHER
First posted: 2017-08-18
Enrollment: 100
Sex: ALL
Maximum age (years): 120
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Includes all patients visiting an emergency department in New York State

Brief summary: 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: 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.

Eligibility criteria: 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).

Primary outcomes:
measure: Emergency Deparrtment (ED) visit by a patient
timeFrame: 1 Day
Secondary outcomes:
measure: Surveillance of Disease Prevalence
timeFrame: 1 Day
measure: Extension to Other Disease Conditions and Geographies
timeFrame: 1 Day
measure: Hospital Selection
timeFrame: 1 Day
Other outcomes:
Locations:
city: New York
country: United States
facility: New York University School of Medicine
state: New York
Study officials:
affiliation: NYU Langone Health
name: David Lee, MD
role: PRINCIPAL_INVESTIGATOR
References: