The shifting landscape in utilization of inpatient, observation, and emergency department services across payers

Teryl K. Nuckols, Kathryn R. Fingar, Marguerite Barrett, Claudia Angelica Steiner, Carol Stocks, Pamela L. Owens

Research output: Contribution to journalArticle

Abstract

Recent policies by public and private payers have increased incentives to reduce hospital admissions. Using data from four states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Patients had an expected primary payer of private insurance, Medicare, Medicaid, or no insurance. Across all four payer populations, inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased. Implications for quality of care and costs to patients warrant further examination.

Original languageEnglish (US)
Pages (from-to)443-446
Number of pages4
JournalJournal of Hospital Medicine
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

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Hospital Emergency Service
Inpatients
Quality of Health Care
Observation
Insurance
Health Services Research
Medicaid
Public Policy
Medicare
Health Care Costs
Population
Motivation
Hospitalization
Costs and Cost Analysis

ASJC Scopus subject areas

  • Leadership and Management
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

Cite this

The shifting landscape in utilization of inpatient, observation, and emergency department services across payers. / Nuckols, Teryl K.; Fingar, Kathryn R.; Barrett, Marguerite; Steiner, Claudia Angelica; Stocks, Carol; Owens, Pamela L.

In: Journal of Hospital Medicine, Vol. 12, No. 6, 01.06.2017, p. 443-446.

Research output: Contribution to journalArticle

Nuckols, Teryl K. ; Fingar, Kathryn R. ; Barrett, Marguerite ; Steiner, Claudia Angelica ; Stocks, Carol ; Owens, Pamela L. / The shifting landscape in utilization of inpatient, observation, and emergency department services across payers. In: Journal of Hospital Medicine. 2017 ; Vol. 12, No. 6. pp. 443-446.
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