Reduction in pediatric gastroenterology ED visits can be sustained through physician accountability and financial incentives
| Autor: | Jeffrey B. Weilburg, Jungyeon Kim, Sandhya Rao, Emily L. Aaronson, Jarone Lee, Haytham M.A. Kaafarani, Esther J. Israel |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Office visits Psychological intervention Pediatrics 03 medical and health sciences 0302 clinical medicine Financial incentives Intervention (counseling) medicine Humans Longitudinal Studies Pediatric gastroenterology Aged Academic Medical Centers Motivation Social Responsibility business.industry Gastroenterologists Gastroenterology 030208 emergency & critical care medicine General Medicine Overcrowding Leadership Physician Incentive Plans Family medicine Accountability Emergency Medicine business Specialist Physician Emergency Service Hospital Boston |
| Zdroj: | The American journal of emergency medicine. 37(6) |
| ISSN: | 1532-8171 |
| Popis: | Objective There have been various interventions to reduce ED utilization. Little is known about the sustainability of outcomes of interventions to reduce ED overcrowding. We sought to investigate whether the outcomes from one of successful interventions to reduce ED utilization, specialist physician level reporting were sustained over time and how this practice change was sustained over time. Method This study is a longitudinal analysis of the pre and post intervention ED utilization data collected on ED pediatric patients who were followed by pediatric gastroenterologists in an urban, academic hospital. The primary outcome was the mean rate of ED visits per 1000 office visits from January, 2013 to June, 2017 using a u control chart with three sigma limits. Results There were continuous leadership's support, physicians' engagement and communications among different members involved in the intervention. The rate of gastrointestinal (GI)-related ED visits after an intervention decreased by 54% from 4.89 to 2.23 during all hours and by 59% from 2.19 to 0.91 during office hours. Discussion Physician-level reporting reduced ED utilization over a four year period. The outcomes could be sustained over time with sustained leadership and physicians' engagement. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect