Emergency Care Sensitive Conditions in the VA

退伍军人管理局的紧急护理敏感情况

基本信息

项目摘要

 DESCRIPTION (provided by applicant). Background. Emergency care is a critical, but understudied, part of the continuum of services offered to Veterans by the VA. While the VA is committed to providing timely and high-quality emergency care, surprisingly little is known about Veteran access to acute care or about the quality of care provided. Using a model derived from the development and widespread use of ambulatory care sensitive conditions (ACSCs) we propose using the emergency care sensitive condition (ECSC), a newly defined concept, as a novel framework to examine variation in access to and quality of emergency care systems. Analogous to ACSCs, ECSCs are conditions for which early access to high-quality emergency diagnosis and intervention in acute illness or acutely decompensated chronic illness improves patient outcomes. Objectives. This pilot lays the groundwork for two subsequent Investigator Initiated Research proposals that will examine access to emergency care and the individual, organizational and system factors related to ECSC outcomes, such as survival rates and 30 day post-discharge events. Our specific objectives for this pilot are. (1) to create a VA Emergency Department (ED) visit level dataset that can be used as part of a future study of Veteran utilization of emergency care across VHA and non-VHA settings; (2) to calculate the prevalence and determine variation, if any, of ECSCs across all VHA EDs; and (3) to refine the recently defined list of ECSCs and identify the ECSCs of most import to Veterans. Project Methods. First, using VA administrative files, we will construct a database that includes women and men Veterans aged 18 years and over who had any VA care, including outpatient, inpatient, non-VA care (Fee) services, or pharmacy services identified in the ADUSH Enrollment File FY10-FY12. All ED visits among the cohort will be identified. ED visits will be specified to be either an (1) ED visit resulting in discharge [ED tret-and-release visit], (2) ED visit resulting in hospital admission, (3) ED visit resulting in patient death, (4) an ED observation stay or (5) fee basis non-VA ED visit. The database will be structured to reflect the anticipated three-level analysis structure (i.e., visits are clustered by patients, which in turn, are clustered within stations). Next, using descriptive statistics, we wil calculate prevalence and determine variation, if any, of ECSCs across all VHA EDs. Finally, using a modified Delphi approach, we will refine the list of ECSCs of import to Veterans. These data will us to design and conduct a national study of the Veteran-, ED-, system-, and geographic-level predictors of access to high quality ED care.
 描述(由申请人提供)。 背景:紧急护理是退伍军人管理局向退伍军人提供的连续服务的一个重要但尚未得到充分研究的部分。使用源自门诊护理敏感状况(ACSC)的发展和广泛使用的模型,我们建议使用紧急护理敏感状况(ECSC)这一新定义的概念作为检查变化的新框架。获得质量与 ACSC 类似,ECSC 是对急性疾病或急性失代偿性慢性疾病进行早期获得的治疗,为改善患者治疗效果奠定了基础。它将检查紧急护理的获得情况以及与 ECSC 结果相关的个人、组织和系统因素,例如生存率和出院后 30 天的事件,我们该试点的具体目标是 (1) 创建一个。 VA 急诊科 (ED) 就诊级别数据集可用作退伍军人在 VHA 和非 VHA 环境中使用紧急护理的未来研究的一部分;(2) 计算 ECSC 的患病率并确定差异(如果有);所有 VHA ED;(3) 完善最近定义的 ECSC 列表并确定对退伍军人最重要的 ECSC 项目方法 首先,我们将使用 VA 行政档案构建一个包含 18 岁女性和男性退伍军人的数据库。接受任何 VA 护理(包括 2010 财年至 2012 财年 ADUSH 登记文件中确定的门诊、住院、非 VA 护理(收费)服务或药房服务)的所有 ED 就诊将被确定。指定为 (1) 急诊科就诊导致出院 [急诊科治疗和出院就诊],(2) 急诊科就诊导致患者入院,(3) 急诊科就诊导致患者入院 死亡,(4) 急诊观察住院或 (5) 收费的非 VA 急诊就诊 数据库的结构将反映预期的三级分析结构(即,就诊按以下因素进行聚类)。 接下来,我们将使用描述性统计来计算所有 VHA ED 中 ECSC 的患病率并确定变异(如果有)。 ECSC 对退伍军人很重要。这些数据将用于设计和开展一项关于退伍军人、急诊科、系统和地理层面获得高质量急诊科护理的预测因素的全国性研究。

项目成果

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Anita A Vashi其他文献

What Should Healthcare Systems Consider When Modernizing Call Centers? Early Considerations From the Veterans Health Administration
医疗保健系统在呼叫中心现代化时应考虑什么?

Anita A Vashi的其他文献

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{{ truncateString('Anita A Vashi', 18)}}的其他基金

Telehealth for Acute Care in VA
弗吉尼亚州紧急护理远程医疗
  • 批准号:
    10245055
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
Veteran Access to Emergency Care
退伍军人获得紧急护理
  • 批准号:
    9695870
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:
Veteran Access to Emergency Care
退伍军人获得紧急护理
  • 批准号:
    10827365
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:

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