Geography of ED Use and Population Health

Diabetes Mellitus Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03254524
• Other study ID #: 14-01408
• Status: Completed
• Start date: August 20, 2014
• Est. completion date: December 31, 2020

Study information

• Verified date: February 2021
• Source: NYU Langone Health
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 100
• Est. completion date: December 31, 2020
• Est. primary completion date: December 31, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A to 120 Years

Eligibility

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).

Related Conditions & MeSH terms

• Diabetes Mellitus
• Emergencies

Intervention

Other:
• Statewide Planning and Research Cooperative System Database
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.

Locations

Country	Name	City	State
United States	New York University School of Medicine	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
NYU Langone Health

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	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
Secondary	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
Secondary	Hospital Selection	Identification of the selection of a given hospital by patients based on facility codes contained within the SPARCS database.	1 Day