Grand Rounds - Dr. Laura Burke - Emergency Physicians as leaders of high-value healthcare

Always On EM - Mayo Clinic Emergency Medicine

Dr. Laura Burke is a health sciences researcher and assistant professor of emergency medicine at Harvard Medical School. She gave a reaffirming grand rounds talk to us, packed full of evidence to support the concept that emergency medicine and emergency physicians provide an incredible quality of service and value to the healthcare system overall. Listen in!

Articles she references throughout are listed below in chronological order.

CONTACTS

Twitter - @AlwaysOnEM; @VenkBellamkonda; @LauraBurke20

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [e-mail]

REFERENCES & LINKS

• Li G, Lau JT, McCarthy M, Schull MJ, Vermeulen M, Kelen GD. Emergency Department Utilization in the United States and Ontario, Canada. Acad Emerg Med June 2007, Vol 14, No. 6
• Papanicolas I, Woskie LR, Jha AK. Health Care Spending in the United States and Other High-Income Countries. JAMA. 2018;319(10):1024-1039
• Papanicolas I, Woskie LR, Orlander D, Orav EJ, Jha AK. The Relationship between health spending and social spending in high-income countries: How does the US compare? Health Aff (Millwood). 2019 Sep;38(9):1567-1575
• Zhou RA, Baicker K, Taubman S, Finkelstein AN. The uninsured do not use the emergency department more – they use other care less. Health Affairs (Millwood). 2017 Dec;36(12):2115-2122
• Smulowitz PB, Lipton R, Wharam JF, Adelman L, Weiner SG, Burke L, Baugh CW, Schuur JD, Liu SH, McGrath ME, Liu B, Sayah A, Burke MC, Pope JH, Landon BE. Emergency department utilization after the implementation of Massachussetts health reform. Annals of Emergency Medicine. 2011 Sep;58(3):225-234
• Singer AJ, Thode HC, Pines JM. US Emergency Department visits and hospital discharges among uninsured patients before and after implementation of the Affordable Care Act. JAMA Network Open. 2019 Apr 5;2(4):e192662
• Brook, Robert H., Emmett B. Keeler, Kathleen N. Lohr, Joseph P. Newhouse, John E. Ware, William H. Rogers, Allyson Ross Davies, Cathy D. Sherbourne, George A. Goldberg, Patricia Camp, Caren Kamberg, Arleen Leibowitz, Joan Keesey, and David Reboussin, The Health Insurance Experiment: A Classic RAND Study Speaks to the Current Health Care Reform Debate. Santa Monica, CA: RAND Corporation, 2006. https://www.rand.org/pubs/research_briefs/RB9174.html.
• Vogel JA, Rising KL, Jones J, Bowden ML, Ginde AA, Havranek EP. Reasons patients choose the emergency department over primary care: A qualitative metasynthesis. J Gen Intern Med. 2019 Nov; 34(11):2610-2619
• Chou SC, Gondi S, Baker O, Venkatesh AK, Schuur JD. Analysis of a commercial insurance policy to deny coverage for emergency department visits with nonemergent diagnoses. JAMA network Open. 2018 Oct 5;1(6):e183731
• Raven MC, Lowe RA, Maselli J, Hsia RY. Comparison of presenting complaint vs discharge diagnosis for identifying nonemergency emergency department visits. JAMA. 2013 Mar 20;309(11):1145-53
• Arnetz BB, Goetz C, vanSchagen J, Baer W, Smith S, Arnetz JE. Patient-reported factors associated with avoidance of in-person care during the COVID-19 pandemic: Results from a national survey. PLoS One. 2022 Aug 5;17(8):e0272609
• Sharma M, Lioutas VA, Madsen T, Clark J, O’Sullivan J, Elkind MSV, Willey JZ, Marshall RS, Selim MH, Greer D, Tirschwell DL, Burton T, Boehme A, Aparicio HJ. Decline in stroke alerts and hospitalisations during the COVID-19 pandemic. Stroke Vascular Neurology. 2020 Dec;5(4):403-405
• Bradley CJ, Neumark D, Walker LS. The effect of primary care visits on other health care utilization: A randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia. J Health Economics. 2018 Nov;62:121-133
• Peikes D, Dale S, Ghosh A, Taylor EF, Swankoski K, O’Malley AS, Day TJ, Duda N, Singh P, Anglin G, Sessums LL, Brown RS. The comprehensive primary care initiative: effects on spending, quality, patients and physicians. Health Affairs (Millwood). 2018 Jun;37(6):890-899
• Song Z, Gondi S. Will increasing primary care spending alone save money? JAMA. 2019 Oct 8;322(14)1349-1350
• Weinik RM, Burns RM, Mehrotra A. Many emergency department visits could be managed at urgent care centers and retail clinics. Health Affairs (millwood). 2010 Sep;29(9):1630-6
• Wang B, Mehrotra A, Friedman AB. Urgent care centers deter some emergency department visits but, on net, increase spending. Health Affairs (Millwood). 2021 Apr;40(4):587-595
• Pitts SR, Pines JM, Handrigan MT, Kellermann AL. National trends in emergency department occupancy, 2001-2008:effect of inpatient admissions versus emergency department practice intensity. Annals of Emergency Medicine. 2012 Dec;60(6):679-686
• Burke LG, Wild RC, Orav EJ, Hsia RY. Are trends in billing for high-intensity emergency care explained by changes in services provided in the emergency department? An observational study among US Medicare beneficiaries. BMJ Open. 2018 Jan 30;8(1):e019357
• Schuur JD, Venkatesh AK. The growing role of emergency departments in hospital admissions. NEJM. 2012 Aug 2;367(5):391-3
• Chou SC, Baker O, Schuur JD. Changes in Emergency Department Care Intensity from 2007-16: Analysis of the National Hospital Ambulatory Medical Care Survey. Western Journal of Emergency Medicine. 2020 Feb 21;21(2):209-216
• Janke AT, Gettel C, Vacirca RK, Lin MP, Kocher KE, Venkatesh AK. Trends in treat and release emergency care visits with high-intensity billing in the US, 2006-19. Health Affairs (Millwood). 2022 Dec;41(12)1772-1780
• Gani F, Canner JK, Pawlik TM. Assessing coding practices for gastrointestinal surgery over time in the United States. Surgery. 2018 Sep;164(3):530-538
• Schonberger RB, Dutton RP, Dai F. Is there evidence for systematic upcoding of ASA physical status coincident with payer incentives? A regression discontinuity analysis of the national anesthesia clinical outcomes registry. Anesthesia Analgesia. 2016 Jan;122(1):243-50
• Rajkumar CA, Suh WM, Francis DP. Upcoding of clinical information to meet appropriate use criteria for percutaneous coronary intervention. Circulation: Cardiovascular Quality and Outcomes. 2019 Mar;12(3):e005025
• Smulowitz PB, Honigman L, Landon BE. A novel approach to identifying targets for cost reduction in the emergency department. Annals of Emergency Medicine. 2013 Mar;61(3):293-300
• Burke LG, Burke RC, Epstein SK, Orav EJ, Jha AK. Trends in costs of care for Medicare beneficiaries treated in the emergency department from 2011 to 2016. JAMA Network Open. 2020 Aug 3;3(8):e208229
• Tsai TC, Greaves F, Zheng J, Orav EJ, Zinner MJ, Jha AK. Better patient care at high-quality hospitals may save medicare money and bolster episode-based payment models. Health Affairs (Millwood). 2016 Sep 1;35(9):1681-9
• Lin MP, Baker O, Richardson LD, Schuur JD. Trends in emergency department visits and admission rates among US acute care hospitals. JAMA Intern Med. 2018 Dec 1;178(12):1708-1710
• Pomerantz A, Burke R, Friedman A, Burke L, Wolfe R, Smulowitz P. The influence of Medicare for all on reimbursement for emergency care treat-and-release visits. Annals of Emergency Medicine. 2020 Oct;76(4):454-458
• Obermeyer Z, Cohn B, Wilson M, Jena AB, Cutler DM. Early death after discharge from emergency departments: analysis of national US insurance claims data. BMJ. 2017 Feb 1;356:j239
• Burke LG, Epstein SK, Burke RC, Orav EJ, Jha AK. Trends in mortality for medicaire beneficiaries treated in the emergency department from 2009 to 2016. JAMA Internal Medicine. 2020 Jan 1;180(1):80-88
• Marco CA, Courtney DM, Ling LJ, Salsberg E, Reisdorff EJ, Gallahue FE, Suter RE, Muelleman R, Chappell B, Evans DD, Vafaie N, Richwine C. The emergency medicine physician workforce: projections for 2030. Annals of Emergency Medicine. 2021 Dec;78(6):726-737
• Paul Genberg. The Value of Being a Generalist. Forbes. June 3, 2021