Emergency Department Utilisation
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Emergency department (ED) utilisation among commercial (18 and older) and Medicare (18 and older) health plan members.
Numerator
Denominator
Exclusions
Use of Risk Adjustment
Risk Adjustments
The observed and expected rates are used to calculate a calibrated observed-to-expected ratio that assesses whether plans had more, the same or less emergency department visits than expected, while accounting for incremental improvements across all plans over time. The observed-to-expected ratio is multiplied by the emergency department visit rate across all health plans to produce a risk-standardised rate which allows for national comparison.
Stratifications
By organisation (commercial HMO, commercial PPO, Medicare HMO, Medicare PPO).
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Healthcare Effectiveness Data and Information Set (HEDIS)
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
HEDIS measures are reported on by the NCQA in a variety of specialised annual reports, but may also be utilised and reported on by other organisations with permission from NCQA.