Number of Outpatient Emergency Department Visits per 1,000 Long-Stay Resident Days
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Number of all-cause outpatient emergency department (ED) visits. (Outpatient ED visits are ED visits that do not result in an outpatient observation stay or inpatient hospital stay).
Numerator
All ED visits for while residing in the nursing home that did not result in outpatient or inpatient hospitalisation and not enrolled in hospice.
Denominator
The sum of all long-stay days in the target period, divided by 1,000.
Exclusions
Not a Medicare beneficiary or enrolled in Medicare, enrolled in hospice care, resident not in the nursing home for any reason during the episode.
Use of Risk Adjustment
Risk Adjustments
Claims covariates: age, sex, race / ethnicity, number of acute care hospitalisations in 365 days prior to nursing home admission, comorbidity index MDS covariates: functional status, clinical conditions (SoB exertion, SoB lying, end-stage prognosis, internal bleeding, surgical wound), clinical treatments (antibiotic, diuretic, chemotherapy for cancer, radiation for cancer, oxygen therapy, tracheostomy care, ventilator or respirator, IV medications, transfusion, hospice care after nursing home admission, speech therapy, respiratory therapy), clinical diagnoses (cancer, GERD or ulcer, ulcerative colitis/Crohn's disease/IBD, neurogenic bladder, multiresistant organism, septicaemia, CVA/ TIA/stroke, quadriplegia, MS, Parkinson's disease, anxiety, respiratory failure), other (entered nursing home from psychiatric facility).
Stratifications
None
Data Attributes
Type of Data Collection
Data Collection Methods
Medicare claims data. All days after the resident's one-hundredth cumulative day in the nursing home or the beginning of the 12-month target period (whichever is later) and until the day of discharge, the day of death, or end of the 12-month target period (whichever is earlier).
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Nursing Home Care Comparison publicly reported on CMS website of all Medicare and Medicaid US nursing homes. Reports the average adjusted QM values for most recent three quarters. Quality measure reports available at national, state, facility and resident level (providers only). Five-star quality rating system (n=9 QIs) available publicly online.