Medicaid Beneficiaries Who Continue To Use The ED: A Focus On The Illinois Medical Home Network | 41367
Journal of Community Medicine & Health Education
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Objectives: Frequent, non-urgent emergency department use continues to plague the American healthcare system through ineffective
disease management and unnecessary costs. In 2012, the Illinois Medical Home Network (MHN) was implemented, in part, to reduce
an overreliance on already stressed emergency departments through better care coordination and access to primary care. The purpose
of this study is to characterize MHN patients and compare them to non-MHN patients for a preliminary understanding of MHN
patients who visit the emergency department. Variables of interest include: 1) frequency of emergency department use during the
previous twelve months; 2) demographic characteristics; 3) acuity; 4) disposition; and 5) comorbidities.
Methods: We performed a retrospective data analysis of all emergency department visits at a large, urban academic medical center in
2013. Binary logistic regression analyses and analysis of variance were used to analyze data.
Results: MHN patients visited the emergency department more often than non-MHN patients. MHN patients were more likely to
be African American, Hispanic/Latino, female, and minors when compared with non-MHN patients. Greater proportions of MHN
patients visiting the emergency department had asthma diagnoses. MHN patients possessed higher acuity but were more likely to be
discharged from the emergency department compared with non-MHN patients.
Conclusions: This research may assist with developing and evaluating intervention strategies targeting the reduction of health
disparities through decreased use of emergency department services in these traditionally underserved populations.
Yanina Purim-Shem-Tov graduated from the University of Chicago, Pritzker School of Medicine in 1998; completed emergency medicine residency at Cook County Hospital, in 2002, and began full-time employment at Rush University Medical Center (RUMC). She has completed Master’s Program in Clinical Research in 2006. Her Master Thesis focused on patients with chest pain, whom were admitted to the Emergency Department Observation Unit, a published manuscript. Presently, she is a Senior Medical Director of the Department of Emergency Medicine at RUMC. She is an NIH-supported researcher, clinician, and an educator. I have numerous publications in the areas of Emergency Medicine.