2.50
Hdl Handle:
http://hdl.handle.net/10755/164580
Category:
Abstract
Type:
Presentation
Title:
Emergency department utilization in Tennessee 1990 - 1998
Author(s):
Scherubel, Janet
Author Details:
Janet Scherubel, PhD, University of Memphis Loewenberg School of Nursing, Memphis, Tennessee, USA, email: jscherub@memphis.edu
Abstract:
Specific Aims: The purpose of this study was to examine the influence of managed care on Emergency Department (ED) utilization in Tennessee over a nine-year period. Specific hypotheses were: 1) There was no change in (ED) organization, 2) There were no decreases in available ED services; 3) There was a significant decrease in ED visits; 4) There was a significant decrease in ED nursing staff. Hypotheses were tested at the hospital, county, region and state level. Sample: The ED sample (n=120) represented over 96% of total EDs within TN during the study period. Data were derived from nine years of hospital data tapes (Tennessee Department of Health, 1990-1998). The tapes provide extensive annual hospital and nursing resource utilization data. Prior research (Chang, 1992; Scherubel, 1997) demonstrated the data to be reliable and valid for the intended purposes through the use of conventional "data cleaning" programs, related studies, and analyses of one county's hospital resource utilization. Analyses were presented regionally to validate results (Scherubel, 1997). Procedures: All data were coded to protect individual institutions. The University IRB approved the study. Data analyses were conducted using SPSS-PC. Analyses: Initially, all variables were analyzed using descriptive statistics. Next, specific hypotheses were tested. The independent variable was the implementation of TennCare, January 1994. Dependent variables included: ED organization type, ED services, ED visits, and ED nursing personnel data. Statistical tests included Cochran's Q for categorical data and repeated measures ANOVA for interval data. The alpha level was .01. Results: Data were available from 120 hospitals across 6 state regions and 99 counties depending on the year studied. Wide variability in health care services was found across the state ranging from several counties with no hospitals (or EDs) to urban counties with 17 hospitals and associated EDs. Significant decreases were seen in ED services at the regional and county and level, particularly in rural areas. In contrast to managed care goals, ED visits remained stable or significantly increased. There were no significant changes in ED professional nursing staff, yet ancillary ED nursing personnel declined significantly. Study results will be discussed and health policy issues identified.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEmergency department utilization in Tennessee 1990 - 1998en_GB
dc.contributor.authorScherubel, Janeten_US
dc.author.detailsJanet Scherubel, PhD, University of Memphis Loewenberg School of Nursing, Memphis, Tennessee, USA, email: jscherub@memphis.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/164580-
dc.description.abstractSpecific Aims: The purpose of this study was to examine the influence of managed care on Emergency Department (ED) utilization in Tennessee over a nine-year period. Specific hypotheses were: 1) There was no change in (ED) organization, 2) There were no decreases in available ED services; 3) There was a significant decrease in ED visits; 4) There was a significant decrease in ED nursing staff. Hypotheses were tested at the hospital, county, region and state level. Sample: The ED sample (n=120) represented over 96% of total EDs within TN during the study period. Data were derived from nine years of hospital data tapes (Tennessee Department of Health, 1990-1998). The tapes provide extensive annual hospital and nursing resource utilization data. Prior research (Chang, 1992; Scherubel, 1997) demonstrated the data to be reliable and valid for the intended purposes through the use of conventional "data cleaning" programs, related studies, and analyses of one county's hospital resource utilization. Analyses were presented regionally to validate results (Scherubel, 1997). Procedures: All data were coded to protect individual institutions. The University IRB approved the study. Data analyses were conducted using SPSS-PC. Analyses: Initially, all variables were analyzed using descriptive statistics. Next, specific hypotheses were tested. The independent variable was the implementation of TennCare, January 1994. Dependent variables included: ED organization type, ED services, ED visits, and ED nursing personnel data. Statistical tests included Cochran's Q for categorical data and repeated measures ANOVA for interval data. The alpha level was .01. Results: Data were available from 120 hospitals across 6 state regions and 99 counties depending on the year studied. Wide variability in health care services was found across the state ranging from several counties with no hospitals (or EDs) to urban counties with 17 hospitals and associated EDs. Significant decreases were seen in ED services at the regional and county and level, particularly in rural areas. In contrast to managed care goals, ED visits remained stable or significantly increased. There were no significant changes in ED professional nursing staff, yet ancillary ED nursing personnel declined significantly. Study results will be discussed and health policy issues identified.en_GB
dc.date.available2011-10-27T14:33:54Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:33:54Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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