A national study examining emergency medicine specialty training and quality measures in the emergency department.
The objective of this study was to measure the relationship between emergency medicine (EM) specialty training and quality measures in the emergency department (ED). Data were gathered from the 2003-2004 National Hospital Ambulatory Medical Care Survey. The outcome was proportion of patients with acute myocardial infarction (AMI), pneumonia (PNA), and long-bone fracture (LBF) who received recommended therapy. These measures were analyzed with respect to EM residency completion. Compared with EDs with more than 80% EM-trained physicians, EDs with fewer than 80% EM-trained physicians had similar rates of aspirin (43% vs 42%) and β-blocker (26% vs 19%) use for AMI, appropriate antibiotics (78% vs 83%) and pulse oximetry (51% vs 55%) for PNA, and analgesia (85% vs 79%) for LBF. Additionally, a composite end point and an adjusted model showed no statistical difference across these measures. The proportion of residency-trained EM physicians did not affect the use of recommended treatment for AMI, PNA, and LBF.
Mathews
Simon C
SC
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kelen
Gabor D
GD
Pronovost
Peter J
PJ
Pham
Julius Cuong
JC
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000700:Analgesics / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D050723:Fractures, Bone / Q000188:drug therapy; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010092:Oximetry; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy; D011787:Quality of Health Care / Q000706:statistics & numerical data*
D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D000900:Anti-Bacterial Agents; D001241:Aspirin