title: Medical group practice characteristics influencing inappropriate emergency department and avoidable hospitalization rates.
abstract: The inappropriate use of emergency departments (EDs) and ambulatory care sensitive hospital admission rates by patients attributed to a national sample of 212 medical group practices is documented, and the characteristics of practices that influence these rates are identified. Hospital-owned practices have higher nonemergent and emergent primary care treatable ED rates and higher ambulatory care sensitive hospitalization rates. Practices with electronic health records have lower inappropriate ED rates but those in rural areas have significantly higher rates. Practices with lower operating costs have higher inappropriate ED and ambulatory care sensitive rates, raising questions about the costs of preventing these incidents at the medical group practice level.
authors.affiliation: Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota (Drs Kralewski and Dowd and Mr Knutson); and Medica Research Institute, Minnetonka, Minnesota (Dr Kralewski, Ms Savage, and Mr Tong).
authors.forename: John
authors.initials: J
authors.lastname: Kralewski
authors.forename: Bryan
authors.initials: B
authors.lastname: Dowd
authors.forename: Dave
authors.initials: D
authors.lastname: Knutson
authors.forename: Megan
authors.initials: M
authors.lastname: Savage
authors.forename: Junliang
authors.initials: J
authors.lastname: Tong
mesh_terms: D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006123:Group Practice / Q000458:organization & administration*; D006300:Health Services Misuse / Q000517:prevention & control*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006278:Medicare; D014481:United States