title: Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.
abstract: To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health.
  
  
  
  Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases.
  
  
  
  Empirical analyses and structured panel reviews.
  
  
  
  Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs).
  
  
  
  ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated.
  
  
  
  The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research.
authors.affiliation: Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Davies
authors.affiliation: Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Schultz
authors.affiliation: Department of Emergency Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Maria
authors.initials: M
authors.lastname: Raven
authors.affiliation: Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Nancy Ewen
authors.initials: NE
authors.lastname: Wang
authors.affiliation: Division of Healthcare Delivery Data, Measures, and Research, Center for Delivery, Organization and Markets (CDOM), Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Carol L
authors.identifier: 0000-0003-3440-3193
authors.initials: CL
authors.lastname: Stocks
authors.affiliation: Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Mucio Kit
authors.initials: MK
authors.lastname: Delgado
authors.affiliation: Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: McDonald
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis / Q000628:therapy; D001416:Back Pain / Q000175:diagnosis / Q000628:therapy; D002908:Chronic Disease; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008484:Medicaid; D017057:Medically Uninsured; D011203:Poverty; D011634:Public Health; D019984:Quality Indicators, Health Care / Q000592:standards*; D012737:Sex Factors; D009057:Stomatognathic Diseases / Q000175:diagnosis / Q000628:therapy; D014481:United States; D016270:United States Agency for Healthcare Research and Quality / Q000592:standards*
keywords: Emergency department; ambulatory care sensitive conditions; community health; quality indicators