1. R 5 Initiative Improving Access to the Right Care in the Right Place at the Right Time for the Right Reason at the Right Cost Erin Knoerl EPI 621 April 29, 2010

2. Introduction Healthy Capital District Initiative Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) Phase IX grant HEAL goals ▫Identify causes of sub-optimal ED utilization ▫Identify and adopt promising best practices ▫Increase patient and provider engagement

3. Introduction 18% increase in ED visits from 1994-2004 12.4% decrease in #’s of ED 55% of ED visits- non-urgent (National Center for Health Statistics) $1.3 billon- annual cost for NYS (National Association of Community Health Centers) ▫$2.7 billon- one local hospital ▫~$12 million for Capital Region

4. Introduction-Objectives Determine: ▫What areas are the largest utilizers of ED services  Primary Care Related  Non-Urgent ▫If insurance type affects ED visit type ▫If the presence of hospitals affects the visit rate To see the general trend of data

5. Methods- NYU Algorithm NYU Center for Health and Public Service Research, Commonwealth Fund, Robert Wood Johnson Foundation, and United Hospital Fund of NY Used to help classify ED utilization Based on hospital records ▫Data driven ▫Each record classified into 1 of 4 categories

7. Methods- Visit Types Non-Emergent ▫Care not needed within 12 hours Emergent- Primary Care Treatable ▫Treatment needed within 12 hours ▫Other places could treat- equipment/resources ▫No constant observation

8. Methods- Visit Types Emergent- Primary Care Preventable ▫ED care required- complaint or resources ▫Condition preventable- timely care Emergent- Not Preventable ▫ED care required ▫Ambulatory care- not preventable

9. Methods- Data Sources ▫SPARCS data ▫I drive  NYS Zips 2004  NYS Hospital ▫Google Earth Software ▫Map Info ▫Google Earth ▫Excel

10. Methods- Mapping Capital Region- 3 counties ▫69 Zip codes ▫35 Zip code groupings Hospitals ▫NYS, MA, VT Thematic maps

11. Results