Hospitalizations – Emergency Room Visits
This indicator reports the number and rate of emergency room visits among Medicare beneficiaries age 65 and older. This indicator is relevant because emergency room visits are “high intensity” services that can burden on both health care systems and patients. High rates of emergency room visits “may indicate poor care management, inadequate access to care or poor patient choices, resulting in ED visits that could be prevented”1.
Source
Source Description
The Centers for Medicare & Medicaid Services (CMS), a branch of the Department of Health and Human Services (HHS), is the federal agency that runs the Medicare Program and monitors Medicaid programs offered by each state. Medicare is a type of federally-funded health insurance available to disabled persons and the population age 65 and older. The Office of Enterprise Data and Analytics within the Centers for Medicare & Medicaid Services (CMS) developed a public use file to support further analysis of the geographic variation in the amount and quality of the health care services that Medicare beneficiaries receive. For more information, please see the Geographic Variation Public Use File Methodology document.
Methodology
This indicator reports information on variation in services utilization by Medicare patients. Data are from the Centers for Medicare & Medicaid Services (CMS) Geographic Variation Public Use File, which was developed to enable researchers and policymakers to evaluate geographic variation in the utilization and quality of health care services for the Medicare fee-for-service population. The Geographic Variation Public Use File includes demographic, spending, utilization, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands), hospital referral region (HRR) level, and county level. Definitions for map layers obtained from this dataset are as follows:
- Ambulance Users: Number of beneficiaries using Ambulance services
- Ambulance Events Rate: Ambulance Events Per 1000 Beneficiaries
- Hospital Readmissions: Total count of inpatient readmissions within 30 days of an acute hospital stay during the reference period
- Hospital Readmission Rate: Percentage of inpatient readmissions within 30 days of an acute hospital stay during then reference period
- Emergency Department Visits: Total count of inpatient or hospital outpatient emergency department visits
- Emergency Department Visits Rate: Inpatient or hospital outpatient emergency department visits per 1000 beneficiaries
Each file has a Documentation section which explains the individual indicators in more detail. Information on the sample population and the methodology used to calculate these indicators can be found in the Methodological Overview paper and the Technical Supplement on Standardization paper.
Data Breakouts Available
- Emergency Room Visit Rates by Year
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