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Who provides what care? An analysis of clinical focus among the national emergency care workforce
- Source :
- Am J Emerg Med
- Publication Year :
- 2020
-
Abstract
- Objective Clinician expertise has been associated with improved patient outcomes, yet ED clinicians often work in various clinical settings beyond the ED and, therefore, may risk expertise by having less clinical focus. We sought to describe clinical focus among the emergency care workforce nationally. Methods Using the 2017 Medicare Public Use Files (PUF), we performed a cross-sectional analysis of clinicians receiving reimbursement for emergency care Evaluation & Management (E/M) services from Medicare fee-for-service Part B. Clinicians were categorized by type as EM physicians, non-EM physicians, and advanced practice providers (APPs). The primary outcome was the clinical focus of the individual clinician, defined as the proportion of E/M services within the ED setting relative to a clinician's total E/M services across all practice settings. Results Of 65,710 unique clinicians providing care to Medicare fee-for-service beneficiaries in the ED setting, 39,016 (59.4%) were classified as EM physicians, 8123 (12.4%) as non-EM physicians, and 18,571 (28.5%) as APPs. The individual clinician median focus was 92.8% (interquartile range [IQR]: 87.0, 100.0) for EM physicians, 45.2% (IQR: 5.1, 97.0) for non-EM physicians, and 100.0% (IQR: 96.3, 100.0) for APPs. Conclusion EM physicians have twice as much clinical focus in comparison to non-EM physicians providing emergency care to Medicare fee-for-service beneficiaries. These findings underscore the importance of diverse training and certification programs to ensure access to clinically focused ED clinicians.
- Subjects :
- medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
business.industry
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
030208 emergency & critical care medicine
Clinical settings
General Medicine
Certification
Article
03 medical and health sciences
0302 clinical medicine
Primary outcome
Interquartile range
Family medicine
Workforce
Emergency Medicine
Medicine
business
Reimbursement
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Am J Emerg Med
- Accession number :
- edsair.doi.dedup.....0ab0a4bbe644011dedbc3ca93c97bc0e