Medical care research and review : MCRR
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Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization. Patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
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This article describes trends in nonemergent emergency department (ED) visits by insurance type, using the 2000-2009 National Hospital Ambulatory Medical Care Survey and Current Population Survey. We analyzed trends in the probability that an ED visit is nonemergent and in nonemergent ED visit rates per person. We found that visits for Medicare enrollees were least likely to be for nonemergent reasons, while uninsured visits were most likely to be nonemergent. ⋯ Trends in nonemergent ED visit rates were stable for all insurance groups. The findings suggest a reliance on the ED for nonemergent care by the Medicaid population. It will be important to continue to track patterns of nonemergent ED utilization after Medicaid expansions under the Affordable Care Act.