EMRA+PolicyRx HPJC (Future)

Since 1965, the US federal government has incentivized physicians to practice in high-need areas of the country through the designation of Health Professional Shortage Areas (HPSAs). Despite its being in place for more than half a century and directing more than a billion dollars annually, there is limited evidence of the HPSA program's effectiveness at reducing geographic disparities in access to care and health outcomes. Using a generalized difference-in-differences design with matching, we found no statistically significant changes in mortality or physician density from 1970 to 2018 after a county-level HPSA designation...

When a randomized evaluation finds null results, it is important to understand why. We investigated two very different explanations for the finding from a randomized evaluation that the Camden Coalition's influential care management program-which targeted high-use, high-need patients in Camden, New Jersey-did not reduce hospital readmissions. One explanation is that the program's underlying theory of change was not right, meaning that intensive care coordination may have been insufficient to change patient outcomes...

UNLABELLED: Temperature conditions vary in emergency service vehicles, which may pose a risk to the integrity of the drugs on board, possibly rendering them ineffective and increasing morbidity and mortality in patients. AIM: This study assessed the stability of four emergency care drugs (adrenaline, etomidate, ketamine, and rocuronium) after eight weeks of deployment in the prehospital context. METHODS: The study adopted a longitudinal quantitative design to evaluate the chemical stability of emergency care drugs...

IMPORTANCE: Virtual visits became more common after the COVID-19 pandemic, but it is unclear in what context they are best used. OBJECTIVE: To investigate whether there was a difference in subsequent emergency department use between patients who had a virtual visit with their own family physician vs those who had virtual visits with an outside physician. DESIGN, SETTING, AND PARTICIPANTS: This propensity score-matched cohort study was conducted among all Ontario residents attached to a family physician as of April 1, 2021, who had a virtual family physician visit in the subsequent year (to March 31, 2022)...

BACKGROUND: The latest comprehensive diagnosis-specific estimates of hospital professional fees relative to facility fees are from 2004 to 2012. OBJECTIVE: Update professional fee ratio (PFR) estimates to improve cost analysis opportunities with hospital discharge data sources and compare them with previous PFR estimates. SUBJECTS: 2016-2020 MarketScan inpatient admissions and emergency department (ED) treat and release claims. MEASURES: PFR was calculated as total admission or ED visit payment divided by facility-only payment...

High levels of uncompensated care impact hospital profitability and may create challenges for rural hospitals at financial risk of closure. We explore 2019 hospital uncompensated care as a percentage of operating expenses and draw comparisons at a state level by Medicaid expansion status and rural classification. We further compare uncompensated care in 2019 to 2014 in rural hospitals by Medicaid expansion implementation timing. We found that, overall, rural hospitals had more uncompensated care than urban hospitals in 2019 (3...