Determining factors that influence Emergency Department overuse

Project Description

ED overuse is a problem which causes significant waste of healthcare financial resources, lower quality of care and ED facility overload. Using HMS claims data and available social determinant (SDOH) data, a predictive model/profile to identify patients with high likelihood of ED overuse will be developed.

Project Objectives

This project aims to identify characteristics of patients likely to overuse the Emergency Department for non-emergency issues. Currently these patients are only identified when they have developed an extensive history of ED use for non-emergency reasons (i.e. excess cost and diminished quality of care has already occurred). Developing a predictive model or profile would allow proactive education (e.g. alternatives to ED, proper use of ED, importance of primary care provider (PCP), etc.) and intervention (i.e. help modify impact of SDOH barriers to primary care, establish a bond with the PCP, address mental health issues, etc.) prior to the occurrence of ED overuse.