Unnecessary-ED-Visits - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Emergency department visits for conditions that could be treated in an alternative primary care setting (Retired)

Alternate Name

Percentage of patients who had an unscheduled emergency department visit that potentially could have been treated in an alternative primary care setting

INDICATOR DESCRIPTION

Description

This indicator describes the percentage of patients aged 1 to 74 who had an unscheduled emergency department visit that potentially could have been treated in an alternative primary care setting, such as a family doctor's office. A lower percentage is better.

Indicator Status

Retired

HQO Reporting tool/product

Public reporting

Dimension

Efficient

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

The percentage is calculated as: numerator divided by the denominator times 100

Numerator including inclusion/exclusion

The number of patients with an less-urgent or non-urgent unscheduled emergency department visit for a list of select conditions.

Inclusions:

1. Unscheduled visits to emergency rooms (including urgent care centres);

2. Specific selection criteria: ICD -10-CA codes (MRDx): A740, B309, H100, H101, H102, H103, H104, H105, H108, H109, H130, H131, H132, H133, N300, N301, N302, N303, N304, N308, N309, N330, N390, H650, H651, H652, H653, H654, H659, H660, H661, H662, H663, H664, H669, H670, H671, H678, J00, J010, J011, J012, J013, J014, J018, J019, J028, J029, J038, J039, J040, J041, J060, J068, J069, J310, J311, J312, J320, J321, J322, J323, J324, J328, J329, J350, J351, J352, J353, J358, J359, J399;

3. Canadian Emergency Department Triage and Acuity Scale (CTAS) levels – IV and V (less-urgent, non-urgent).

Exclusions:

Persons less than zero years of age or age 75 and older.
Emergency visits resulting in an inpatient admission (visit disposition not equal to 06 or 07).
Out of province patients.

Denominator including inclusion/exclusion

The number of people in Ontario aged 0 to 74.

Exclusions:

Birthdate after April 1st of given fiscal year.
Death date before April 1st of given fiscal year.
Missing sex.
Non-Ontario resident (April 1st of given fiscal year).
Age less than 0 or greater than 74 (April 1st of given fiscal year).
Not eligible for OHIP (April 1st of given fiscal year)

Adjustment (risk, age/sex standardization)- detailed

Direct age-sex standardized rate using the 2011 Canadian population

Data Source

National Ambulatory Care Reporting System (NACRS), Registered Persons Database (RPDB)

Data provided to HQO by

Institute for Clinical Evaluative Sciences (ICES)

Reported Levels of comparability /stratifications (defined)

Institution, Province

OTHER RELEVANT INFORMATION

Caveats and Limitations

It is not possible to know for sure if an emergency department visit could be treated in an alternative primary care setting. An emergency department visit for these conditions may not always be reflective of poor access to care for a patient. In some cases, a patient may go to the emergency department because their primary care provider works there.

Comments Detailed

Retired since this indicator is no longer reported in Measuring Up. Conditions selected for this indicator are considered common high volume conditions. If multiple conditions are diagnosed throughout the emergency visit, the diagnosis/condition responsible for the greatest resource use is chosen as the most clinically-significant reason for the visit.

Footnotes

Based on: http://www.health.gov.on.ca/en/pro/programs/ris/docs/emergency_visits_that_could_be_treated_in_alternative_primary_care_setting_en.pdf