Understanding the value of emergency care: A framework incorporating stakeholder perspectives

Adam L. Sharp*, Enesha M. Cobb, Scott M. Dresden, Derek K. Richardson, Amber K. Sabbatini, Kori Sauser, Keith E. Kocher

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background In the face of escalating spending, measuring and maximizing the value of health services has become an important focus of health reform. Recent initiatives aim to incentivize high-value care through provider and hospital payment reform, but the role of the emergency department (ED) remains poorly defined. Objectives To achieve an improved understanding of the value of emergency care, we have developed a framework that incorporates the perspectives of stakeholders in the delivery of health services. Methods A pragmatic review of the literature informed the design of this framework to standardize the definition of value in emergency care and discuss outcomes and costs from different stakeholder perspectives. The viewpoint of patient, provider, payer, health system, and society is each used to assess value for emergency medical conditions. Results We found that the value attributed to emergency care differs substantially by stakeholder perspective. Potential targets to improve ED value may be aimed at improving outcomes or controlling costs, depending on the acuity of the clinical condition. Conclusion The value of emergency care varies by perspective, and a better understanding is achieved when specific outcomes and costs can be identified, quantified, and measured. Using this framework can help stakeholders find common ground to prioritize which costs and outcomes to target for research, quality improvement efforts, and future health policy impacting emergency care.

Original languageEnglish (US)
Pages (from-to)333-342
Number of pages10
JournalJournal of Emergency Medicine
Volume47
Issue number3
DOIs
StatePublished - Sep 2014

Keywords

  • emergency department utilization
  • health care administration
  • health policy
  • health services research
  • public health
  • value

ASJC Scopus subject areas

  • Emergency Medicine

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