Economic Evaluation of the Emergency Department After Implementation of an Emergency Psychiatric Assessment, Treatment, and Healing Unit

Chris Stamy; Dan M Shane; Levi Kannedy; Paul Van Heukelom; Nicholas M Mohr; Jodi Tate; Kelsey Montross; Sangil Lee; Damon R Kuehl

doi:10.1111/acem.14118

Back

Economic Evaluation of the Emergency Department After Implementation of an Emergency Psychiatric Assessment, Treatment, and Healing Unit

Journal article

Open access

Peer reviewed

Economic Evaluation of the Emergency Department After Implementation of an Emergency Psychiatric Assessment, Treatment, and Healing Unit

Chris Stamy, Dan M Shane, Levi Kannedy, Paul Van Heukelom, Nicholas M Mohr, Jodi Tate, Kelsey Montross, Sangil Lee and Damon R Kuehl

Academic emergency medicine, Vol.28(1), pp.82-91

01/2021

DOI: 10.1111/acem.14118

PMID: 32869891

Files and links (1)

url

https://doi.org/10.1111/acem.14118View

Published (Version of record) Open Access

Abstract

Objectives We sought to evaluate the impact of an emergency psychiatric assessment, treatment, and healing (EmPATH) unit on emergency department (ED) revenue, psychiatric boarding time, and length of stay (LOS). Methods We conducted a before‐and‐after economic evaluation of a single academic midwestern ED (60,000 annual visits) for all adult (≥18 years) patients before (December 2017–May 2018) and after (December 2018–May 2019) opening an EmPATH unit. These are outpatient hospital‐based programs that provide emergent treatment and stabilization for mental health emergencies from ED patients. The Holt–Winters method was used to forecast pre‐EmPATH expected ED levels of patients leaving without being seen, leaving against medical advice, eloping, or being transferred using 3 years of ED visits. ED revenues were calculated by finding the difference of pre‐EmPATH expected and post‐EmPATH observed values and multiplying by the revenue per visit. ED boarding time and LOS were obtained from the hospital’s electronic medical record. Results There were 23,231 and 23,336 ED visits evaluated during the pre– and post–EmPATH unit periods. The ED generated an estimated additional $404,954 in the 6 months and $861,065 annually after the implementation of the EmPATH unit. The median (interquartile range [IQR]) psychiatric boarding time decreased from 212 (119–536) minutes to 152 (86–307) minutes (mean difference = 189 minutes, 95% confidence interval [CI] = 150 to 228 minutes) and median (IQR) LOS decreased from 351 (204–631) minutes to 334 (212–517) minutes (mean difference = 114 minutes, 95% CI = 87 to 143 minutes). Conclusion The EmPATH unit had a positive impact on ED revenue and decreased ED boarding time and LOS for psychiatric patients.

Details

Title: Subtitle: Economic Evaluation of the Emergency Department After Implementation of an Emergency Psychiatric Assessment, Treatment, and Healing Unit
Creators: Chris Stamy - University of Iowa Carver College of Medicine
Dan M Shane - University of Iowa Carver College of Medicine
Levi Kannedy - University of Iowa Carver College of Medicine
Paul Van Heukelom - University of Iowa Carver College of Medicine
Nicholas M Mohr - University of Iowa Carver College of Medicine
Jodi Tate - University of Iowa Carver College of Medicine
Kelsey Montross - University of Iowa Carver College of Medicine
Sangil Lee - University of Iowa Carver College of Medicine
Damon R Kuehl
Resource Type: Journal article
Publication Details: Academic emergency medicine, Vol.28(1), pp.82-91
DOI: 10.1111/acem.14118
PMID: 32869891
NLM abbreviation: Acad Emerg Med
ISSN: 1069-6563
eISSN: 1553-2712
Number of pages: 10
Grant note: University of Iowa Emergency Department Seed Grant
Language: English
Date published: 01/2021
Academic Unit: Psychiatry; Health Management and Policy; Epidemiology; Economics; Emergency Medicine; Anesthesia; Injury Prevention Research Center; Public Policy Center (Archive)
Record Identifier: 9984214838602771

Metrics

22 Record Views

19 Times Cited - Web of Science