ANALYZING THE ASSOCIATION OF EMERGENCY CARE USE AND SHARED DECISION-MAKING: EVIDENCE FROM MEPS 2002-2023
Author(s)
Anika Mehta, MTech, MSc1, Seyed M. Karimi, MS, PhD2.
1Doctoral Candidate, University of Louisville, Louisville, KY, USA, 2University of Louisville, Louisville, KY, USA.
1Doctoral Candidate, University of Louisville, Louisville, KY, USA, 2University of Louisville, Louisville, KY, USA.
OBJECTIVES: Shared Decision Making (SDM) is an essential part of Patient Centered Care (PCC). SDM empowers patients with evidence-based information. Most Emergency department visits occur due to fear of unknown, misunderstanding care options or perceived emergency. The objective of this research is to analyze (1) the trend of SDM from 2002 to 2023 in the United States and (2) the association of emergency care usage and SDM by insurance types.
METHODS: The Medical Expenditure Panel Survey (MEPS) was used from 2002 to 2023. Shared decision-making (SDM) is a patient-centered approach in which clinicians and patients jointly decides. The dataset has a variable DECIDE42 (dependent variable) that defines if the provider asks the person to help make decisions between a choice of treatments. The participants were then divided into SDM and Non SDM groups. The association of both the groups with emergency department usage was studied. Trend analysis of total emergency care use and emergency care use by insurance type (Medicare, Medicaid, and private insurance) was performed for participants in both groups. The independent variables included sex, age, race, ethnicity, income, education, marriage status, and country region.
RESULTS: Patients receiving SDM had lower mean annual emergency visits than those not receiving SDM (0.26 vs 0.21). A lower mean emergency use was observed among patients receiving SDM for private insurance (0.18 vs. 0.15), Medicare (0.39 vs. 0.33), and Medicaid (0.33 vs. 0.28). Overall, emergency department utilization was lower among all participants receiving SDM. Among all insurance types, the lowest emergency use was found in SDM participants with private insurance, and the highest in SDM participants on Medicare who were not receiving SDM.
CONCLUSIONS: Overall, participants receiving SDM thus have a better health literacy and understanding along with having preferred-sensitive treatment that results in lower use of emergency care, beneficial to both patients and hospital.
METHODS: The Medical Expenditure Panel Survey (MEPS) was used from 2002 to 2023. Shared decision-making (SDM) is a patient-centered approach in which clinicians and patients jointly decides. The dataset has a variable DECIDE42 (dependent variable) that defines if the provider asks the person to help make decisions between a choice of treatments. The participants were then divided into SDM and Non SDM groups. The association of both the groups with emergency department usage was studied. Trend analysis of total emergency care use and emergency care use by insurance type (Medicare, Medicaid, and private insurance) was performed for participants in both groups. The independent variables included sex, age, race, ethnicity, income, education, marriage status, and country region.
RESULTS: Patients receiving SDM had lower mean annual emergency visits than those not receiving SDM (0.26 vs 0.21). A lower mean emergency use was observed among patients receiving SDM for private insurance (0.18 vs. 0.15), Medicare (0.39 vs. 0.33), and Medicaid (0.33 vs. 0.28). Overall, emergency department utilization was lower among all participants receiving SDM. Among all insurance types, the lowest emergency use was found in SDM participants with private insurance, and the highest in SDM participants on Medicare who were not receiving SDM.
CONCLUSIONS: Overall, participants receiving SDM thus have a better health literacy and understanding along with having preferred-sensitive treatment that results in lower use of emergency care, beneficial to both patients and hospital.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR150
Topic
Economic Evaluation, Health Policy & Regulatory, Patient-Centered Research
Topic Subcategory
Patient Engagement
Disease
No Additional Disease & Conditions/Specialized Treatment Areas