Boggs Krislyn M, Sullivan Ashley F, Espinola Janice A, Gao Jingya, Camargo Carlos A
Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USA.
J Am Coll Emerg Physicians Open. 2022 Apr 1;3(2):e12704. doi: 10.1002/emp2.12704. eCollection 2022 Apr.
Emergency department (ED) data are often used to address questions about access to and quality of emergency care. Our objective was to compare one of the most commonly used data sources for national ED information, the American Hospital Association (AHA) Annual Survey, with a criterion database: the National Emergency Department Inventory (NEDI)-USA data set.
We compared the 2015 and 2016 AHA surveys to the following 3 criterion standards: (1) the 2015 and 2016 NEDI-USA databases, which have information about all US EDs, including merged data from (2) Council of Teaching Hospitals (COTH) and (3) the Critical Access Hospital (CAH) program. We present descriptive results about the number of EDs in each data set; total and median visit volumes; locations in rural areas; and COTH, CAH, and freestanding ED (FSED) status.
The AHA survey identified 3893 US EDs in 2015. These EDs had a total annual visit volume of 129,197,493 visits, with a median of 22,772 visits (interquartile range, 8311-47,938). Compared with the NEDI-USA, the AHA included 1433 fewer EDs (-27%; 95% confidence interval [CI], -28% to -26%) and 23,615,163 (-15%) fewer visits. Specifically, AHA was missing 245 (-22%; 95% CI, -24% to -19%) of those located in rural areas, 268 (-20%; 95% CI, -22% to -18%) in a CAH, and 240 (-47%; 95% CI, -51% to -42%) FSEDs. We saw similar results using 2016 data.
Although several aggregated results were similar between the compared data sources, the AHA data set excluded many US EDs, including many rural EDs and FSEDs. Consequently, the AHA underreported total ED visits by 15%. We encourage data users to be cautious when interpreting results from any 1 ED data source, including the AHA.
急诊科（ED）数据常被用于解决有关急诊医疗可及性和质量的问题。我们的目的是将美国医院协会（AHA）年度调查这一最常用的全国急诊科信息数据源之一，与一个标准数据库：美国国家急诊科库存（NEDI）数据集进行比较。
我们将2015年和2016年的AHA调查与以下3个标准进行比较：（1）2015年和2016年的NEDI - 美国数据库，该数据库包含所有美国急诊科的信息，包括来自（2）教学医院理事会（COTH）和（3）临界接入医院（CAH）项目的合并数据。我们展示了每个数据集中急诊科数量、就诊总量和中位数、农村地区的位置以及COTH、CAH和独立急诊科（FSED）状态的描述性结果。
2015年AHA调查确定了3893家美国急诊科。这些急诊科的年就诊总量为129,197,493人次，中位数为22,772人次（四分位间距，8311 - 47,938）。与NEDI - 美国相比，AHA少统计了1433家急诊科（-27%；95%置信区间[CI]，-28%至-26%），就诊人次少了23,615,163人次（-15%）。具体而言，AHA遗漏了245家（-22%；95%CI，-24%至-19%）位于农村地区的急诊科、268家（-20%；95%CI，-22%至-18%）CAH急诊科和240家（-47%；95%CI,-51%至-42%）FSED急诊科。使用2016年数据时我们看到了类似结果。
尽管比较的数据源之间有几个汇总结果相似，但AHA数据集排除了许多美国急诊科，包括许多农村急诊科和FSED急诊科。因此，AHA少报了15%的急诊科就诊总量。我们鼓励数据使用者在解读任何一个急诊科数据源（包括AHA）的结果时要谨慎。
