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CENTER FOR HEALTH INFORMATION AND ANALYSISMassachusettsAcute Care HospitalEmergencyDepartment DataFFY 2016-2019September 2021
Table of ContentsExecutive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Section 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Characteristics of Massachusetts Hospitals with Emergency Departments, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Massachusetts Emergency Department Campuses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Metro Boston Emergency Department Campuses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Section 2: Statewide Visit Characteristics and Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Visit Utilization Overview, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Visits by Hospital Cohort, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Visits by System Affiliation, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Visits by High Public Payer Status, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Visits by Trauma Designation, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Visits by Expected Primary Payer Type, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Visits by Patient EMS Region, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Visits by Expected Primary Payer Type and Patient EMS Region, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Visits by Age Group, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Visits by Gender, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Visits by Age Group and Gender, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Visits by Expected Primary Payer Type and Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Visits by Race/Ethnicity, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20211
Table of Contents (continued)Section 3: Behavioral Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27Visits with Behavioral Health Primary Diagnoses, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Visits with Behavioral Health Primary Diagnoses by Expected Primary Payer Type, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 30Visits with Behavioral Health Primary Diagnoses by Patient EMS Region, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Visits with Behavioral Health Primary Diagnoses by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Visits with Behavioral Health Primary Diagnoses by Gender, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Visits with Behavioral Health Primary Diagnoses by Race/Ethnicity, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Section 4: Frequent Utilizers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Patients and Visits by Frequent Utilizer Status, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Patients and Visits by Frequent Utilizer Status and Expected Primary Payer Type, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 37Patients and Visits by Frequent Utilizer Status and Patient EMS Region, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Patients and Visits by Frequent Utilizer Status and Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Patients and Visits by Frequent Utilizer Status and Gender, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Patients and Visits by Frequent Utilizer Status and Race/Ethnicity, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Section 5: Treat-and-Release Visit Characteristics and Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42Treat-and-Release Visits: Utilization Overview, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44Treat-and-Release Visits: Departure Status, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Treat-and-Release Visits: Most Common Primary CCSR Diagnoses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46Treat-and-Release Visits: Length of Stay among Most Common Primary CCSR Diagnoses, 2019 . . . . . . . . . . . . . . . . . . . 47CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20212
Table of Contents (continued)Treat-and-Release Visits: Most Common Non-Behavioral Health and Behavioral Health Primary CCSR Diagnoses, 2019 . . . . . . . 48Treat-and-Release Visits: Length of Stay among Most Common Non-Behavioral Health andBehavioral Health Primary CCSR Diagnoses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Treat-and-Release Visits: Most Common Primary CCSR Diagnoses by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . 50Treat-and-Release Visits: Visits with Excess Length of Stay, 2016-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51Treat-and-Release Visits: Excess Length of Stay by Hospital Cohort, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52Treat-and-Release Visits: Excess Length of Stay by High Public Payer Status, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . 53Treat-and-Release Visits: Excess Length of Stay by Expected Primary Payer Type, 2019 . . . . . . . . . . . . . . . . . . . . . . . 54Treat-and-Release Visits: Excess Length of Stay by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Treat-and-Release Visits: Excess Length of Stay by Race/Ethnicity, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56Treat-and-Release Visits: Excess Length of Stay by Behavioral Health Primary Diagnoses, 2019 . . . . . . . . . . . . . . . . . . . . 57Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20213
Executive SummaryThis is the first annual statewide report on emergencyOverall ED Utilizationdepartment (ED) utilization and part of a new reporting In FFY 2019, there were over 3.1 million ED visits inseries providing analyses on patterns and trends of acutecare hospital services from CHIA’s Case Mix database.This report presents key measures of ED utilization overalland by hospital, patient, and visit characteristics. Exceptwhere specified, ED visits in this report include thoseassociated with inpatient admissions or observation Over three quarters (76.8%) of ED visits were treat-andrelease, 17.0% resulted in inpatient admission, and6.1% resulted in placement in observation. Per capita ED visit rates were highest in Western andSoutheastern MA and lowest in Metro Boston.stays, as well as treat-and-release visits, which are EDHospital and Patient Characteristicsvisits associated with neither an inpatient admission nor Fifty-one percent of ED visits were at communityan observation stay. Annual rates are provided for federalhospitals with a high public-payer designation.fiscal year (FFY) 2019, and trends are provided for theyears FFY 2016-2019.CHIAthe Commonwealth.Center for Health Information and Analysis Most (51.1%) ED visits were among patients youngerthan 45 years old.Massachusetts Acute Care Hospital Emergency Department Data September 20214
Non-Hispanic Black and Hispanic patients haddisproportionately high rates of ED visits (26.6% ofvisits, 24.9% of patient population vs. 19.5% of residentpopulation).Payer Type Nearly thirty-two percent of ED visits had an expectedprimary payer type of Medicaid, followed by Medicare(28.2%) and commercial insurance (26.9%). Medicaid was the most common expected primarypayer type in all regions except Metro Boston, wherecommercial insurance was the most common. From FFY 2016 to 2019, Medicaid and Commercial EDvisits declined (by 10.7% and 7.5%, respectively), whileMedicare ED visits remained stable.Behavioral Health Nearly eight percent of ED visits had a primarydiagnosis of a behavioral health condition; 4.3% weremental health diagnoses and 3.7% were substance usedisorder diagnoses. ED visits with behavioral health primary diagnoses werenearly twice as common among Medicaid patients as Adults aged 18-64 had the highest proportion of EDvisits with behavioral health primary diagnoses. Behavioral health-related ED visits were more commonamong non-Hispanic American Indian/Alaska Native(9.1%) and non-Hispanic White patients (8.6%) thanother race/ethnicity groups (5.1-7.9%). Metro Boston and Western Massachusetts had thehighest proportion of ED visits with behavioral healthprimary diagnoses (8.7% and 8.2%, respectively).Frequent ED Utilizers Patients with a history of frequent ED use represented1.2% of ED patients and accounted for 9.4% of allED visits. Medicaid and Medicare patients were much more likelyto be identified as frequent ED utilizers than patientswith commercial insurance. Adults aged 45-64 represented the highest proportionof frequent ED utilizers by age group. Non-Hispanic Black patients were disproportionatelyfound to be frequent ED utilizers.among Medicare and commercially insured patients(11.3%, 6.1%, and 6.6%, respectively).CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20215
Treat-and-Release Visit Characteristics Treat and release ED visits declined by 3.6% from FFY2016 to FFY 2019. The most frequent diagnoses for treat-and-release visits Over thirty-two percent of treat-and-release visits lastedmore than four hours; this was twice as common amongtreat-and-release visits with behavioral health primarydiagnoses.were abdominal pain and injuries among adults, andCHIA will continue to monitor ED visit patterns and trendsupper respiratory infections among children.as hospitals continue to evolve to meet the changing health The average length of stay among treat-and-releasecare needs of the residents in the Commonwealth. nvisits remained stable from FFY 2016 to FFY 2019 atapproximately four hours. Treat-and-release visits for behavioral health conditionshad much longer average length of stay than othertypes of treat-and-release visits.CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20216
SECTION 1:IntroductionSection 8 of Chapter 12C of the Massachusetts GeneralED visits in a given 12-month period. Finally, the reportLaws grants the Massachusetts Center for Healthpresents select characteristics of treat-and-release EDInformation and Analysis (CHIA) authority to collect datavisits, which are those ED visits resulting in neither anfrom Massachusetts hospitals. CHIA, and its predecessorinpatient admission nor an observation stay at the sameagency the Division of Health Care Finance and Policy, havefacility. These analyses include overall utilization; hospital,collected data from Massachusetts acute care hospitalspatient, and visit characteristics; and excess length offor more than twenty years, including inpatient, emergencystay, defined as ED visits lasting more than four hoursdepartment (ED), and outpatient observation data.from the time of registration. Annual rates in this report areTo better understand patterns and trends in ED utilization,CHIA has analyzed ED visits in all Massachusetts acutecare hospitals over a four-year period, from FFY 2016 toFFY 2019 (October 1, 2015 – September 30, 2019). ThisCHIAprovided for FFY 2019 unless otherwise specified, andtrends are provided for the years FFY 2016-2019. Thereport is accompanied by a databook with more detailedanalyses and findings as well as a technical appendix.report presents key measures of ED utilization overallThe source of this report is CHIA’s Acute Hospital Caseand by hospital, patient, and visit characteristics. It alsoMix Database (Case Mix), which includes CHIA’s Hospitalprovides a deeper look at visits for behavioral healthInpatient Discharge Databases (HIDD), Observationconditions and visits by patients who are frequent utilizersOutpatient Databases (OOD), and Emergency Departmentof the ED, defined as patients who have 10 or moreDatabases (EDD). These databases contain visit-levelCenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20217
data provided by all acute care hospitals in Massachusetts Over half (38 of 57) of Massachusetts EDs are affiliatedon patient characteristics, admission and departure status,with High Public Payer (HPP) hospitals, meaning thatdiagnoses, treatments, services, charges, and length of stay. EDthe hospital received more than 63% of its Gross Patientvisits are allocated to one of these three databases hierarchically:Service Revenue from government payers. These includevisits associated with an inpatient admission are located on theMedicare, Medicaid, and other government payers suchinpatient discharge record in the HIDD; visits associated with anobservation stay but not an inpatient admission are located on theobservation stay record in the OOD; and treat-and-release visitsassociated with neither an inpatient admission nor an observationstay are in the EDD. Except for Section 5: Treat-and-Release Visitas the Massachusetts Health Safety Net. Of the 42 EDsassociated with community hospitals, 30 are affiliated withthose designated as HPP hospitals. Most EDs (44 of 57) in Massachusetts are affiliated withCharacteristics and Utilization, analyses in this report include EDa multi-hospital system, consisting of two or more hospitalsvisits from all three databases.(note that EDs may have multiple campuses but can stillOf the 61 acute care hospitals in Massachusetts, 57 operate EDswith one or more campuses, totaling 71 locations. Throughoutthis report, EDs and their campuses are classified by the hospitalcharacteristics of their affiliated acute care hospital. Thesecharacteristics include hospital cohort, high public payer (HPP)status, multi-hospital system affiliation, and trauma designation.For a list of all hospitals and ED campuses included in this report,please see the technical appendix. Most EDs (42 of 57) in Massachusetts are affiliated withcommunity hospitals. Additionally, six EDs are affiliated withAcademic Medical Centers (AMCs), seven are affiliated withteaching hospitals, and two are affiliated with specialty hospitals.be classified as individual hospitals). In FFY 2019, therewere 11 multi-hospital systems in Massachusetts, downfrom 12 in FFY 2018 after the merger of CareGroup andLahey Health System to form Beth Israel Lahey Health asof March 1, 2019.This report is the first annual statewide report on ED utilizationand part of a new series providing analyses on patterns andtrends of acute care hospital services from the Case Mixdatabase. In addition to this report, CHIA published a parallelreport on inpatient visits in Massachusetts in December 2020.For further information about the Case Mix data and measuresused in this report, please see the technical appendix. nCHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20218
Characteristics of Massachusetts Hospitals with Emergency Departments, 2019Hospital CharacteristicNumber of EmergencyDepartmentsAll Emergency Departments57CohortHospital CharacteristicNumber of EmergencyDepartmentsHospital SystemBaystate Health4Academic Medical Center6Berkshire Health Systems2Community Hospital12Beth Israel Lahey Health9Community Hospital-High Public Payer30Teaching Hospital7Cape Cod Healthcare2Specialty Hospital2Heywood Healthcare2Partners HealthCare9Steward Health Care8Tenet Healthcare2UMass Memorial Health Care3Wellforce3High Public PayerYes38No19Tax StatusNon-Profit/Municipal47For-Profit10System AffiliationNot Affiliated13Affiliated44Trauma Designation — AdultLevel I8Level II1Level III7Trauma Designation — PediatricLevel I4Level II2Note: Hospitals may have one or more EDcampuses; reporting for this table is at the hospitallevel. For a list of hospitals and ED campusesincluded in this report, please see the databookFor hospital characteristic definitions, please seethe technical appendix.Data source: CHIA Hospital Profiles, 2019CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 20219
Massachusetts Emergency Department Campuses, 201927A81210221A 21B15A291615B4367ED Name9A1151Anna Jaques Hospital10Athol Memorial Hospital8Baystate Franklin Medical Center6Baystate Medical Center3Baystate Noble Hospital9A Baystate Wing Hospital9B Baystate Wing Hospital - Mary Lane Campus2Berkshire Medical Center53Beth Israel Deaconess Hospital - Plymouth39B Cambridge Health Alliance - Everett HospitalCampus56Cape Cod Hospital4Cooley Dickinson Hospital1Fairview Hospital54Falmouth Hospital11Harrington Memorial Hospital15B HealthAlliance - Clinton Hospital15A HealthAlliance Hospital - Leominster Campus12Heywood Hospital5Holyoke Medical Center52B Lahey Health - Addison Gilbert Hospital52A Lahey Health - Beverly HospitalCHIA#1852B49B47 48ED Name25B Lahey Medical Center, Peabody2829Lawrence General Hospital35A Lawrence Memorial Hospital Campus MelroseWakefield Healthcare21A Lowell General Hospital21B Lowell General Hospital - Saints Campus55Martha’s Vineyard Hospital35B MelroseWakefield Hospital Campus MelroseWakefield Healthcare7Mercy Medical Center19B MetroWest Medical Center - Leonard MorseCampus18Milford Regional Medical Center40Morton Hospital57Nantucket Cottage Hospital16Nashoba Valley Medical Center49B North Shore Medical Center - Salem Campus49A North Shore Medical Center - Union Campus13Saint Vincent Hospital48Signature Healthcare Brockton Hospital31A Southcoast Hospitals Group - Charlton MemorialHospitalCenter for Health Information and Analysis52AMetro Boston.39B22#25B49A511314A14B9B5127Blease see page 11 for detailed* Pviewof hospital campuses in534031C31A5631B545557#ED Name31B31C4727B27A282214A14BSouthcoast Hospitals Group - St. Luke’s HospitalSouthcoast Hospitals Group - Tobey HospitalSteward Good Samaritan Medical CenterSteward Holy Family Hospital - HaverhillSteward Holy Family Hospital - MethuenSteward Saint Anne’s HospitalSturdy Memorial HospitalUMass Memorial Campus UMass Memorial Medical Center - UniversityCampusNote: Hospitals may have one or more EDcampuses; reporting on this page is at the EDcampus level. For a list of all hospitals and EDcampuses included in this report, please seethe databook.Data source: CHIA Hospital Profiles, 2019 andMassGIS 1Massachusetts Acute Care Hospital Emergency Department Data September 202110
Metro Boston Emergency Department Campuses, 2019#ED Campus Name41Beth Israel Deaconess Hospital - Milton24Beth Israel Deaconess Hospital - Needham36B Beth Israel Deaconess Medical Center East Campus36A Beth Israel Deaconess Medical Center West Campus25A342038Boston Children’s Hospital42 oston Medical Center - Menino PavilionBCampus33Brigham and Women’s Faulkner Hospital37Brigham and Women’s Hospital39A Cambridge Health Alliance - CambridgeHospital Campus2039A3217302336B36A 38374344464219B24Steward Norwood Hospital17Marlborough Hospital43Massachusetts Eye and Ear Infirmary44Massachusetts General Hospital19B MetroWest Medical Center – LeonardMorse Campus4541262619A MetroWest Medical Center - FraminghamCampus3319AEmerson Hospital25A Lahey Hospital & Medical Center32Mount Auburn Hospital23Newton-Wellesley Hospital50South Shore Hospital45Steward Carney Hospital30Steward St. Elizabeth’s Medical Center46Tufts Medical Center34Winchester Hospital50Note: Hospitals may have one or more EDcampuses; reporting on this page is at the EDcampus level. For a list of all hospitals and EDcampuses included in this report, please seethe databook.Data source: CHIA Hospital Profiles, 2019 andMassGIS 2CHIACenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 202111
SECTION 2:Statewide Visit Characteristics and UtilizationEmergency departments are a vital setting of care in theCommonwealth, with over 3.1 million ED visits in FFY 2019.by 3.6%, whereas ED visits resulting in inpatientThis section presents visit-level information on ED visits,admissions and observation stays increased (by 1.7%including annual trends in ED utilization for FFY 2016-2019,and 3.0%, respectively).as well as hospital characteristics, patient characteristics,and expected primary payer type for FFY 2019.All ED visits at acute care hospitals are included in theanalyses in this section, including treat-and-release visitsas well as those associated with inpatient admissionsand/or observation stays.KEY FINDINGS:Utilization Total ED visits from Massachusetts’ 57 acute carehospital EDs declined 2.3% from FFY 2016 to FFY 2019(from 3,222,853 to 3,148,111 visits).CHIA Treat-and-release ED visits declined over this periodCenter for Health Information and AnalysisHospital Characteristics Fifty-one percent of ED visits were at communityhospitals with a high public-payer designation. From FFY 2016 to FFY 2019, the share of ED visitsfrom community HPP hospitals has grown slightly (from48.9% to 51.0%). An observed increase in ED visitsamong community HPP hospitals is attributable to anincrease in the number of hospitals classified as HPPhospitals between FFY 2017 and FFY 2018. Over two in three ED visits (68.3%) were to hospitalswith a multi-hospital system affiliation.Massachusetts Acute Care Hospital Emergency Department Data September 202112
Over two in five visits (41.7%) were to traumadesignated hospitals and more than one in five EDpopulation4). This share also increased over the fouryear period.visits overall (22.6%) were to hospitals with the highesttrauma designation (Level I).Patient Characteristics Most (51.1%) ED visits were among patients youngerthan 45 years old. ED visits for patients aged 65 and over increased overthe four-year period, whereas visits declined for all otherage groups. The percentage of ED visits that were for femalepatients exceeded that of male patients byapproximately 6 percentage points, due in part tohospital visits for obstetric care and other maternityrelated conditions and because female residents makeup a larger share of Massachusetts residents over theage of 65.3 Non-Hispanic Black and Hispanic patients hadCHIA Nearly all (95.8%) of ED visits were for patients with apermanent residence in Massachusetts. Per capita ED visit rates were highest in the Westernand Southeastern Massachusetts regions, and lowestin the Metro Boston region.Payer Type Nearly thirty-two percent of ED visits had an expectedprimary payer type of Medicaid, followed by Medicare(28.2%) and commercial insurance (26.9%). From FFY 2016 to FFY 2019, Medicaid and CommercialED visits declined (by 10.7% and 7.5%, respectively),while Medicare ED visits remained stable. Medicaid was the most common expected primarydisproportionately high rates of ED visits (26.6% ofpayer type in all regions except Metro Boston, wherevisits, 24.9% of patient population vs. 19.5% of residentcommercial insurance was the most common. nCenter for Health Information and AnalysisMassachusetts Acute Care Hospital Emergency Department Data September 202113
Visit Utilization Overview, ,455,500Total Visits3,148,1112.8M2.4M2,508,4142,419,170Visits Resulting 2922016201720182019Center for Health Information and AnalysisVisits Resultingin AdmissionVisits Resultingin ObservationNote: ED visit information from the MassachusettsAcute Hospital Case Mix Database came fromone of three mutually exclusive data sources: visitsresulting in treat-and-release are ED visits thatwere not associated with an inpatient visit or anobservation stay; visits resulting in admission wereED visits associated with an inpatient admission;and visits resulting in observation are ED visitsassociated with an observation stay but noinpatient admission.Data source: Massachusetts Acute Hospital CaseMix Emergency Department Databases (EDD),Hospital Inpatient Discharge Databases (HIDD),and Outpatient Observation Databases (OOD),FFY 2016-2019.Massachusetts Acute Care Hospital Emergency Department Data September 202114
Visits by Hospital Cohort, 2016-20192.7%SpecialtyHospital16.9%2016Academic Medical Center48.9%16.9%14.7%Community HPP HospitalCommunity HospitalTeaching Hospital2.7%SpecialtyHospital16.9%2017Academic Medical Center16.6%14.8%49.0%Community HPP HospitalCommunity HospitalTeaching .3%Academic Medical Center Community HospitalTeaching HospitalCommunity HPP Hospital2.7%SpecialtyHospital16.9%2019Academic Medical Center0%51.0%14.5%14.9%Community HPP HospitalCommunity Hospital25%50%Teaching Hospital75%100%2016201720182019Academic Medical Center543,983537,939527,968532,077Community ,8661,638,9541,604,069Teaching Hospital473,643469,347475,332469,657Specialty 3,182,9333,148,111Community HPP HospitalTotalCHIACenter for Health Information and AnalysisNote: Each acute care hospital is assigned toone of five mutually exclusive hospital groups:Academic Medical Centers (AMCs), teachinghospitals other than AMCs, community-HighPublic Payer (HPP) hospitals, other communityhospitals, and specialty hospitals. Hospitalcharacteristics are assessed at the end of thestate fiscal year. Percentages may not sumto 100% due to rounding and missing data.The number of visits with missing cohort datadue to missing hospital ID information was 4 inFFY 2016, 1 in FFY 2017, and 2 in FFY 2019.See technical appendix for more information.Data source: Massachusetts Acute Hospital CaseMix Emergency Department Databases (EDD),Hospital Inpatient Discharge Databases (HIDD),and Outpatient Observation Databases (OOD),FFY 2016-2019.Massachusetts Acute Care Hospital Emergency Department Data September 202115
Visits by System Affiliation, 2016-2019Key201612.7%12.2%5.2% 5.9% 6.6%6.8%5.9%11.5%33.2%201712.7%12.4%5.3% 5.9%6.9% 1%0%5.4% 5.7%12.0%25%6.5%6.9%6.8%6.4% 5.9%6.7%50%5.7%11.4%Partners HealthCareSteward Health CareBeth Israel Lahey HealthLahey Health SystemCareGroupBaystate HealthUMass Memorial Health CareWellforceOther Multi-Acute Health SystemIndependent Health System31.7%75%100%Note: The Executive Office of Health and HumanServices (EOHHS) categorizes certain acutehospitals as High Public Payer (HPP) hospitalsfor the purpose of setting MassHealth rates.A hospital qualified for HPP status if it had63% or more of
payer type in all regions except Metro Boston, where . Behavioral health-related ED visits were more common among non-Hispanic American Indian/Alaska Native . 2019 . Center for Health Information and Analysis. Center for Health Information and Analysis * Hospital. Center for Health Information and Analysis. Center for Health Information .
