{"id":"https://openalex.org/W15330571","doi":"https://doi.org/10.18043/ncm.72.4.265","title":"Cost Analysis of the Use of Emergency Departments for Primary Care Services in Charlotte, North Carolina","display_name":"Cost Analysis of the Use of Emergency Departments for Primary Care Services in Charlotte, North Carolina","publication_year":2011,"publication_date":"2011-07-01","ids":{"openalex":"https://openalex.org/W15330571","doi":"https://doi.org/10.18043/ncm.72.4.265","mag":"15330571","pmid":"https://pubmed.ncbi.nlm.nih.gov/22128684"},"language":"en","primary_location":{"id":"doi:10.18043/ncm.72.4.265","doi":"https://doi.org/10.18043/ncm.72.4.265","is_oa":false,"landing_page_url":"https://doi.org/10.18043/ncm.72.4.265","pdf_url":null,"source":{"id":"https://openalex.org/S2753624605","display_name":"North Carolina Medical Journal","issn_l":"0029-2559","issn":["0029-2559","2379-4313"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","poland-20","russia-white-list-2"],"host_organization":"https://openalex.org/P4320800613","host_organization_name":"North Carolina Medical Society Foundation's Community Practitioner Program","host_organization_lineage":["https://openalex.org/P4320800613"],"host_organization_lineage_names":["North Carolina Medical Society Foundation's Community Practitioner Program"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"North Carolina Medical Journal","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5053340970","display_name":"Andrew D. McWilliams","orcid":"https://orcid.org/0000-0003-3406-9201","observed_orcids":["https://orcid.org/0000-0003-3406-9201","https://orcid.org/0000-0002-8397-3531"]},"institutions":[{"id":"https://openalex.org/I114027177","display_name":"University of North Carolina at Chapel Hill","ror":"https://ror.org/0130frc33","country_code":"US","type":"education","lineage":["https://openalex.org/I114027177"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrew McWilliams","raw_affiliation_strings":["School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA","institution_ids":["https://openalex.org/I114027177"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5023816784","display_name":"Hazel Tapp","orcid":"https://orcid.org/0000-0003-0867-4635","observed_orcids":["https://orcid.org/0000-0003-0867-4635"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hazel Tapp","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5068441507","display_name":"Jolene Barker","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jolene Barker","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5002225118","display_name":"Michael Dulin","orcid":"https://orcid.org/0000-0002-2530-9915","observed_orcids":["https://orcid.org/0000-0002-2530-9915"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Michael Dulin","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":4.0566,"has_fulltext":false,"cited_by_count":64,"citation_normalized_percentile":{"value":0.93074466,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":94,"max":99},"biblio":{"volume":"72","issue":"4","first_page":"265","last_page":"271"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/emergency-department-use","display_name":"emergency department utilization","score":0.7850000262260437},{"id":"https://openalex.org/keywords/ambulatory-care-sensitive-conditions","display_name":"ambulatory care sensitive conditions","score":0.9139999747276306},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.7279999852180481},{"id":"https://openalex.org/keywords/primary-health-care-center","display_name":"primary health centers","score":0.753000020980835},{"id":"https://openalex.org/keywords/safety-net-clinics","display_name":"safety-net clinics","score":0.8669999837875366},{"id":"https://openalex.org/keywords/medicaid","display_name":"Medicaid","score":0.47999998927116394},{"id":"https://openalex.org/keywords/uninsured-patients","display_name":"uninsured patients","score":0.8399999737739563},{"id":"https://openalex.org/keywords/racial-and-ethnic-disparities","display_name":"racial and ethnic disparities","score":0.9700000286102295},{"id":"https://openalex.org/keywords/sex-differences","display_name":"sex differences","score":0.574999988079071},{"id":"https://openalex.org/keywords/hospital-charges","display_name":"hospital charges","score":0.621999979019165},{"id":"https://openalex.org/keywords/cost-reduction","display_name":"cost reduction","score":0.3319999873638153}],"concepts":[{"id":"https://openalex.org/C25602115","wikidata":"https://www.wikidata.org/wiki/Q407111","display_name":"Ubiquitin","level":3,"score":0.7849950194358826},{"id":"https://openalex.org/C134459356","wikidata":"https://www.wikidata.org/wiki/Q4274835","display_name":"Ubiquitin ligase","level":4,"score":0.7575057744979858},{"id":"https://openalex.org/C204628709","wikidata":"https://www.wikidata.org/wiki/Q864854","display_name":"Biotinylation","level":2,"score":0.5534802675247192},{"id":"https://openalex.org/C182561583","wikidata":"https://www.wikidata.org/wiki/Q7876535","display_name":"Ubiquitin-conjugating enzyme","level":5,"score":0.5241848826408386},{"id":"https://openalex.org/C70721500","wikidata":"https://www.wikidata.org/wiki/Q177005","display_name":"Computational biology","level":1,"score":0.5212752819061279},{"id":"https://openalex.org/C2778834346","wikidata":"https://www.wikidata.org/wiki/Q422794","display_name":"Thioester","level":3,"score":0.5184173583984375},{"id":"https://openalex.org/C175114707","wikidata":"https://www.wikidata.org/wiki/Q408483","display_name":"DNA ligase","level":3,"score":0.5090512633323669},{"id":"https://openalex.org/C116834253","wikidata":"https://www.wikidata.org/wiki/Q2039217","display_name":"Identification (biology)","level":2,"score":0.4771841764450073},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.4729097783565521},{"id":"https://openalex.org/C55493867","wikidata":"https://www.wikidata.org/wiki/Q7094","display_name":"Biochemistry","level":1,"score":0.4636387228965759},{"id":"https://openalex.org/C181199279","wikidata":"https://www.wikidata.org/wiki/Q8047","display_name":"Enzyme","level":2,"score":0.45958012342453003},{"id":"https://openalex.org/C95444343","wikidata":"https://www.wikidata.org/wiki/Q7141","display_name":"Cell biology","level":1,"score":0.35746699571609497},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.28029558062553406},{"id":"https://openalex.org/C104317684","wikidata":"https://www.wikidata.org/wiki/Q7187","display_name":"Gene","level":2,"score":0.12102517485618591},{"id":"https://openalex.org/C59822182","wikidata":"https://www.wikidata.org/wiki/Q441","display_name":"Botany","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003365","descriptor_name":"Costs and Cost Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D005006","descriptor_name":"Ethnicity","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008484","descriptor_name":"Medicaid","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D009657","descriptor_name":"North Carolina","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D012307","descriptor_name":"Risk Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012737","descriptor_name":"Sex Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016009","descriptor_name":"Chi-Square Distribution","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016015","descriptor_name":"Logistic Models","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017677","descriptor_name":"Age Distribution","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019458","descriptor_name":"Insurance Coverage","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.18043/ncm.72.4.265","doi":"https://doi.org/10.18043/ncm.72.4.265","is_oa":false,"landing_page_url":"https://doi.org/10.18043/ncm.72.4.265","pdf_url":null,"source":{"id":"https://openalex.org/S2753624605","display_name":"North Carolina Medical Journal","issn_l":"0029-2559","issn":["0029-2559","2379-4313"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","poland-20","russia-white-list-2"],"host_organization":"https://openalex.org/P4320800613","host_organization_name":"North Carolina Medical Society Foundation's Community Practitioner Program","host_organization_lineage":["https://openalex.org/P4320800613"],"host_organization_lineage_names":["North Carolina Medical Society Foundation's Community Practitioner Program"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"North Carolina Medical Journal","raw_type":"journal-article"},{"id":"pmid:22128684","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/22128684","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"North Carolina medical journal","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9789000153541565,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"sustainable_development_goals_aurora":[],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G2118811065","display_name":null,"funder_award_id":"R01 HS 016023-01","funder_id":"https://openalex.org/F4320332177","funder_display_name":"Agency for Healthcare Research and Quality"}],"funders":[{"id":"https://openalex.org/F4320332177","display_name":"Agency for Healthcare Research and Quality","ror":"https://ror.org/03jmfdf59"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":23,"referenced_works":["https://openalex.org/W1500366358","https://openalex.org/W1968640360","https://openalex.org/W1994112607","https://openalex.org/W1997152706","https://openalex.org/W1997871748","https://openalex.org/W2002200694","https://openalex.org/W2027081399","https://openalex.org/W2038823715","https://openalex.org/W2045421220","https://openalex.org/W2047402026","https://openalex.org/W2047534876","https://openalex.org/W2061822304","https://openalex.org/W2071435448","https://openalex.org/W2077687069","https://openalex.org/W2102903514","https://openalex.org/W2105664881","https://openalex.org/W2111296951","https://openalex.org/W2122029571","https://openalex.org/W2126571024","https://openalex.org/W2133440648","https://openalex.org/W2150242099","https://openalex.org/W2402525848","https://openalex.org/W2405236420"],"related_works":["https://openalex.org/W2007636624","https://openalex.org/W2162411862","https://openalex.org/W2414938791","https://openalex.org/W7215027357","https://openalex.org/W3039783251","https://openalex.org/W3043382462","https://openalex.org/W1601816539","https://openalex.org/W2319435743","https://openalex.org/W192642131","https://openalex.org/W2324980206"],"abstract_inverted_index":{"BACKGROUND:":[0],"Patients":[1],"often":[2],"inappropriately":[3],"seek":[4],"emergency":[5,16],"services":[6],"for":[7,34,43,58,96,113,165,204,244],"ambulatory":[8],"care-sensitive":[9],"conditions":[10,223],"(ACSCs).":[11],"The":[12,184,220],"unnecessary":[13],"use":[14,246],"of":[15,40,105,108,120,125,129,133,169,180,194,200,222,247],"departments":[17],"(EDs)":[18],"is":[19],"an":[20],"expensive":[21],"burden":[22],"on":[23],"hospitals":[24],"and":[25,36,45,53,65,91,98,147,197,257,262],"payers.":[26],"Here,":[27],"we":[28],"identify":[29,82],"factors":[30],"influencing":[31],"ED":[32,110,227],"visits":[33,42,111,122,196,228],"ACSCs":[35,172],"analyze":[37],"the":[38,75,118,152,160,192,198],"costs":[39],"such":[41,207],"EDs":[44,67,153],"primary":[46,60,161,176,232],"care":[47,61,162,177,233],"clinics.":[48],"METHODS:":[49],"Age,":[50],"race,":[51],"sex,":[52],"insurance":[54,126],"data":[55,90],"from":[56],"2007":[57],"3":[59],"safety":[62],"net":[63,92],"clinics":[64,178,234],"4":[66],"in":[68,151,159,175,181,191,231,264],"Charlotte,":[69],"North":[70],"Carolina,":[71],"were":[72,112,154],"analyzed":[73],"using":[74],"New":[76],"York":[77],"University":[78],"(NYU)":[79],"algorithm":[80,186],"to":[81,250,260],"ACSC":[83],"diagnoses.":[84],"Cost":[85],"analyses":[86],"used":[87],"hospital":[88,99,258],"charge":[89],"margins":[93],"as":[94,208],"surrogates":[95],"payer":[97],"system":[100],"costs.":[101],"RESULTS:":[102],"A":[103],"total":[104],"113,730":[106],"(59.4%)":[107],"191,622":[109],"ACSCs.":[114],"Factors":[115],"that":[116],"increased":[117],"number":[119],"ACSC-related":[121,195],"included":[123],"lack":[124],"coverage;":[127],"receipt":[128],"Medicaid":[130],"insurance;":[131],"age":[132],"less":[134,215],"than":[135,157,216],"2":[136,217],"years;":[137],"African":[138],"American,":[139],"Hispanic,":[140],"or":[141,145,212,235],"Native":[142],"American":[143],"race":[144],"ethnicity;":[146],"female":[148],"sex.":[149],"Charges":[150],"320%-728%":[155],"higher":[156,242],"those":[158,209,213],"clinics,":[163],"allowing":[164],"a":[166],"potential":[167],"savings":[168],"69%-86%":[170],"had":[171],"been":[173],"treated":[174,224],"instead":[179],"EDs.":[182,248],"LIMITATIONS:":[183],"NYU":[185],"may":[187],"have":[188],"inherent":[189],"weaknesses":[190],"categorization":[193],"accuracy":[199],"cost":[201],"assignment,":[202],"especially":[203],"vulnerable":[205],"patients,":[206],"with":[210],"comorbidities":[211],"aged":[214],"years.":[218],"CONCLUSION:":[219],"majority":[221],"during":[225],"outpatient":[226],"are":[229,240],"treatable":[230],"even":[236],"preventable.":[237],"Some":[238],"groups":[239],"at":[241],"risk":[243],"inappropriate":[245],"Solutions":[249],"this":[251],"complex":[252],"problem":[253],"will":[254],"require":[255],"payers":[256],"systems":[259],"design":[261],"invest":[263],"novel":[265],"targeted":[266],"interventions.":[267]},"counts_by_year":[{"year":2024,"cited_by_count":3},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":6},{"year":2021,"cited_by_count":4},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":10},{"year":2018,"cited_by_count":2},{"year":2017,"cited_by_count":7},{"year":2016,"cited_by_count":5},{"year":2015,"cited_by_count":10},{"year":2014,"cited_by_count":6},{"year":2013,"cited_by_count":3},{"year":2012,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}