Table 1 Characteristics of ACSC ED visits by Medicare Patients to All Hospitals and High ACSC Hospitals

N

2,722

559

555

553

Unique visits (N)

5,192,729

1,009,543

997,439

1,019,814

Unique patients (N)

3,670,027

710,058

719,112

712,689

Patient characteristics

Median age (IQR)

78 (72–85)

78 (71–85)

79 (72–86)

78 (71–85)

Age

 65–74

1,844,151 (35.5%)

372,865 (36.9%)

349,918 (35.1%)

383,138 (37.6%)

 75–84

1,874,734 (36.1%)

367,253 (36.4%)

361,901 (36.3%)

369,433 (36.2%)

 85 + 

1,473,844 (28.4%)

269,425 (26.7%)

285,620 (28.6%)

267,243 (26.2%)

Female

3,183,433 (61.3%)

627,141 (62.1%)

622,502 (62.4%)

627,180 (61.5%)

Race

 White

4,179,259 (80.5%)

763,046 (75.6%)

824,608 (82.7%)

737,814 (72.3%)

 Black

711,134 (13.7%)

181,526 (18.0%)

113,997 (11.4%)

215,608 (21.1%)

 Other

302,336 (5.8%)

64,971 (6.4%)

58,834 (5.9%)

66,392 (6.5%)

Comorbidity count (Elixhauser)

3 (2–5)

4 (2–5)

3 (2–5)

4 (2–5)

Elixhauser comorbidities

 0–1

995,837 (19.2%)

168,684 (16.7%)

189,980 (19.0%)

157,065 (15.4%)

 2

796,795 (15.3%)

154,055 (15.3%)

156,843 (15.7%)

151,288 (14.8%)

 3 + 

3,400,097 (65.6%)

686,804 (68.0%)

650,616 (65.2%)

711,461 (69.8%)

Dual-eligible

1,261,508 (24.3%)

300,022 (29.7%)

257,399 (25.8%)

311,754 (30.6%)

Hospital characteristics

 Teaching Hosp

  None

785 (28.8%)

131 (24.3%)

126 (24.2%)

150 (26.2%)

  Minor teaching hospital (AMA)

236 (8.7%)

15 (2.8%)

9 (1.7%)

35 (6.1%)

  Major teaching hospital (COTH)

1,701 (62.5%)

394 (73.0%)

386 (74.1%)

388 (67.7%)

 Bed Size

  50–99

568 (20.9%)

142 (26.3%)

152 (29.2%)

123 (21.5%)

  100–199

879 (32.3%)

193 (35.7%)

202 (38.8%)

199 (34.7%)

  200 + 

1,275 (46.8%)

205 (38.0%)

167 (32.1%)

251 (43.8%)

 Ownership

  For-profit

511 (19.7%)

137 (26.9%)

121 (24.6%)

142 (26.5%)

  Public

354 (13.6%)

57 (11.2%)

62 (12.6%)

63 (11.8%)

  Non-profit

1,736 (66.7%)

316 (62.0%)

308 (62.7%)

330 (61.7%)

 Safety net

  Highest quartile of DSH

692 (25.9%)

175 (32.4%)

131 (25.1%)

206 (36.0%)

Community characteristics

 Region

  Northeast

473 (17.4%)

107 (19.8%)

88 (16.9%)

132 (23.0%)

  Midwest

659 (24.2%)

114 (21.1%)

113 (21.7%)

127 (22.2%)

  South

1,074 (39.5%)

280 (51.9%)

260 (49.9)

276 (48.2%)

  West

516 (19.0%)

39 (7.22%)

60 (11.5%)

38 (6.6%)

 Urbanicity (NCHS, 2013)

  Large central metro

649 (23.9%)

132 (24.5%)

88 (17.0%)

169 (29.6%)

  Large fringe metro

587 (21.6%)

127 (23.6%)

125 (24.1%)

129 (22.6%)

  Medium/Small metro

879 (32.3%)

117 (21.8%)

148 (28.5%)

130 (22.8%)

  Non-metro

604 (22.2%)

162 (30.1%)

158 (30.4%)

142 (25.0%)

Hospital community characteristics Median (IQR)

 % Poverty

15.6 (12.0–18.7)

17.4 (13.9–20.1)

16.5 (13.1–19.1)

17.4 (13.9–20.3)

 Median household income

50,774 (43,103–58,539)

46,070.5 (40,530–53,624)

47,123 (40,751–55,686)

47,024 (40,957–53,795)

 Didn’t see doctor because of cost

13.8 (10.7–17.2)

14.8 (12.4–18.4)

14.5 (11.5–17.8)

14.7 (12.2–17.9)

 High housing costs

34.4 (28.8–40.5)

31.7 (26.9–38.5)

30.5 (26.3–36.8)

33.8 (28.3–41.1)

 High school education or higher

86.9 (82.5–89.7)

84.4 (78.7–88.4)

85.0 (79.7–88.9)

84.8 (79.6–88.2)

 Food insecurity

15.3 (12.7–17.6)

16.1 (13.6–17.9)

15.3 (12.9–17.6)

16.2 (13.6–18.3)

 Federally qualified health centers /100 K

1.3 (0.5–2.7)

1.4 (0.5–2.8)

1.3 (0.4–2.8)

1.4 (0.5–2.8)

 Primary care / 100 K

72.1 (53.5–92.7)

61.3 (45.1–82.1)

61.1 (44.9–81.5)

65.5 (48.2–85.0)

 % White

79.5 (64.2–89.4)

79.9 (63.0–91.8)

81.7 (68.9–91.8)

76.2 (62.1–89.7)

 % Black

8.3 (2.7–18.6)

10.5 (2.8–22.2)

7.2 (2.5–18.7)

12.5 (4.1–24.4)

 % Hispanic

7.6 (3.4–19.6)

5.5 (2.3–19.1)

5.7 (2.4–17.1)

6.7 (2.6–19.7)