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Patient Preference for Specialty Care in the ED May Inform Resource Allocation for Otolaryngology Acute Care

by Mary Beth Nierengarten • January 8, 2017

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What value do specialty emergency departments (EDs) provide for healthcare delivery?

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A new study asked this question to patients presenting in EDs with eye, ear, nose, and throat complaints and found that the patients placed a value on direct specialist care in the ED as opposed to more general emergency room care.

Additionally, the patients were willing to pay for it, at least theoretically, said Matthew Naunheim, MD, MBA, author of the study and chief resident in the department of otolaryngology at Massachusetts Eye and Ear, Harvard Medical School in Boston.

Dr. Naunheim used contingent valuation (CV) data and willingness-to-pay (WTP) analysis to assess the value of specialty emergency services to ophthalmology or otolaryngology patients. Although he said that CV data and WTP analysis are not commonly performed in otolaryngologic research, he said that their use can help clarify what patients want and the value they place on those desires.

In the study, Dr. Naunheim sent a validated WTP survey to 423 patients with ophthalmology or otolaryngology complaints who presented to the ED between October 2014 and October 2015. In the survey, patients were asked to place a value (“willingness to pay”) on specialty services provided by otolaryngologists and ophthalmologists relative to general emergency care.

A total of 327 patients responded—211 otolaryngology and 116 ophthalmology patients. Overall, the survey showed that patients placed a mean explicit value on specialty emergency services of $340 per visit ($321 for otolaryngology patients and $377 for ophthalmology patients).

The value patients placed on specialty services was independent of the level of their distress, income, and demographic characteristics. Patients with higher estimates of total ED cost, however, were more likely to have a higher WTP.

“These findings can help otolaryngologists, hospitals, and payers determine the relative value, and potentially someday reimbursement, for care provided to ENT patients,” said Dr. Naunheim. “In an era of increasing scrutiny regarding healthcare spending, otolaryngologists should lead the way in defining and demonstrating the value we provide to patients.”

Filed Under: Online Exclusives Tagged With: acute care, acute specialty care, emergency department

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