Researchers and physicians at the University of Pittsburgh School of Medicine have created a map of referral regions for acute conditions. They expect the tool to help policymakers improve overall care quality.
The new map, dubbed the Pittsburgh Atlas, was published today in the Annals of Emergency Medicine. It supplants the 20-year-old Dartmouth Atlas of Health Care as a reference for regional governments to monitor and improve access to trauma care and emergency services, improving on its predecessor in several key ways. Specifically, the 326 distinct regions laid out in the Pittsburgh Atlas stay within county and state borders, making it easier to identify the government stakeholders capable of regulating and coordinating care within the regions.
. @PittCCM docs divided the U.S. into 326 emergency referral regions that will allow for quality improvements. The "Pittsburgh Atlas" is reported in @AnnalsofEM. Learn more. https://t.co/QIiD2Y0ZG1 pic.twitter.com/Zn2Oh3dmf9— UPMC (@UPMCnews) March 29, 2018
In a statement, the project’s lead author, David J. Wallace, M.D., assistant professor in the school's department of critical care medicine, cited the recent changes in the way the healthcare industry measures quality as a primary driver of the new map. Payer incentives driving improved population health have helped to spur collaborative efforts across regions.
The researchers also cite reports from the National Academy of Medicine and National Quality Forum urging improved coordination of emergency services at the regional level.
To create the referral regions, researchers used data from Medicare patients who received care for three time-sensitive acute conditions: heart attack, stroke or moderate-to-severe trauma. After devising six different ways to carve up the regions, they settled on the one that kept the majority of patients as close to home as possible based upon where the patient population they studied actually sought out their care.
The resulting analysis shows many areas lack a high-volume referral center for the time-sensitive conditions, providing a basis for improving an important quality metric that otherwise might have gone unnoticed.
“This project gives researchers, policymakers, hospital systems and public health agencies a way to move beyond simply comparing apples to apples, and into thinking about orchards,” Wallace says.