• Henry T Stelfox, Simon Berthelot, Eddy S Lang, and Panel on Emergency-Sensitive Conditions (PESC).
• Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: siberth@me.com.
• Ann Emerg Med. 2014 Apr 1;63(4):418-24.e2.

Study ObjectiveHospital standardized mortality ratios are used for hospital performance assessment. As a first step to develop a ratio variant sensitive to the outcome of patients admitted from the emergency department (ED), we identified International Classification of Diseases, 10th Revision, Canada diagnosis groups in which high-quality ED care would be expected to reduce inhospital mortality (emergency-sensitive conditions).MethodsTo identify emergency-sensitive conditions, we assembled a multidisciplinary panel of emergency care providers and managers (n=14). Using a modified RAND/University of California, Los Angeles Appropriateness Method, 3 rounds of independent ratings including a teleconference were conducted from May to October 2012. Panelists serially rated diagnosis groups included in the Canadian hospital standardized mortality ratio (n=72) according to the extent ED management influences mortality.ResultsThe panel rated ED care as potentially reducing patient mortality for 37 diagnosis groups (eg, sepsis) and morbidity for 43 diagnosis groups (eg, atrial fibrillation) and rated timely ED care as critical for 40 diagnosis groups (eg, stroke). Panelists also identified 47 diagnosis groups (eg, asthma) not included in the Canadian hospital standardized mortality ratio in which mortality could potentially be decreased by ED care.ConclusionWe identified 37 diagnosis groups representing emergency-sensitive conditions that will enable the calculation of a hospital standardized mortality ratio relevant to emergency care.Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

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