The Emergency Severity Index Triage Algorithm Version 2 Is Reliable and Valid

Eitel, David

doi:10.1197/s1069-6563(03)00350-6

Cited by 208 publications

(115 citation statements)

References 38 publications

(54 reference statements)

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“…According to the results of the current study, higher acuity of ESI triage level was associated with higher mortality rate ( Table 1). This finding is consistent with the results of previous studies in this regard (7,20,21). Higher correlation coefficient of hospitalization and mortality rates among male patients could be due to the over-triaging of female patients or under-triaging of male patients.…”

Section: Discussionsupporting

confidence: 83%

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Pourasghar

Tabrizi

Ala

et al. 2016

J Nurs Midwifery Sci

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Background and Purpose: The emergency severity index (ESI) triage system has been recommended by the Ministry of Health to classify patients at emergency departments. This study aimed to assess the validity of ESI system (version 4) in the emergency department of a teaching hospital. Outcome measures were hospitalization, emergency department (ED) length of stay, resource consumption, in-hospital mortality, and patient service costs. Methods:In this retrospective cross-sectional study, medical records of 562 ED patients were reviewed to determine the ESI level and outcome measures in April 2013. Possible correlations were assessed using Phi and Cramer's V and Spearman's Rho. Data analysis was performed in SPSS V.16, and P value of 0.05 was considered significant. Results:In this study, frequency of five ESI levels (1-5) was 24, 14, 365, 158 and 0, respectively. In addition, Phi and Cramer's V for hospitalization and mortality were 0.350 (P<0.001) and 0.345 (P<0.001), respectively. Spearman's Rho for patient service costs, ED length of stay, and resource consumption were -0.434 (P<0.001), -0.015 (P=0.362), and -0.411 (P<0.001), respectively. According to our findings, the association between triage levels and resource consumption was more significant compared to other outcome measures. Conclusion:According to the results of this study, ESI triage ratings could successfully predict patient outcomes in terms of hospitalization, in-hospital mortality, resource consumption, and patient service costs. Therefore, use of this valid triage system is recommended for the arrangement of human and physical resources at emergency departments.

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Section: Discussionsupporting

confidence: 83%

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Pourasghar

Tabrizi

Ala

et al. 2016

J Nurs Midwifery Sci

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“…During most of the study period, acuity was assessed using the Emergency Severity Index, previously shown to be reliable and valid. 28,29 During the first eight months of our study period, acuity was assessed using the Canadian Triage and Acuity Scale, which has also been shown to be reliable. 30 Chief complaints were also assessed at triage by an RN and were grouped into 53 categories for analysis.…”

Section: Study Protocolmentioning

confidence: 99%

Emergency Department Overcrowding: Analysis of the Factors of Renege Rate

2007

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“…17 ESI has been validated for interrater and interinstitution reliability and is endorsed as a best practice by the Agency for Healthcare Research and Quality. 1,[17][18][19] The extent to which the ESI algorithm is used nationally is not known, but in a recent national poll of 300 ED directors in hospitals across the United States, 71% of 127 respondents reported that they used ESI. 20 Because potential charges cannot be calculated for patients who LWBS, the magnitude of lost revenue to the physician is unknown.…”

mentioning

confidence: 99%

Emergency Severity Index Triage System Correlation with Emergency Department Evaluation and Management Billing Codes and Total Professional Charges

Wiler

Poirier

Farley

et al. 2011

Academic Emergency Medicine

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Objectives: All services provided by physicians to patients during an emergency department (ED) visit, including procedures and ''cognitive work,'' are described by common procedural terminology (CPT) codes that are translated by coders into total professional (physician) charges for the visit. These charges do not include the technical (facility) charges. The objectives of this study were to characterize associations between Emergency Severity Index (ESI) acuity level, ED Evaluation and Management (E&M) billing codes 99281-99285 and 99291, and total ED provider charges (sum of total procedure and E&M professional charges). Secondary objectives were to identify factors that might affect these associations and to evaluate the performance of ESI and identified variables to predict E&M code and average total professional charges. Methods:The authors reviewed 276,824 patient records for calendar year 2007, of which 193,952 adult ED visits from three different ED types (community, university-based academic, and non-universitybased academic) met inclusion criteria. Correlations between 1) ESI level and E&M billing code per visit by institution and 2) ESI and total professional charges were analyzed using Spearman rank correlation. Linear regression analysis was performed to identify variables that significantly affected these correlations.Results: ESI level and E&M codes were moderately correlated (Spearman r = 0.51). ESI levels corresponded proportionately to higher E&M codes. ESI 1, 2, and 3 most frequently corresponded with E&M level 5 (50, 62, and 45%, respectively), and ESI 4 and 5 most frequently corresponded with E&M level 3 (56 and 67%, respectively). Only age by decade significantly affected the association between ESI level and E&M billing code. The mean total professional charge for all patient encounters was $421 (SD ± $204) with increasing mean charges per patient by increasing ESI acuity. Race and E&M code significantly affected the relationship between ESI level and total ED professional charges per patient (adjusted r 2 = 0.66).Conclusions: A moderate, nonlinear correlation exists between ESI acuity levels and ED E&M billing codes. Increasing age affects this correlation. Race and E&M code affect the correlation between ESI level and total professional charges. As such, basic triage data can be used to estimate E&M code and total professional charges. Future studies are needed to validate these findings across other institutional settings.

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The Emergency Severity Index Triage Algorithm Version 2 Is Reliable and Valid

Abstract: ESI v. 2 triage produced reliable, valid stratification of patients across seven sites. ESI triage should be evaluated as an ED casemix identification system for uniform data collection in the United States and compared with other major ED triage methods.

Cited by 208 publications

References 38 publications

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Emergency Department Overcrowding: Analysis of the Factors of Renege Rate

Emergency Severity Index Triage System Correlation with Emergency Department Evaluation and Management Billing Codes and Total Professional Charges

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