Figure 9. Algorithm for Classifying Emergency Department Utilization, New York University-United Health Fund of New York

[D] The emergency department algorithm developed by the New York University Center for Health and Public Service Research and the United Hospital Fund of New York classifies ED use into four basic categories:

• Non-emergent. Cases where immediate care is not required within 12 hours (e.g., sore throat).
• Emergent-primary care treatable. Care is needed within 12 hours, but care could be provided in a typical primary care setting (infant with a 102º fever).
• Emergent-ED care needed: preventable/avoidable. Immediate care in an ED setting is needed, but the condition could potentially have been prevented or avoided with timely and effective ambulatory care (asthma, diabetic ketoacidosis, and so on).
• Emergent-ED care needed: not preventable/avoidable. Immediate care in an ED setting is needed, and the condition could not have been prevented/avoided with ambulatory care (heart attacks, multiple trauma, and so on).

In addition, the algorithm separates out visits with a primary diagnosis involving mental health, substance abuse, or injury since these conditions are difficult to classify and may be of special interest to analysts. Figure 9 illustrates the algorithm.

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