Table 6. Quality Assessment of Selected Observational Studies on Non-ED Interventions to Reduce ED Utilization Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Criteria.
Possible limits of observational studies
| ||
---|---|---|
First Author (Reference) | Existing Limitations | Overall Quality of Evidence |
Patient education | ||
Glavan (10) | 1, 3, 4 | Very low |
McWilliams (11) | 1, 3 | Very low |
Schonlau (13) | 1, 3 | Very low |
Non-ED capacity increase | ||
Chalder (22) | 1, 2, 3 | Very low |
Hsu (24) | 1, 3, 4 | Very low |
Hudec (15) | 1, 3, 4 | Very low |
O'Kelly (16) | 1, 2, 3, 4 | Very low |
Philips (23) | 1, 2, 3 | Very low |
Rust (19) | 1, 2, 3 | Very low |
Solberg (20) | 1,2,3 | Very low |
Solberg (21) | 1,2,3,4 | Very low |
van Uden (17) | 1, 2, 3 | Very low |
Wang (18) | 2, 3 | Very low |
Prehospital diversion | ||
Schaefer (25) | 1, 3, 5 | Very low |
Managed care | ||
Badgett (27) | 1, 3, 4 | Very low |
Catalano (28) | 1, 3 | Very low |
Catalano (29) | 1,3, 4 | Very low |
Dickey (30) | 1, 3, 4 | Very low |
Franco (31) | 1, 2, 3 | Very low |
Glazier (32) | 1, 3 | Very low |
Hurley (33) | 1, 2, 3, 4 | Very low |
Josephson (34) | 1,3, 4 | Very low |
Murphy (35) | 1, 3 | Very low |
Piehl (36) | 3, 4 | Very low |
Price (37) | 2, 4 | Very low |
Patient financial incentives | ||
Hsu (39) | 3 | Very low |
Lowe (47) | 1, 2, 3 | Very low |
Lowe (40) | 2, 3 | Very low |
Mortensen (48) | 1, 2, 3, 5 | Very low |
Selby (42) | 3 | Very low |
Wallace (43) | 3 | Very low |
Waters (45) | 2, 3,4 | Very low |
Wharam (44) | 1,3,5 | Very low |
Wilson (46) | 2, 3 | Very low |