For this dashboard, DSHS analyzed 2023 ED visits data using a methodology involving specific diagnosis codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), which is developed by the World Health Organization. 

The ICD-10-CM principal diagnostic codes listed on Table A were used to determine avoidable ED visits. The avoidable ED visits ICD-10-CM diagnosis codes were obtained by converting the emergency room collaborative avoidable visits International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes from the Statewide Collaborative Quality Improvement Project: Reducing Avoidable Emergency Room Visits, Final Remeasurement Report by the California Department of Health Care Services’ Medi-Cal Managed Care Division. 

All avoidable ED visits are for patients who were treated and sent home because their condition did not require hospital admission. Thus, only DSHS Outpatient ED Public Use Data Files were analyzed. 

However, for mental health and substance abuse (MHSA) avoidable ED visits, both DSHS Inpatient and Outpatient ED Public Use Data Files were analyzed using the MHSA ICD-10-CM diagnoses codes. The lesser-known certainty of disease processes for patients with MHSA diagnoses or conditions yields difficulty in determining MHSA ED visits that are truly avoidable. Furthermore, it should be noted that data for people for whom Medicaid was identified as the payer for their ED visit at the time of the visit, may differ from data collected and reported by the Texas Health and Human Services Commission’s Medicaid program.

Potentially Preventable Visits