Renee Hsia, MD, MSc, FACEP

Associate Professor

Renee Y. Hsia, M.D., M.Sc., FACEP is Associate Professor of Emergency Medicine, Health Policy at the University of California San Francisco (UCSF). Her principal interest is the study of health systems to improve the access and delivery of timely acute care for patients, with a particular emphasis on vulnerable populations. Her work has centered around closures of emergency services (including trauma services) in California and nationally, and the effects of closures on patient outcomes for time-sensitive illnesses.  Dr. Hsia also analyzes issues of ED utilization across different insurance groups, and ED crowding (using measures such as ambulance diversion and length of stay) and its association with poorer patient outcomes.

Dr. Hsia is also part of the UCSF Center for Healthcare Value, in the section on Price Transparency, with research focusing on the wide variation of prices and lack of price transparency for healthcare in the United States. 

Her research extends globally, specifically regarding cost-effectiveness of emergency care in developing countries.  She is currently involved in the Disease Control Priorities project with a focus on pre-hospital care.  Dr. Hsia has had clinical and public health experience in numerous countries in Africa, including Rwanda, Uganda, Eritrea, Sudan, South Africa, Senegal, and South Sudan.  She is fluent in Mandarin, Cantonese, French, and Spanish, and is a member of the UCSF Global Health Economics Consortium and the Global Health Steering Committee for the UCSF Department of Emergency Medicine.

Dr. Hsia’s work has been published in high-impact journals, including JAMA, Health Affairs, Medical Care, Health Services Research, Archives of Internal Medicine, Annals of Emergency Medicine, and the American Journal of Public Health.   Her research has been featured nationally in print media (New York Times, Washington Post, USA Today, etc), radio, and network television.  Her work has been funded by the National Institute of Health, Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, American Heart Association, and Emergency Medicine Foundation. 

Publications: 

1.     Hsia RY, Chan J, Baker LC. Do Mandates Requiring Insurers To Pay For Emergency Care Influence The Use Of The Emergency Department? Health Affairs 2006;25(4): 1086-1094. PMID: 16835190.

2.     Hsia RY, MacIsaac D, Baker LC. Decreasing Reimbursements for Outpatient ED Visits Across Payer Groups from 1996-2004. Annals of Emergency Medicine 2008; 51 (3): 265-274. PMID: 17997503.

3.     Hsia RY, MacIsaac D, Palm E, Baker LC. Trends in charges and payments for non-hospitalized emergency department pediatric visits, 1996-2003. Academic Emergency Medicine 2008; 15(4): 347-54. PMID: 18370988.

4.     Ozgediz D, Hsia RY, Weiser T, Gosselin R, Spiegel D, Bickler S, Dunbar P, McQueen K. Population Health Metrics for Surgery: Effective Coverage of Surgical Services in Low-Income and Middle-Income Countries. World Journal of Surgery 2009 Jan;33(1):1-5. PMID: 18958518.

5.     Shen YC, Hsia RY, Kuzma K. Understanding the Risk Factors of Trauma Center Closures: Do Financial Pressure and Community Characteristics Matter? Medical Care 2009; 47 (9): 968-978. PMID: 19704354.

6.     Jayaraman S, Mabweijano JR, Lipnick M, Caldwell N, Miyamoto J, Wangoda R, Mijumbi C, Hsia R, Dicker R, Ozgediz D. Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay-First-Responder Training Program. World Journal of Surgery 2009; 33:2512–2521.;PMID: 19669228.

7.     Jayaraman S, Mabweijano JR, Lipnick M, Caldwell N, Miyamoto J, Wangoda R, Mijumbi C, Hsia R, Dicker R, Ozgediz D. First things first: effectiveness and scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One 2009; 4(9): e6955, 1-7. PMID: 19759831. PMCID: PMC2736400.

8.     Luboga S, Macfarlane SB, von Schreeb J, Kruk ME, Cherian MN, Bergström S, Bossyns P, Denerville E, Dovlo D, Galukande M, Hsia RY, Jayaraman SP, Lubbock LA, Mock C, Ozgediz D, Sekimpi P, Wladis A, Zakariah A, Dade NB, Donkor P, Gatumbu JK, Hoekman P, IJsselmuiden CB, Jamison DT, Jessani N, Jiskoot P, Kakande I, Mabweijano J, Mbembati N, McCord C, Mijumbi C, de Miranda H, Mkony CA, Mocumbi P, Ndihokubwayo JB, Ngueumachi P, Ogbaselassie G, Okitombahe EL, Toure CT, Vaz F, Zikusooka CM, and Debas HT. Increasing Access to Surgical Services in Sub-Saharan Africa: Priorities for National and International Agencies Recommended by the Bellagio Essential Surgery Group.PLoS Medicine 2009; 6 (12): e1000200, 1-5. PMID: 20027218. PMCID: PMC2791210.

9.     Hsia RY, Wang NE, Torres H, Saynina O, Wise P. Disparities in trauma center access despite increasing utilization: Data from California, 1999-2006. Journal of Trauma, Injury, Infection and Critical Care2010; 68(1):217-24. PMID: 19901854. PMCID: PMC2805766.

10.     Riviello R, Ozgediz D, Hsia RY, Azzie G, Newton M, Tarpley J. The Role of Collaborative Academic Partnerships in Surgical Training, Education and Provision. World Journal of Surgery 2010; 34(3):459-65.PMID: 20049438. PMCID: PMC2816823.

11.     Hsia RY, Razzak J, Tsai AC, Hirshon JM. Placing Emergency Care on the Global Health Research Agenda. Annals of Emergency Medicine 2010; 56(2): 142-149. PMID: 20138398.

12.     Shen YC, Hsia, RY. Changes in Emergency Department Access Between 2001 and 2005: Are Vulnerable Populations More at Risk for Declines in Access? American Journal of Public Health 2010; 100(8): 1462-1469.

13.     Ravikumar D, Hsia RY. Do lower socioeconomic areas have less access to emergency department care? Academic Emergency Medicine 2010 17 (5): 508-513.

14.     Kruk ME, Wladis A, Mbembati N, Ndao-Brumblay SK, Hsia RY, Galunkande M, Luboga S, Matovu A, de Miranda H, Ozgediz D, Quiñones AR, Rockers PR, von Schreeb J, Vaz F, Debas HR, Macfarlane SM. Human resource and funding constraints for essential surgery in district hospitals in Africa. PLoS Med. 2010 Mar 9;7(3):e1000242. PMID: 20231869 PMCID: PMC2834706.

15.     Bickler S, Ozgediz D, Gosselin R, Weiser T, Spiegel D, Hsia R, Dunbar P, McQueen K, Jamison D. Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care.World J Surg. 2010 Mar;34(3):374-80.PMID: 19862570. PMCID: PMC2816802.

16.     Hsia RY, Ozgediz D, Mutto M, Jayaraman S, Kyamanywa P, Kobusingye O. Epidemiology of Injuries Presenting to the National Hospital in Kampala, Uganda: Implications for Research and Policy. International Journal of Emergency Medicine 2010; 3: 176-172.

17.     McQueen K, Ozgediz D, Riviello R, Hsia RY, Jayaraman S, Sullivan S, Meara J. Surgery: An integral part of the human right to the highest attainable standard of health. Health and Human Rights 2010; 12(1): 137-152.

18.     Tang N, Stein J, Hsia RY, Maselli JH, Gonzales R. Trends and Characteristics of U.S. Emergency Department Visits, 1997-2007, JAMA 2010; 304(6): 664-670.

19.     Pilgrim R, Hilton J, Carrier E, Pines JM, Hufstetler G, Thorby S, Milling TJ, Cesta B, Hsia RY. Research Priorities for Administrative Challenges of Integrated Networks of Care, Academic Emergency Medicine 2010; 17(12): 1330-1336.

20.     Jayaraman S, Ozgediz D, Miyamoto J, Caldwell N, Lipnick M, Mijumbi C, Mabweijano JR, Hsia R, Dicker R. Disparities in Injury Mortality between Uganda and the United States: Comparative Analysis of a Neglected Disease, World Journal of Surgery 2011; 35:505–511.

21.     Hsia RY, Shen YC. Possible Geographical Barriers to Trauma Center Access for Underserved Patients in the United States? Archives of Surgery 2011; 146 (1): 1-7.

22.     Hsia RY, Wang NE, Saynina O, Wise P, Perez-Stable E, Auerbach A. Factors associated with Trauma Center Utilization for Elderly Patients with Trauma: A Statewide Analysis, 1999-2008, Archives of Surgery 2011; 146(5), 585-92.

23.     Hsia RY, Asch SM, Weiss RE, Zingmond D, Liang LJ, Han W, McCreath H, Sun BC. Hospital Determinants of Emergency Department Left Without Being Seen Rates, Annals of Emergency Medicine 2011; 58 (1): 24-32.

24.     Shen YC, Hsia RY. Does Decreased Access to Emergency Departments Affect Patient Outcomes? Analysis of AMI Population 1996-2005. National Bureau of Economic Research Working Paper, #16690, 2011.

25.     Hsia RY, Ozgediz D, Jayaraman S, Mutto M, Jayaraman S, Kyamanywa P, Kobusingye O. Epidemiology of Child injuries in Uganda : Challenges for health policy. Journal of Public Health in Africa 2011; 2(1): e15. doi:10.4081/jphia.2011.e15.

26.     Hsia RY, Mbembati NA, Macfarlane S, Kruk ME. "Access to Emergency and Surgical Care in sub-Saharan Africa: The Infrastructure Gap. Health Policy and Planning, 2011 Mar; 27(3): 234-44. 11-1.doi: 10.1093/heapol/czr023.

27.     Hsia RY, Kellermann A, Shen YC. Factors Associated With Closure of Emergency Departments in the United States. JAMA  2011; 305 (19): 1978-1985.

28.     Shen YC, Hsia RY. Association Between Ambulance Diversion and Survival Among Patients With Acute Myocardial Infarction. JAMA 2011; 305 (23): 2440-2447.

29.     Hsia RY, Shen YC.  Rising Closures of Trauma Centers Disproportionately Burdens Vulnerable Populations. Health Affairs 2011; 30(10): 1912-1920.

30.     Hsia RY, Srebotnjak T, Kanzaria HK, McCulloch C, Auerbach AD. System-Level Health Disparities in California Emergency Departments: Are Minorities and Poorly Insured Patients At Higher Risk of Losing Their EDs? Annals of Emergency Medicine 2012; 59: 358-365. PMID: 22093435.

31.     Shen YC, Hsia RY. Does Decreased Access to Emergency Departments Affect Patient Outcomes? Analysis of AMI Population 1996-2005. Health Services Research 2012; 47(1):188-210.

32.     Fee C, Burstin H, Maselli JH, Hsia RY. Association of emergency department length of stay with safety net status. JAMA 2012; 307(5): 476-82.

33.     Hsia RY, Kothari AH, Srebotnjak T, Maselli J. Health Care as a “Market Good”? Appendicitis as a Case Study. Archives of Internal Medicine, 2012; 172 (10) 818-9.

34.     Hsia RY, Asch SM, Weiss RE, Zingmond D, Liang LJ, Han W, McCreath H, Sun BC. California Hospitals Serving Large Minority Populations Were More Likely Than Others to Employ Ambulance Diversion, Health Affairs 2012; 31(8): 1767-1776.

35.     Hsia RY, Kanzaria HK, Srebotnjak T, Maselli J, McCulloch C, Auerbach AD. Is Increased Distance to the Nearest Emergency Department Associated with Increased Inpatient Mortality? Ann Emerg Med 2012; 60(6): 707-715.

36.     Sun BC, Hsia RY, Weiss RE, Zingmond D, Liang LJ, Han W, McCreath H, Asch SM. Effect of Emergency Department Crowding on Outcomes of Admitted Patients. Ann Emerg Med 2013; 61(6):605-611.e6

37.     Caldwell N, Srebotnjak T, Wang T, Hsia RY. “How Much Will I Get Charged for This?” Patient Charges for Top Ten Diagnoses in the Emergency Department. PLOS ONE 2013; 8(2): e55491. doi:10.1371/journal.pone.0055491.

38.     Raven MC, Lowe RA, Maselli J, Hsia RY. “Comparison of Presenting Complaint vs Discharge Diagnosis for Identifying Nonemergency Emergency Department Visits.” JAMA 2013; 309 (11)1145-1153.

39.     Xu M, Wong TC, Wong SY, Chin KS, Tsui KL, Hsia RY. Delays in Service for Non-Emergent Patients Due to Arrival of Emergent Patients in the Emergency Department: A Case Study in Hong Kong. J Emerg Med. 2013 Jun 4. [Epub ahead of print] PMID: 23759699

40.    Charles Liu, Tanja Srebotnjak and Renee Y. Hsia, "California Emergency Department Closures Are Associated With Increased Inpatient Mortality At Nearby Hospitals." Health Affairs, August 2014 vol. 33 no. 8 1323-1329 doi:10.1377/hlthaff.2013.1203

 

Selected Projects: 

Effect of Emergency Care Availability on Racial Disparities in Access & Outcomes

Does ED access block contribute to the widening of disparities in outcomes for cardiovascular disease?

The Far-Researching Effects of Emergency Department Closure: Is ED Closure Associated with Increased Mortality Rates for Patients in Surrounding Communities?