2974	Assessment
Research Question	The stated question, "What is the effect of healthcare coverage on health care treatment outcomes of emergency care patients in the United States?", is clear, however its intent is not.  Healthcare coverage and treatment outcomes are both vague.  Between Medicare, Medicaid, and highly varied insurance plans, healthcare coverage is a very broad category.  The meaning of "treatment outcomes" depends considerably on the range of issues being treated, and we expect rather high variation within any medical issue category.
Relevant Literature	The literatures on health care treatments, outcomes, and insurance are large, and the stated starting points are not enough to get you going.
Causal Interpretations	The relevant causal conditions seem significantly broader and more complex than those mentioned.  The form of health care coverage may affect the type and severity of conditions that bring people to emergency care facilities, but this would be difficult to know from the data, as some of the circumstances influencing health care coverage might also influence use of medical facilities independently of coverage (e.g., age, class, education, population density).  This also suggests why one cannot reasonably do a descriptive study of these issues without a causal theory.
Data	From a quick look at the unfamiliar data, it is not clear that they are adequate for the study as described.  The NIS seems to have the individual data that is the goal, but not hospital identifiers to connect these to the facilities.  The data on emergency rooms seems to have the opposite character.  The NIS data do seem appropriate for the general area of research, it just is not clear that they can support the project as intended.
Research Value	It seems unlikely that this data can allow any strong inferences about the relative quality of care received by those without health care coverage compared to those that have it.  Aside from all the issues concerning variations in the presenting conditions of the two groups, it would seem just as likely that the characterizations of patients' illnesses and outcomes would be influenced by their health care coverage as their treatment.
Timetable	The schedule is vague, and probably unrealistic.
Priorities for Developing a Full Draft	Need clarification of the research goals and the applicability of the proposed data.
Miscellaneous Notes