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Preventable emergency visits

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https://www.readbyqxmd.com/read/28729199/violent-firearm-related-conflicts-among-high-risk-youth-an-event-level-and-daily-calendar-analysis
#1
Patrick M Carter, Maureen A Walton, Jason Goldstick, Quyen M Epstein-Ngo, Marc A Zimmerman, Melissa C Mercado, Amanda Garcia Williams, Rebecca M Cunningham
Firearm homicide is the leading cause of violence-related youth mortality. To inform prevention efforts, we analyzed event-level data to identify unique precursors to firearm conflicts. Youth (ages:14-24) seeking Emergency Department (ED) treatment for assault or for other reasons and reporting past 6-month drug use were enrolled in a 2-year longitudinal study. Time-line follow-back substance use/aggression modules were administered at baseline and each 6-month follow-up. Violent non-partner conflicts were combined across time-points...
July 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28723915/key-findings-from-a-prospective-trauma-registry-at-a-regional-hospital-in-southwest-cameroon
#2
Alain Chichom-Mefire, Obieze C Nwanna-Nzewunwa, Vincent Verla Siysi, Isabelle Feldhaus, Rochelle Dicker, Catherine Juillard
INTRODUCTION: Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED) of Limbe Regional Hospital (LRH) and assess the completeness of data obtained by a trauma registry. METHODS AND FINDINGS: From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument...
2017: PloS One
https://www.readbyqxmd.com/read/28720631/accrued-cost-savings-of-a-free-clinic-using-quality-adjusted-life-years-saved-and-return-on-investment
#3
Jim Sanders, Marcus Lacey, Clare E Guse
INTRODUCTION: Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. METHODS: We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI)...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720619/predictors-of-emergency-department-use-by-adolescents-and-adults-with-autism-spectrum-disorder-a-prospective-cohort-study
#4
Yona Lunsky, Jonathan A Weiss, Melissa Paquette-Smith, Anna Durbin, Ami Tint, Anna M Palucka, Elspeth Bradley
OBJECTIVES: To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD). DESIGN: Prospective cohort study. SETTING: Community-based study from Ontario, Canada. PARTICIPANTS: Parents reported on their adult sons and daughters with ASD living in the community (n=284). MAIN OUTCOME MEASURES: ED visits for any reason, ED visits for medical reasons and ED visits for psychiatric reasons over 1 year...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28719481/opioid-prescribing-practices-in-pediatric-acute-care-settings
#5
Michelle DePhillips, Jennifer Watts, Jennifer Lowry, M Denise Dowd
OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system. METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28715239/parental-self-efficacy-to-support-teens-during-a-suicidal-crisis-and-future-adolescent-emergency-department-visits-and-suicide-attempts
#6
Ewa K Czyz, Adam G Horwitz, Carlos E Yeguez, Cynthia J Ewell Foster, Cheryl A King
This study of adolescents seeking emergency department (ED) services and their parents examined parents' self-efficacy beliefs to engage in suicide prevention activities, whether these beliefs varied based on teens' characteristics, and the extent to which they were associated with adolescents' suicide-related outcomes. Participants included 162 adolescents (57% female, 81.5% Caucasian), ages 13-17, and their parents. At index visit, parents rated their self-efficacy to engage in suicide prevention activities and their expectations regarding their teen's future suicide risk...
July 17, 2017: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/28713805/the-benefits-and-challenges-of-managing-asthma-in-hispanic-families-in-south-texas-a-mixed-methods-study
#7
Genny Carrillo, Maria J Perez-Patron, Rose L Lucio, Lucia Cabrera, Alyssa Trevino, Xiaohui Xu, Nelda Mier
BACKGROUND: Understanding the experience of Hispanic parents of children diagnosed with asthma can be useful in the delivery of effective and meaningful asthma education. In order to assess the needs of Hispanic families with asthmatic children in South Texas, investigators utilized a combination of qualitative and quantitative research methods. OBJECTIVES: This study aimed (1) to assess the impact of asthma in the quality of life of Hispanic children and their families and (2) to identify barriers and challenges to asthma management as perceived by parents of children diagnosed with asthma...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28709634/examining-the-role-of-the-pediatric-emergency-department-in-reducing-unintended-adolescent-pregnancy
#8
Michelle Solomon, Gia M Badolato, Lauren S Chernick, Maria E Trent, James M Chamberlain, Monika K Goyal
OBJECTIVES: To determine pregnancy risk and receptiveness to emergency department (ED)-based pregnancy prevention interventions among adolescents accessing care in the ED. STUDY DESIGN: Cross-sectional electronic survey of adolescent females in a pediatric ED used to calculate the Pregnancy Risk Index, a validated measure estimating the annual risk of becoming pregnant based on recent sexual activity, contraceptive method(s), method-specific contraceptive failure rates, and interest in receipt of ED-based contraceptive services...
July 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28701194/characterization-and-productivity-profiles-of-aedes-aegypti-l-breeding-habitats-across-rural-and-urban-landscapes-in-western-and-coastal-kenya
#9
Harun N Ngugi, Francis M Mutuku, Bryson A Ndenga, Peter S Musunzaji, Joel O Mbakaya, Peter Aswani, Lucy W Irungu, Dunstan Mukoko, John Vulule, Uriel Kitron, Angelle D LaBeaud
BACKGROUND: Aedes aegypti, the principal vector for dengue and other emerging arboviruses, breeds preferentially in various man-made and natural container habitats. In the absence of vaccine, epidemiological surveillance and vector control remain the best practices for preventing dengue outbreaks. Effective vector control depends on a good understanding of larval and adult vector ecology of which little is known in Kenya. In the current study, we sought to characterize breeding habitats and establish container productivity profiles of Ae...
July 12, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28700457/discontinuity-of-medicaid-coverage-impact-on-cost-and-utilization-among-adult-medicaid-beneficiaries-with-major-depression
#10
Xu Ji, Adam S Wilk, Benjamin G Druss, Cathy Lally, Janet R Cummings
BACKGROUND: Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. OBJECTIVE: Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression...
August 2017: Medical Care
https://www.readbyqxmd.com/read/28699849/protein-energy-wasting-significantly-increases-healthcare-utilization-and-costs-among-patients-with-chronic-kidney-disease-a-propensity-score-matched-cohort-study
#11
Chia-Ter Chao, Chao-Hsiun Tang, Rhoda Wen-Yi Cheng, Michael Yao-Hsien Wang, Kuan-Yu Hung
BACKGROUND: Disease-related malnutrition is highly prevalent and has prognostic implications for patients with chronic kidney disease (CKD); however, few studies have investigated the impact of malnutrition, or protein-energy wasting (PEW), on healthcare utilization and medical expenditure among CKD patients. METHODS: Using claim data from the National Health Insurance in Taiwan, we identified patients with CKD between 2009 and 2013 and categorize into those with mild, moderate, or severe CKD...
July 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28697159/outpatient-parenteral-antimicrobial-therapy-and-judicious-use-of-pediatric-emergency-resources
#12
Michael Xu, Quynh Doan
BACKGROUND: Pediatric returns to the emergency department (RTED) vary between 3% and 13% of the total ED volume of visits. However, the incidence and contribution of scheduled RTED on pediatric emergency department (PED) utilization is less clear. Antimicrobial stewardship programs on inpatient wards have been shown to improve judicious use of outpatient parenteral antimicrobial therapy (OPAT) in upon discharge. The implementation of such programs in PEDs has yet to be reported. The objectives of this study are to quantify the burden of scheduled RTED for OPAT on PED utilization and to examine how frequently OPAT use are supported by published practice standards for 3 common pediatric infections-cellulitis, pneumonia, and urinary tract infections...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28697098/implementation-of-a-risk-based-heparin-protocol-for-postpartum-venous-thromboembolism-prevention
#13
Elizabeth Robison, Kent Heyborne, Amanda A Allshouse, Carolyn Valdez, Torri D Metz
OBJECTIVE: To evaluate the effect of a postpartum risk-based low-molecular-weight heparin protocol for venous thromboembolism prevention. METHODS: We conducted a retrospective cohort study of postpartum women at a safety net hospital before (2013), during (2014), and after (2015) implementation of a risk-based enoxaparin thromboembolism prevention protocol. The calculated sample size was based on a primary outcome of enoxaparin administration rate. Secondary outcomes included incidence of postpartum thromboembolism, wound complications, and 30-day readmission rates...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28696804/healthcare-utilization-by-children-with-asthma-displaced-by-hurricane-katrina
#14
Troy Quast
OBJECTIVE: To assess the performance of TexKat, the largest Hurricane Katrina Medicaid Emergency Waiver, in providing care to asthmatic children. METHODS: Medicaid enrollment and encounter data for 2004 and 2006 from Louisiana and Texas were analyzed in a pre-post comparison. Changes in utilization by children in the waiver were compared to changes in utilization by children in Medicaid in three control groups: children in Louisiana counties that were designated as a disaster assistance area but who were not displaced; children in Louisiana counties that were not designated as a disaster assistance area, and children in Texas...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28693638/randomized-controlled-trial-of-emergency-department-initiated-smoking-cessation-counselling-and-referral-to-a-community-counselling-service
#15
Ka Wai Cheung, Ian Wh Wong, Warren Fingrut, Amy Po Yu Tsai, Sally R Ke, Shayan Shojaie, Jeffrey R Brubacher, Lauren C Stewart, Shannon Erdelyi
OBJECTIVE: Worldwide, tobacco smoke is still the leading cause of preventable morbidity and mortality. Many smokers develop chronic smoking-related conditions that require emergency department (ED) visits. However, best practices for ED smoking cessation counselling are still unclear. METHODS: A randomized controlled trial was conducted to determine whether an "ask, advise, and refer" approach increases 12-month, 30-day quit rates in the stable adult ED smoking population compared to usual care...
July 11, 2017: CJEM
https://www.readbyqxmd.com/read/28693328/eliminating-disparities-in-asthma-care-identifying-broad-challenges-in-quality-improvement
#16
Joseph P Anarella, Victoria L Wagner, Susan G McCauley, Jennifer B Mane, Patricia A Waniewski
Racial disparities in asthma care persist in New York State's Medicaid Program. African Americans with asthma experience higher rates of emergency department visits and inpatient hospitalizations, coupled with lower rates of long-term control medication use compared to other racial/ethnic groups. Within this context, and with funding from the Centers for Disease Control and Prevention, the New York State Department of Health designed and implemented the Eliminating Disparities in Asthma Care (EDAC) Collaborative to improve the quality of asthma care delivered in 7 provider sites located in Central Brooklyn, New York...
December 1, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28692402/enhanced-influenza-surveillance-using-telephone-triage-and-electronic-syndromic-surveillance-in-the-department-of-veterans-affairs-2011-2015
#17
Cynthia Lucero-Obusan, Carla A Winston, Patricia L Schirmer, Gina Oda, Mark Holodniy
Telephone triage (TT) is a method whereby medical professionals speak by telephone to patients to assess their symptoms or health concerns and offer advice. These services are often administered through an electronic TT system, which guides TT professionals during the encounter through the use of structured protocols and algorithms to help determine the severity of the patients' health issue and refer them to appropriate care. TT is also an emerging data source for public health surveillance of infectious and noninfectious diseases, including influenza...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28685852/the-relationship-between-rural-health-clinic-use-and-potentially-preventable-hospitalizations-and-emergency-department-visits-among-medicare-beneficiaries
#18
Brad Wright, Andrew J Potter, Amal N Trivedi, Keith J Mueller
PURPOSE: High rates of potentially preventable hospitalizations and emergency department (ED) visits indicate limited primary care access. Rural Health Clinics (RHCs) are intended to increase access to primary care. The goal of this study was to evaluate the role of RHCs and their impact on potentially preventable hospitalizations and ED visits among Medicare beneficiaries based on actual individual-level utilization patterns. METHODS: With Medicare Part A and Part B claims data from 2007 to 2010, we constructed a series of individual-level negative binomial regression models to examine the relationship between RHC use and the number of potentially preventable hospitalizations and ED visits...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28666468/binge-drinking-among-young-adults-in-an-urban-tertiary-care-emergency-department-in-israel
#19
Daphna Levinson, Paola Rosca, Doron Vilner, Idit Brimberg, Yael Stall, Ayelet Rimon
BACKGROUND: Alcohol use is a major preventable public health problem with serious health and social consequences especially among youth. In Israel, alcohol use has become an emerging problem during the last decade, and its use has increased among adolescents and young adults. Binge drinking is the common pattern of alcohol consumption among young adults who drink for recreational purposes. The present survey was conducted among 16-35 years old visitors to the ED. The aim was specifically to identify binge drinkers in order to assess the scope of the need for a brief counseling intervention among young people who arrive intoxicated to a large tertiary care urban ED in Israel...
July 1, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28661886/family-physician-access-to-specialist-advice-by-telephone-reduction-in-unnecessary-specialist-consultations-and-emergency-department-visits
#20
Margot Wilson, Garey Mazowita, Andrew Ignaszewski, Adeera Levin, Clay Barber, David Thompson, Sandra Barr, Scott Lear, Robert D Levy
PROBLEM ADDRESSED: Timely access to specialist care is an important issue for patients with mild to moderate symptoms, and wait times for referrals are currently quite long. OBJECTIVE OF PROGRAM: To provide FPs with quick telephone access to other specialists for treatment advice for patients with nonserious conditions that they would otherwise refer to specialist care. PROGRAM DESCRIPTION: The RACE (Rapid Access to Consultative Expertise) program is a telephone hot-line providing FPs and nurse practitioners in the Vancouver, BC, area with timely access to specialist consultations...
November 2016: Canadian Family Physician Médecin de Famille Canadien
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