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https://www.readbyqxmd.com/read/28634102/depression-and-asthma-outcomes-in-older-adults-results-from-the-national-health-and-nutrition-examination-survey
#1
Pooja O Patel, Minal R Patel, Alan P Baptist
BACKGROUND: Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults. OBJECTIVE: The objective of this study was to determine the association of depression with asthma outcomes in older adults (age ≥ 55) from the National Health and Nutrition Examination Survey (NHANES)...
June 17, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#2
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28626503/does-a-free-office-visit-affect-primary-care-seeking-behavior-a-study-of-new-exchange-health-plan-enrollees-in-mississippi
#3
Bettina M Beech, Tristan Cordier, Laura E Happe, Laura Trunk, Gilbert S Haugh, Richard Kwong, Vipin Gopal, Roy A Beveridge
BACKGROUND: Given the positive association between primary care and overall health, several health plans are offering doctors' visits without patient copay, with the intent to increase primary care use. However, the effectiveness of these offers has not been established in the literature. OBJECTIVE: To evaluate the impact of a free primary care provider (PCP) office visit offered by a health plan on primary care-seeking behaviors. METHODS: This nonrandomized concurrent control study used event/trials logistic regression to compare the differences in primary care utilization between new exchange enrollees in Mississippi who were offered a free nonpreventive PCP visit and concurrent controls from Georgia and Tennessee who were not offered a free visit, between January 1, 2014, and December 31, 2014, which was the first year of the exchange plans...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28624168/antibiotic-prescription-fills-for-acute-conjunctivitis-among-enrollees-in-a-large-united-states-managed-care-network
#4
Nakul S Shekhawat, Roni M Shtein, Taylor S Blachley, Joshua D Stein
PURPOSE: Antibiotics are seldom necessary to treat acute conjunctivitis. We assessed how frequently patients with newly diagnosed acute conjunctivitis fill prescriptions for topical antibiotics and factors associated with antibiotic prescription fills. DESIGN: Retrospective, observational cohort study. PARTICIPANTS: A total of 340 372 enrollees in a large nationwide United States managed care network with newly diagnosed acute conjunctivitis, from 2001 through 2014...
June 14, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28614102/intracranial-complications-of-pediatric-sinusitis
#5
Alexandria J Wiersma, Tien Vu
"Headache and fever" is a common presentation to the urgent care and emergency department setting and can have many etiologies. We present a case of a 10-year-old girl who presented with headache and fever and was found to have intracranial extension of sinusitis despite lack of typical sinus or chronic upper respiratory tract infection symptoms. This case illustrates the need in the emergency department or urgent care to keep a broad differential diagnosis for pediatric headache, especially when initial interventions are unsuccessful...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28611290/a-fragment-of-the-alarmin-prothymosin-%C3%AE-as-a-novel-biomarker-in-murine-models-of-bacteria-induced-sepsis
#6
Pinelopi Samara, Vivi Miriagou, Michael Zachariadis, Olga Mavrofrydi, Vasilis J Promponas, Skarlatos G Dedos, Panagiota Papazafiri, Hubert Kalbacher, Wolfgang Voelter, Ourania Tsitsilonis
Sepsis is a life-threatening condition that requires urgent care. Thus, the identification of specific and sensitive biomarkers for its early diagnosis and management are of clinical importance. The alarmin prothymosin alpha (proTα) and its decapeptide proTα(100-109) are immunostimulatory peptides related to cell death. In this study, we generated bacterial models of sepsis in mice using two Klebsiella pneumoniae strains (L-78 and ATCC 43816) and monitored sepsis progression using proTα(100-109) as a biomarker...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28576895/has-the-nhs-111-urgent-care-telephone-service-been-a-success-case-study-and-secondary-data-analysis-in-england
#7
Catherine Pope, Joanne Turnbull, Jeremy Jones, Jane Prichard, Ali Rowsell, Susan Halford
OBJECTIVES: To explore the success of the introduction of the National Health Service (NHS) 111 urgent care service and describe service activity in the period 2014-2016. DESIGN: Comparative mixed method case study of five NHS 111 service providers and analysis of national level routine data on activity and service use. SETTINGS AND DATA: Our primary research involved five NHS 111 sites in England. We conducted 356 hours of non-participant observation in NHS 111 call centres and the urgent care centres and, linked to these observations, held 6 focus group interviews with 47 call advisors, clinical and managerial staff...
June 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28576575/urgent-care-medicine-and-the-role-of-the-app-within-this-specialty
#8
EDITORIAL
Jerrold B Leikin
No abstract text is available yet for this article.
May 30, 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28569193/health-care-utilization-in-patients-with-gout-a-prospective-multicenter-cohort-study
#9
Jasvinder A Singh, Aseem Bharat, Dinesh Khanna, Cleopatra Aquino-Beaton, Jay E Persselin, Erin Duffy, David Elashoff, Puja P Khanna
BACKGROUND: All published studies of health care utilization in gout have been cross-sectional to date, and most used a patient-reported diagnosis of gout. Our objective was to assess health care utilization and its predictors in patients with physician-confirmed gout in a prospective cohort study. METHODS: In a multi-center prospective cohort study of U.S. veterans with rheumatologist-confirmed gout (N = 186; two centers), we assessed patient self-reported overall and gout-specific health care utilization with the Gout Assessment Questionnaire (GAQ) every 3-months for a 9-month period...
May 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28557873/utilization-of-the-health-care-system-of-community-case-management-patients
#10
Sarah Armold
PURPOSE OF STUDY: The has reduced payments to hospitals that have excessive readmissions. This mandate has made it imperative for hospitals to implement a plan to manage readmissions and transitions of care for patients they serve. The purpose of this study was to ascertain whether an advanced practice, nurse-led, community-based model is effective in reducing acute health care utilization. PRIMARY PRACTICE SETTING: The community case management (CCM) program was created more than 20 years ago to assess and manage care of patients demanding frequent emergency department (ED) visits and frequent hospitalizations, by providing in-home visits and care coordination by an advanced practice nurse or masters-prepared nurse...
July 2017: Professional Case Management
https://www.readbyqxmd.com/read/28557775/nonemergency-acute-care-when-it-s-not-the-medical-home
#11
Gregory P Conners, Susan J Kressly, James M Perrin, Julia E Richerson, Usha M Sankrithi
The American Academy of Pediatrics (AAP) affirms that the optimal location for children to receive care for acute, nonemergency health concerns is the medical home. The medical home is characterized by the AAP as a care model that "must be accessible, family centered, continuous, comprehensive, coordinated, compassionate, and culturally effective." However, some children and families use acute care services outside the medical home because there is a perceived or real benefit related to accessibility, convenience, or cost of care...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28540592/-assistance-nursing-and-participation-in-old-age-future-of-domestic-care-in-cases-of-care-dependency
#12
REVIEW
Josefine Heusinger, Kerstin Hämel, Susanne Kümpers
The future development of home care services for older people in need of care is associated with great challenges. This article begins with a brief summary of the most urgent care problems from the perspective of people requiring care and that of caring relatives. The problems exhibit social and spatial inequalities and are characterized by coordination problems within a fragmented organizational system. Calls for a viable "care mix" are nothing new but have recently gained considerable traction under the label of "caring communities"...
May 24, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28509783/the-evaluation-of-adolescent-chest-pain-a-screening-ecg-or-psc-17
#13
Patricia E Acra, María T Pérez
PURPOSE OF REVIEW: The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain. RECENT FINDINGS: The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28498199/incorporating-alternative-care-site-characteristics-into-estimates-of-substitutable-ed-visits
#14
Nathan Seth Trueger, Kao-Ping Chua, Aamir Hussain, Aisha T Liferidge, Stephen R Pitts, Jesse M Pines
BACKGROUND: Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28493626/why-do-people-choose-emergency-and-urgent-care-services-a-rapid-review-utilizing-a-systematic-literature-search-and-narrative-synthesis
#15
Joanne E Coster, Janette K Turner, Daniel Bradbury, Anna Cantrell
OBJECTIVES: Rising demand for emergency and urgent care services are well documented, as are the consequences, for example, ED crowding, increased costs, pressure on services and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions and behavioural changes relating to how people choose to access health services. The aim of this systematic mapping review is to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487288/primary-care-services-co-located-with-emergency-departments-across-a-uk-region-early-views-on-their-development
#16
Suzanne Ablard, Colin O'Keeffe, Shammi Ramlakhan, Suzanne M Mason
BACKGROUND: Co-location of primary care services with Emergency Departments (ED) is one initiative aiming to reduce the burden on EDs of patients attending with non-urgent problems. However, the extent to which these services are operating within or alongside EDs is not currently known.This study aimed to create a typology of co-located primary care services in operation across Yorkshire and Humber (Y&H) as well as identify early barriers and facilitators to their implementation and sustainability...
May 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#17
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28473509/why-do-patients-seek-primary-medical-care-in-emergency-departments-an-ethnographic-exploration-of-access-to-general-practice
#18
Fiona MacKichan, Emer Brangan, Lesley Wye, Kath Checkland, Daniel Lasserson, Alyson Huntley, Richard Morris, Peter Tammes, Chris Salisbury, Sarah Purdy
OBJECTIVES: To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). DESIGN: Ethnographic case study combining non-participant observation, informal and formal interviewing. SETTING: Six general practitioner (GP) practices located in three commissioning organisations in England. PARTICIPANTS AND METHODS: Reception areas at each practice were observed over the course of a working week (73 hours in total)...
May 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28464887/healthy-families-study-protocol-for-a-randomized-controlled-trial-of-a-screening-brief-intervention-and-referral-to-treatment-intervention-for-caregivers-to-reduce-secondhand-smoke-exposure-among-pediatric-emergency-patients
#19
E Melinda Mahabee-Gittens, Robert T Ammerman, Jane C Khoury, Lara Stone, Gabe T Meyers, John K Witry, Ashley L Merianos, Tierney F Mancuso, Kristin M W Stackpole, Berkeley L Bennett, Laura Akers, Judith S Gordon
BACKGROUND: Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers...
May 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28464172/initial-experience-of-a-primary-urgent-care-clinic-curriculum-and-subspecialty-lectureship-series-implementation-in-a-los-angeles-county-hospital
#20
Harsh Agrawal, Anna Martinez, Elizabeth R Volkmann, Oleg Melamed, Soma Wali
OBJECTIVES: Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning...
May 2017: Southern Medical Journal
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