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DIABETES ED visits

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https://www.readbyqxmd.com/read/28821420/hyperglycemia-in-young-adults-seen-in-the-emergency-department-a-health-records-review
#1
Justin W Yan, Alexandra L Hamelin, Katherine M Gushulak, Kristine Van Aarsen, Melanie P Columbus, Ian G Stiell
Patients with diabetes who are in emerging adulthood, defined as the life stage between 18 and 29 years of age, have unique challenges in managing their illness and are at risk for acute complications and loss to follow up. This study's objective was to describe emergency department (ED) utilization because of hyperglycemia in emerging adults with diabetes and to characterize 30-day outcomes, including return visits and admission for hyperglycemia. This was a health-records review of emerging adults presenting over a 1-year period to 4 tertiary care EDs; the patients had known histories of diabetes and final diagnoses of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemia...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28760098/mind-the-gap-developing-an-integrated-behavioral-health-home-to-address-health-disparities-in-serious-mental-illness
#2
Miriam C Tepper, Alexander M Cohen, Ana M Progovac, Andrea Ault-Brutus, H Stephen Leff, Brian Mullin, Carrie M Cunningham, Benjamin Lê Cook
OBJECTIVE: This study evaluated the impact of an integrated behavioral health home (BHH) pilot on adults with psychotic and bipolar disorders. METHODS: Quasi-experimental methods were used to compare outcomes before (September 2014-August 2015) and after the intervention (September 2015-August 2016) among ambulatory BHH patients and a control group. Electronic health records were compared between 424 BHH patients (N=369, psychotic disorder; N=55, bipolar disorder) and 1,521 individuals from the same urban, safety-net health system who were not enrolled in the BHH...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28759685/association-between-extending-carefirst-s-medical-home-program-to-medicare-patients-and-quality-of-care-utilization-and-spending
#3
G Greg Peterson, Kristin Lowe Geonnotti, Lauren Hula, Timothy Day, Laura Blue, Keith Kranker, Boyd Gilman, Kate Stewart, Sheila Hoag, Lorenzo Moreno
Importance: CareFirst, the largest commercial insurer in the mid-Atlantic Region of the United States, runs a medical home program focusing on financial incentives for primary care practices and care coordination for high-risk patients. From 2013 to 2015, CareFirst extended the program to Medicare fee-for-service (FFS) beneficiaries in participating practices. If the model extension improved quality while reducing spending, the Centers for Medicare and Medicaid Services could expand the program to Medicare beneficiaries broadly...
July 31, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28738911/sentinel-visits-in-emergency-department-patients-with-diabetes-mellitus-as-a-warning-sign-for-hyperglycemic-emergencies
#4
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Alexandra L Hamelin, George A Wells, Ian G Stiell
OBJECTIVES: Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study's objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit. METHODS: This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS...
July 25, 2017: CJEM
https://www.readbyqxmd.com/read/28715984/cost-of-an-integrated-care-program-to-reduce-ed-visits-during-diabetic-prisoner-court-hearings
#5
Tim Pauley, Joy Matienzo, Joseph Ventura, Josie Barbita
Diabetic events occurring during court hearings previously required emergency medical services (EMS) transport to the emergency department (ED). A new process was implemented whereby the provincial court (PC) was notified by the detention center of diabetes status of prisoners scheduled for court later that day, enabling a community nursing services provider to provide on-site diabetes assessment and treatment at the PC. During the 13-month pre-implementation phase, there were 10 incidents of diabetic distress resulting in an ED visit at a total cost of $797...
July 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28704270/impact-of-ramadan-on-emergency-department-visits-and-on-medical-emergencies
#6
Reem G Al Assaad, Rana Bachir, Mazen J El Sayed
BACKGROUND: Fasting during Ramadan is important to Muslims. This study describes changes in emergency department (ED) visits and in frequencies of emergency conditions and impact on clinical outcomes during Ramadan in a tertiary care center in Beirut, Lebanon. PATIENTS AND METHODS: Patients presenting to ED during Ramadan 1 month before and 1 month after Ramadan over a 3-year period with specific conditions (acute coronary syndrome, stroke, seizure, diabetes, renal colic, headache or hypertension) were included...
July 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28702883/risk-factors-for-recurrent-emergency-department-visits-for-hyperglycemia-in-patients-with-diabetes-mellitus
#7
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Kristine van Aarsen, Alexandra L Hamelin, George A Wells, Ian G Stiell
BACKGROUND: Patients with poorly controlled diabetes mellitus may present repeatedly to the emergency department (ED) for management and treatment of hyperglycemic episodes, including diabetic ketoacidosis and hyperosmolar hyperglycemic state. The objective of this study was to identify risk factors that predict unplanned recurrent ED visits for hyperglycemia in patients with diabetes within 30 days of initial presentation. METHODS: We conducted a 1-year health records review of patients ≥18 years presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemic state...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28702257/the-relationship-between-diabetes-mellitus-and-30-day-readmission-rates
#8
Stephanie Ostling, Jennifer Wyckoff, Scott L Ciarkowski, Chih-Wen Pai, Hae Mi Choe, Vinita Bahl, Roma Gianchandani
BACKGROUND: It is estimated that 9.3% of the population in the United States have diabetes mellitus (DM), 28% of which are undiagnosed. The high prevalence of DM makes it a common comorbid condition in hospitalized patients. In recent years, government agencies and healthcare systems have increasingly focused on 30-day readmission rates to determine the complexity of their patient populations and to improve quality. Thirty-day readmission rates for hospitalized patients with DM are reported to be between 14...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/28701374/hospital-admission-rates-and-emergency-department-use-in-relation-to-glycated-hemoglobin-in-people-with-diabetes-mellitus-a-linkage-study-using-electronic-medical-record-and-administrative-data-in-ontario
#9
Richard Birtwhistle, Michael E Green, Eliot Frymire, Simone Dahrouge, Marlo Whitehead, Shahriar Khan, Michelle Greiver, Richard H Glazier
BACKGROUND: The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) collects extensive data on primary care patients but it currently does not gather reliable information on outcomes in other settings. The objectives of this study were to link electronic medical record (EMR) data from Ontario patients in the CPCSSN with administrative data from the Institute for Clinical Evaluative Sciences (ICES), to assess the representativeness of the CPCSSN population, and to identify people with diabetes in the CPCSSN data and describe their emergency department (ED) visits and hospital admissions over a 2-year period (2010-2012) by HbA1c level...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28686322/characteristics-of-frequent-emergency-department-users-with-type-2-diabetes-mellitus-in-korea
#10
Morena Ustulin, Junghoon Woo, Jeong-Taek Woo, Sang Youl Rhee
AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable subjects. We identified the characteristics of "frequent ED users" among Korean patients with type 2 diabetes mellitus (DM). MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service National Patient Sample HIRA-(NPS), which is a nationally representative sample. Subjects (n = 109,412) with type 2 DM as a primary or secondary diagnosis at one of their visits were included...
July 7, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28638568/dizziness-in-a-community-hospital-central-neurological-causes-clinical-predictors-and-diagnostic-yield-and-cost-of-neuroimaging-studies
#11
Hussam Ammar, Rukma Govindu, Ragai Fouda, Wael Zohdy, Emilio Supsupin
Objectives: Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. Methods: We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint. Clinical findings were analyzed using Fisher's exact test to determine how they correlated with central neurological causes of dizziness identified by neuroimaging...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28622820/diabetes-quality-of-care-and-outcomes-comparison-of-individuals-with-and-without-schizophrenia
#12
Paul Kurdyak, Simone Vigod, Raquel Duchen, Binu Jacob, Thérèse Stukel, Tara Kiran
OBJECTIVE: Individuals with schizophrenia are more likely to develop diabetes than individuals without schizophrenia. The objective of this study was to determine the quality of diabetes care and diabetes-related health outcomes among individuals with and without schizophrenia. METHOD: We conducted a retrospective cohort study. As of April 1, 2011, we identified all individuals with diabetes in Ontario with and without a diagnosis of schizophrenia. The main outcomes were quality of diabetes care (guideline-concordant testing for HbA1c, lipid testing, eye exams) and diabetes-related Emergency Department (ED) visits and hospitalizations between April 1, 2011 and March 31, 2013...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28600671/health-care-utilization-among-adenosine-sensitive-supraventricular-tachycardia-patients-presenting-to-the-emergency-department
#13
Thomas A Dewland, Adam Oesterle, John Stein, Gregory M Marcus
PURPOSE: Although adenosine-sensitive supraventricular tachycardia (SVT) is generally curable, it remains an important cause of healthcare utilization. We sought to determine predictors of health care utilization among SVT patients presenting to the emergency department (ED). METHODS: We studied consecutive patients evaluated in an urban, academic ED for adenosine-sensitive SVT. The primary study outcomes were (1) ambulance transportation to the index ED visit, (2) hospital admission from the index ED encounter, and (3) recurrent SVT-associated ED encounters...
August 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28574193/emergency-department-visits-for-dental-problems-not-associated-with-trauma-in-alberta-canada
#14
Rafael Figueiredo, Kerri Fournier, Liran Levin
OBJECTIVES: The objective of this report was to describe the frequency of emergency department (ED) visits for dental problems not associated with trauma (DPNAT) in Alberta, Canada, over a 5-year period. METHODS: In Alberta, ED visits for DPNAT between 1 January 2011 and 30 April 2016 were identified using the codes from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA). The codes for DPNAT range from K00 to K14, described as diseases of the oral cavity, salivary glands and jaws...
June 2, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28495903/health-care-service-and-outcomes-among-an-estimated-6-7-million-ambulatory-care-diabetic-foot-cases-in-the-u-s
#15
Grant H Skrepnek, Joseph L Mills, Lawrence A Lavery, David G Armstrong
OBJECTIVE: To evaluate ambulatory clinical cases of diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) in the U.S. from 2007 to 2013 and to assess outcomes of emergency department or inpatient (ED/IP) admission, number of clinic visits per year, and physician time spent per visit. RESEARCH DESIGN AND METHODS: A cross-sectional historical cohort analysis was conducted by using the nationally representative Centers for Disease Control and Prevention National Ambulatory Medical Care Survey data from 2007 to 2013, including patients age ≥18 years with diabetes and either DFIs or DFUs...
July 2017: Diabetes Care
https://www.readbyqxmd.com/read/28493551/utilization-of-a-sobering-center-for-acute-alcohol-intoxication
#16
Shannon Smith-Bernardin, Adam Carrico, Wendy Max, Susan Chapman
OBJECTIVE: The objective was to describe the population utilizing a sobering center for public alcohol intoxication and compare between single-visit users, repeat users, and high users. METHODS: We conducted a secondary analysis of 1,271 adults cared for in a sobering center from July 2014 to June 2015. We divided the population into three groups-single use (one visit), repeat users (two to five visits), and high (six or more) users-and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28464432/septic-arthritis-in-the-emergency-departments-in-the-u-s-a-national-study-of-healthcare-utilization-and-time-trends
#17
Jasvinder A Singh, Shaohua Yu
OBJECTIVE: To assess health care utilization and emergency department (ED) charges for septic arthritis. METHODS: We performed a retrospective cohort study of ED visits with septic arthritis as the primary diagnosis using the U.S. Nationwide Emergency Department Sample (NEDS) data from 2009-12. We examined ED charges, hospitalization and associated time-trends. Multivariable models adjusted for demographics (age, sex, insurance status, residence, household income), comorbidity and hospital characteristics to assess factors associated with ED charges and hospitalization...
May 2, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28455163/sex-differences-in-outcomes-after-discharge-from-the-emergency-department-for-atrial-fibrillation-flutter
#18
MULTICENTER STUDY
Rhonda J Rosychuk, Brian R Holroyd, Xuechen Zhang, Brian H Rowe, Michelle M Graham
BACKGROUND: Atrial fibrillation and flutter (AFF) are the most common arrhythmias presenting to emergency departments (EDs). We examined sex differences in outcomes for patients with AFF discharged from the ED in Alberta, Canada. METHODS: ED presentations for AFF during 1999-2011 that ended in discharge were extracted from administrative databases for all Alberta residents (age ≥ 35 years). Multivariable models determined the effect of sex on the time to ED return for AFF, the first follow-up visit with a physician, the first follow-up visit with a specialist (cardiologist or internal medicine physician), and death...
June 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28409741/impact-of-comorbidities-among-medicaid-enrollees-with-chronic-obstructive-pulmonary-disease-united-states-2009
#19
Gloria Westney, Marilyn G Foreman, Junjun Xu, Marshaleen Henriques King, Eric Flenaugh, George Rust
INTRODUCTION: Multimorbidity, the presence of 2 or more chronic conditions, frequently affects people with chronic obstructive pulmonary disease (COPD). Many have high-cost, highly complex conditions that have a substantial impact on state Medicaid programs. We quantified the cost of Medicaid-insured patients with COPD co-diagnosed with other chronic disorders. METHODS: We used nationally representative Medicaid claims data to analyze the impact of comorbidities (other chronic conditions) on the disease burden, emergency department (ED) use, hospitalizations, and total health care costs among 291,978 adult COPD patients...
April 13, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28393538/racial-ethnic-differences-in-healthcare-use-among-patients-with-uncontrolled-and-controlled-diabetes
#20
Yhenneko J Taylor, Melanie D Spencer, Rohan Mahabaleshwarkar, Thomas Ludden
OBJECTIVES: To examine racial/ethnic differences in healthcare use among patients classified as having controlled and uncontrolled diabetes. DESIGN: Data from the Carolinas HealthCare System electronic data warehouse were used. Glycemic control was defined as glycosylated hemoglobin (HbA1c) < 8% (64 mmol/mol) in 2012 (n = 9996). Patients with HbA1c ≥ 8% (64 mmol/mol) in 2012 were classified as uncontrolled (n = 2576). Race and ethnicity were jointly classified as non-Hispanic Black, non-Hispanic White or Other...
April 10, 2017: Ethnicity & Health
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