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https://www.readbyqxmd.com/read/28169978/analysis-of-patient-visits-and-collections-after-opening-a-satellite-pediatric-emergency-department
#1
Katherine M Nichols, Kerry Caperell, Keith Cross, Scott Duncan, Ben Foster, Gil Liu, Hank Pritchard, Gary Southard, Ben Shinabery, Brad Sutton, In K Kim
OBJECTIVE: Satellite pediatric emergency departments (PEDs) have emerged as a strategy to increase patient capacity. We sought to determine the impact on patient visits, physician fee collections, and value of emergency department (ED) time at the primary PED after opening a nearby satellite PED. We also illustrate the spatial distribution of patient demographics and overlapping catchment areas for the primary and satellite PEDs using geographical information system. METHODS: A structured, financial retrospective review was conducted...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28159379/factors-affecting-visits-to-the-emergency-department-for-urgent-and-nonurgent-ocular-conditions
#2
Brian C Stagg, Muazzum M Shah, Nidhi Talwar, Dolly A Padovani-Claudio, Maria A Woodward, Joshua D Stein
PURPOSE: To determine the frequency of emergency department (ED) visits for nonurgent and urgent ocular conditions and risk factors associated with ED use for nonurgent and urgent ocular problems. DESIGN: Retrospective, longitudinal cohort analysis. PARTICIPANTS: All enrollees aged 21 years or older in a United States managed care network during 2001-2014. METHODS: We identified all enrollees visiting an ED for ocular conditions identified by International Classification of Diseases, billing codes...
January 31, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28150328/use-of-emergency-ultrasound-in-arizona-community-emergency-departments
#3
Richard Amini, Michael T Wyman, Nicholas C Hernandez, John A Guisto, Srikar Adhikari
OBJECTIVES: Despite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona. METHODS: We conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona...
February 2, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28116025/medical-student-documentation-in-the-electronic-medical-record-patterns-of-use-and-barriers
#4
Kathleen Wittels, Joshua Wallenstein, Rahul Patwari, Sundip Patel
INTRODUCTION: Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28029490/factors-influencing-drainage-setting-and-cost-for-cutaneous-abscesses-among-pediatric-patients
#5
Corrie E Chumpitazi, Chris A Rees, Elizabeth A Camp, Karina L Valdez, Benjamin Choi, Bruno P Chumpitazi, Faria Pereira
OBJECTIVE: To evaluate the clinical and microbiological factors associated with skin and soft tissue infections drained in the emergency department (ED) vs operative drainage (OD) in a tertiary care children's hospital. METHODS: This was a cross-sectional study among children aged 2 months to 17 years who required incision and drainage (I&D). Demographic information, signs and symptoms, abscess size and location, and wound culture/susceptibility were recorded. Patient-specific charges were collected from the billing database...
October 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988262/impact-of-scribes-on-billed-relative-value-units-in-an-academic-emergency-department
#6
Heather A Heaton, David M Nestler, Derick D Jones, Rachelen S Varghese, Christine M Lohse, Eric S Williamson, Annie T Sadosty
BACKGROUND: Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. OBJECTIVES: Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs). METHODS: A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27974361/one-in-five-inpatient-emergency-department-cases-may-lead-to-surprise-bills
#7
Christopher Garmon, Benjamin Chartock
A surprise medical bill is a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient. In 2014, 20 percent of hospital inpatient admissions that originated in the emergency department (ED), 14 percent of outpatient visits to the ED, and 9 percent of elective inpatient admissions likely led to a surprise medical bill.
December 14, 2016: Health Affairs
https://www.readbyqxmd.com/read/27931303/a-comparison-of-seasonal-trends-in-asthma-exacerbations-among-children-from-geographic-regions-with-different-climates
#8
Julia A Wisniewski, Anne P McLaughlin, Philip J Stenger, James Patrie, Mark A Brown, Jane M El-Dahr, Thomas A E Platts-Mills, Nora J Byrd, Peter W Heymann
BACKGROUND: The fall peak in childhood asthma exacerbations is thought to be related to an increase in viral infections and allergen exposure when children return to school. Whether the seasonality of asthma attacks among children from different geographic regions follows similar trends is unclear. OBJECTIVE: To compare seasonal trends in asthma exacerbations among school-age children who lived in different geographic locations, with different climates, within the United States...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27893295/medical-directors-of-breastfeeding-programs-at-academic-medical-centers-duties-and-challenges
#9
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27864915/identification-of-emergency-department-visits-in-medicare-administrative-claims-approaches-and-implications
#10
Arjun K Venkatesh, Hao Mei, Keith Kocher, Mike Granovsky, Ziad Obermeyer, Erica Spatz, Craig Rothenberg, Harlan Krumholz, Zhenqui Lin
OBJECTIVES: Administrative claims datasets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare dataset and to compare this definition to existing operational definitions used by researchers and policymakers...
November 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27836322/anemia-is-not-a-risk-factor-for-developing-pulmonary-embolism
#11
John B Harringa, Rebecca L Bracken, Scott K Nagle, Mark L Schiebler, Brian W Patterson, James E Svenson, Michael D Repplinger
OBJECTIVE: Our aim was to validate the previously published claim of a positive relationship between low blood hemoglobin level (anemia) and pulmonary embolism (PE). METHODS: This was a retrospective study of patients undergoing cross-sectional imaging to evaluate for PE at an academic medical center. Patients were identified using billing records for charges attributed to either magnetic resonance angiography or computed tomography angiography of the chest from 2008 to 2013...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818095/genetic-markers-associated-with-dihydroartemisinin-piperaquine-failure-in-plasmodium-falciparum-malaria-in-cambodia-a-genotype-phenotype-association-study
#12
Roberto Amato, Pharath Lim, Olivo Miotto, Chanaki Amaratunga, Dalin Dek, Richard D Pearson, Jacob Almagro-Garcia, Aaron T Neal, Sokunthea Sreng, Seila Suon, Eleanor Drury, Dushyanth Jyothi, Jim Stalker, Dominic P Kwiatkowski, Rick M Fairhurst
BACKGROUND: As the prevalence of artemisinin-resistant Plasmodium falciparum malaria increases in the Greater Mekong subregion, emerging resistance to partner drugs in artemisinin combination therapies seriously threatens global efforts to treat and eliminate this disease. Molecular markers that predict failure of artemisinin combination therapy are urgently needed to monitor the spread of partner drug resistance, and to recommend alternative treatments in southeast Asia and beyond. METHODS: We did a genome-wide association study of 297 P falciparum isolates from Cambodia to investigate the relationship of 11 630 exonic single-nucleotide polymorphisms (SNPs) and 43 copy number variations (CNVs) with in-vitro piperaquine 50% inhibitory concentrations (IC50s), and tested whether these genetic variants are markers of treatment failure with dihydroartemisinin-piperaquine...
November 3, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27769219/advanced-practice-pharmacists-a-retrospective-evaluation-of-the-efficacy-and-cost-of-clinical-pharmacist-practitioners-managing-ambulatory-medicare-patients-in-north-carolina-apple-nc
#13
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27750249/how-reliable-are-administrative-data-for-capturing-stroke-patients-and-their-care
#14
Joan Porter, Luke Mondor, Moira K Kapral, Jiming Fang, Ruth E Hall
BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. METHODS: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors...
October 18, 2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27747743/utility-of-a-near-real-time-emergency-department-syndromic-surveillance-system-to-track-injuries-in-new-york-city
#15
Kacie Seil, Jennifer Marcum, Ramona Lall, Catherine Stayton
BACKGROUND: The New York City emergency department (ED) syndromic surveillance (SS) system provides near real-time data on the majority of ED visits. The utility of ED SS for injury surveillance has not been thoroughly evaluated. We created injury syndromes based on ED chief complaint information and evaluated their utility compared to administrative billing data. METHODS: Six injury syndromes were developed: traffic-related injuries to pedal cyclists, pedestrians, and motor vehicle occupants; fall-related injuries; firearm-related injuries; and assault-related stabbings...
December 2015: Injury Epidemiology
https://www.readbyqxmd.com/read/27745751/province-wide-review-of-pediatric-shiga-toxin-producing-escherichia-coli-case-management
#16
Stephen B Freedman, Mohamed Eltorki, Linda Chui, Jianling Xie, Sharon Feng, Judy MacDonald, Andrew Dixon, Samina Ali, Marie Louie, Bonita E Lee, Lara Osterreicher, Jennifer Thull-Freedman
OBJECTIVE: To identify the gaps in the care of children infected with Shiga toxin-producing Escherichia coli (STEC), we sought to quantitate care received and management timelines. Such knowledge is crucial to the design of interventions to prevent the development of hemolytic uremic syndrome (HUS). STUDY DESIGN: We conducted a retrospective case-series study of 78 children infected with STEC in Alberta, Canada, through the linkage of microbiology and laboratory results, telephone health advice records, hospital charts, physician billing submissions, and outpatient antimicrobial dispensing databases...
January 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27698180/use-of-point-of-care-ultrasound-in-the-emergency-department-insights-from-the-2012-medicare-national-payment-data-set
#17
M Kennedy Hall, Jane Hall, Cary P Gross, Nir J Harish, Rachel Liu, Sean Maroongroge, Christopher L Moore, Christopher C Raio, R Andrew Taylor
OBJECTIVES: Point-of-care ultrasound is a valuable tool with potential to expedite diagnoses and improve patient outcomes in the emergency department. However, little is known about national patterns of adoption. This study examined nationwide point-of-care ultrasound reimbursement among emergency medicine (EM) practitioners and examined regional and practitioner level variations. METHODS: Data from the 2012 Center for Medicare and Medicaid Services Fee-for-Service Provider Utilization and Payment Data include all practitioners who received more than 10 Medicare Part B fee-for-service reimbursements for any Healthcare Common Procedure Coding System code in 2012...
November 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27682023/fear-vulnerability-and-sacrifice-drivers-of-emergency-department-use-and-implications-for-policy
#18
Anastasia Hudgins, Kristin L Rising
Patients' existential fears of unknowns associated with illness and unusual bodily signs and symptoms are common, but unexamined drivers to the emergency department (ED). This paper examines a May 2015 case study of a 51-year-old low-income, recently insured, African American man in Philadelphia (USA) who had two recent ED visits for evaluation of frequent headaches and described fear of being at risk for a stroke. Through ethnographic methods and anthropological analyses we find that fear of failing to fulfill social roles due to a potentially debilitating illness, and fear of burdening family members with medical bills resulting from doctor's visits affect this man's patterns of health-seeking behaviors...
September 20, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27625723/treatment-of-nausea-and-vomiting-in-pregnancy-factors-associated-with-ed-revisits
#19
Brian R Sharp, Kristen M Sharp, Brian Patterson, Suzanne Dooley-Hash
INTRODUCTION: Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. METHODS: We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27607896/community-needs-assessment-after-microcystin-toxin-contamination-of-a-municipal-water-supply-lucas-county-ohio-september-2014
#20
Carolyn L McCarty, Leigh Nelson, Samantha Eitniear, Eric Zgodzinski, Amanda Zabala, Laurie Billing, Mary DiOrio
On August 1, 2014, routine testing at the Collins Park Water Treatment Plant in Lucas County, Ohio, revealed microcystin toxin levels in drinking water had reached 3.19 μg/L, surpassing the Ohio Environmental Protection Agency (EPA) drinking water advisory threshold of 1.0 μg/L. Microcystin is a hepatoxin released by cyanobacteria in certain harmful algal blooms. Exposure to microcystin has been associated with gastrointestinal and hepatic illness in both humans and animals (1-3). On August 2, a do-not-drink advisory was issued, warning community members not to drink, boil, or use the water for cooking or brushing teeth...
September 9, 2016: MMWR. Morbidity and Mortality Weekly Report
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