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Freestanding emergency center

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https://www.readbyqxmd.com/read/28971915/freestanding-emergency-departments-preferentially-locate-in-areas-with-higher-household-income
#1
Cedric Dark, Yingying Xu, Vivian Ho
Freestanding emergency departments (EDs) are a relatively novel phenomenon, and the epicenter of this movement is in Texas. Limited evidence exists about the communities in which freestanding EDs locate or the possible reasons behind location choice. We estimated logistic regressions to determine whether freestanding EDs in 2016 were more likely to be in areas of high demand or in those that could yield high profits. When we compared Public Use Microdata Areas that contained freestanding EDs and those that did not, we found that areas with such EDs had significantly higher household incomes...
October 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#2
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28800812/highlight-in-telepsychiatry-and-behavioral-health-emergencies
#3
REVIEW
James Rachal, Wayne Sparks, Christine Zazzaro, Terri Blackwell
Carolinas HealthCare System is one of the largest freestanding psychiatric emergency departments in the country. It has grown from a small community mental health center in the 1930s, to one of the largest providers of emergency mental health services in the country. It offers services in person and via telepsychiatry to other emergency departments and primary care clinics. It decreased emergency room wait times and revolutionized where and how patients get their care. This has been the work of several groups from many disciplines...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28546300/implementation-of-pharmacy-services-at-freestanding-emergency-departments-and-urgency-centers
#4
Rachel Root, Paul Krogh, Kristi Gullickson, Barbara Hintzen, Martha Christophersen, Steven Kastendieck, Matt Kresl
No abstract text is available yet for this article.
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28486385/validation-of-the-vasoactive-inotropic-score-in-pediatric-sepsis
#5
Amanda M McIntosh, Suhong Tong, Sara J Deakyne, Jesse A Davidson, Halden F Scott
OBJECTIVES: To assess the validity of Vasoactive-Inotropic Score as a scoring system for cardiovascular support and surrogate outcome in pediatric sepsis. DESIGN: Secondary retrospective analysis of a single-center sepsis registry. SETTING: Freestanding children's hospital and tertiary referral center. PATIENTS: Children greater than 60 days and less than 18 years with sepsis identified in the emergency department between January 2012 and June 2015 treated with at least one vasoactive medication within 48 hours of admission to the PICU...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28330970/variation-in-family-experience-of-pediatric-inpatient-care-as-measured-by-child-hcahps
#6
Sara L Toomey, Marc N Elliott, Alan M Zaslavsky, David J Klein, Sifon Ndon, Shannon Hardy, Melody Wu, Mark A Schuster
BACKGROUND: Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28262320/comparing-utilization-and-costs-of-care-in-freestanding-emergency-departments-hospital-emergency-departments-and-urgent-care-centers
#7
Vivian Ho, Leanne Metcalfe, Cedric Dark, Lan Vu, Ellerie Weber, George Shelton, Howard R Underwood
STUDY OBJECTIVE: We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. METHODS: We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type...
February 15, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#8
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
April 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27664881/postoperative-acute-care-use-after-freestanding-ambulatory-surgery
#9
George Molina, Bridget A Neville, Stuart R Lipsitz, Lorri Gibbons, Ashley Kay Childers, Atul A Gawande, William R Berry, Alex B Haynes
BACKGROUND: Surgical procedures in the United States are increasingly performed in the ambulatory setting, including freestanding ambulatory surgery centers (ASCs). However, there is a lack of research and tracking of surgical outcomes in this setting. MATERIALS AND METHODS: We analyzed data from a state all-payer claims database to produce a retrospective cohort study on the rate of acute care use (emergency department [ED] visits and inpatient admissions) within 7 d after operations performed in freestanding ASCs in South Carolina...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27338533/factors-affecting-pediatric-patient-transfer-in-testicular-torsion
#10
Daniel L Lodwick, Jennifer N Cooper, Peter C Minneci, Katherine J Deans, Daryl McLeod
BACKGROUND: Testicular torsion is a surgical emergency, and interhospital transfer could delay care and increase the risk of orchiectomy. This study identifies factors associated with transfer for pediatric testicular torsion. METHODS: This retrospective cross-sectional study examined emergency department (ED) visits for testicular torsion by men aged 1-21 y in National Emergency Department Sample from 2006 to 2012. Freestanding children's hospitals were excluded...
June 1, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27309191/contextual-factors-associated-with-hospitals-decision-to-operate-freestanding-emergency-departments
#11
Nitish Patidar, Robert Weech-Maldonado, Stephen J O'Connor, Bisakha Sen, J M Mickey Trimm, Carlos A Camargo
BACKGROUND: Freestanding emergency departments (FSEDs) are fast growing entities in health care, delivering emergency care outside of hospitals. Hospitals may benefit in several ways by opening FSEDs. PURPOSE: The study used the resource dependence theory as a means to analyze the relationship between market and organizational factors and the likelihood of hospitals to operate FSEDs. METHODOLOGY: All acute care hospitals in 14 states with FSEDs present during the study period from 2002 to 2011...
July 2017: Health Care Management Review
https://www.readbyqxmd.com/read/27098330/the-safety-of-hand-and-upper-extremity-surgical-procedures-at-a-freestanding-ambulatory-surgery-center-a-review-of-28-737-cases
#12
REVIEW
Kanu S Goyal, Sameer Jain, Glenn A Buterbaugh, Joseph E Imbriglia
BACKGROUND: More procedures are being completed on an outpatient basis at freestanding ambulatory surgery centers. The purpose of our study was to determine the safety and rate of adverse events in outpatient hand and upper-extremity surgical procedures. METHODS: A retrospective review of cases at a single, freestanding ambulatory surgery center over an eleven-year period was performed. In our analysis, 28,737 cases were performed and were included. Adverse events were defined as serious complications causing harm to a patient or leading to additional treatment...
April 20, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/26686934/the-impact-of-a-freestanding-ed-on-a-regional-emergency-medical-services-system
#13
Benjamin J Lawner, Jon Mark Hirshon, Angela C Comer, Jose V Nable, Jeffrey Kelly, Richard L Alcorta, Laura Pimentel, Christina L Tupe, Mary Alice Vanhoy, Brian J Browne
OBJECTIVE: The objective of the study is to examine the effect of the opening of a freestanding emergency department (FED) on the surrounding emergency medical services (EMS) system through an examination of EMS system metrics such as ambulance call volume, ambulance response times, and turnaround times. METHODS: This study is based on data from the county's computer-aided dispatch center, the FED, and the Maryland Health Services Cost Review Commission. The analysis involved a pre/post design, with a 6-month washout period...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26520697/preventable-transfers-in-pediatric-trauma-a-10-year-experience-at-a-level-i-pediatric-trauma-center
#14
Stephen J Fenton, Justin H Lee, Austin M Stevens, Kyle C Kimbal, Chong Zhang, Angela P Presson, Ryan R Metzger, Eric R Scaife
BACKGROUND: Injured children are often treated at one facility then transferred to another that specializes in pediatric trauma care. The purpose of this study was to identify and characterize potentially preventable transfers (PT) to a freestanding level-I pediatric trauma center. METHODS: Children with traumatic injuries transferred between 2003 and 2013 were retrospectively analyzed. A PT was defined as a child who was discharged within 36hours of arrival without surgical intervention or advanced imaging studies...
April 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26484036/role-of-interventional-nephrology-in-the-multidisciplinary-approach-to-hemodialysis-vascular-access-care
#15
REVIEW
Gerald A Beathard
Dialysis vascular access planning, creation, and management is of critical importance to the dialysis patient population. It requires a multidisciplinary approach involving patients and their families, dialysis facility staff, the nephrologist, the surgeon, and the interventionalist. With the emergence of interventional nephrology as a subspecialty of nephrology, the nephrologist is increasingly providing both the nephrology and interventional aspects of care, and in some areas, the surgical functions as well...
September 2015: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/26378263/consumer-choice-between-hospital-based-and-freestanding-facilities-for-arthroscopy-impact-on-prices-spending-and-surgical-complications
#16
COMPARATIVE STUDY
James C Robinson, Timothy T Brown, Christopher Whaley, Kevin J Bozic
BACKGROUND: Hospital-based outpatient departments traditionally charge higher prices for ambulatory procedures, compared with freestanding surgery centers. Under emerging reference-based benefit designs, insurers establish a contribution limit that they will pay, requiring the patient to pay the difference between that contribution limit and the actual price charged by the facility. The purpose of this study was to evaluate the impact of reference-based benefits on consumer choices, facility prices, employer spending, and surgical outcomes for orthopaedic procedures performed at ambulatory surgery centers...
September 16, 2015: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/26359473/electronic-health-record-challenges-workarounds-and-solutions-observed-in-practices-integrating-behavioral-health-and-primary-care
#17
COMPARATIVE STUDY
Maribel Cifuentes, Melinda Davis, Doug Fernald, Rose Gunn, Perry Dickinson, Deborah J Cohen
PURPOSE: This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. METHODS: This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care...
September 2015: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/26344718/structure-and-function-of-observation-units-in-children-s-hospitals-a-mixed-methods-study
#18
Leticia A Shanley, Carla Hronek, Matthew Hall, Elizabeth R Alpern, Evan S Fieldston, Paul D Hain, Samir S Shah, Michelle L Macy
OBJECTIVE: Observation unit (OU) use has been promoted recently to decrease resource utilization and costs for select patients, but little is known about the operations of pediatric OUs. This study aimed to characterize the infrastructure and function of OUs within freestanding children's hospitals and to compare characteristics between hospitals with and without OUs. METHODS: All 43 freestanding children's hospitals that submit data to the Pediatric Health Information System were contacted in 2013 to identify OUs that admitted unscheduled patients from their emergency department (ED) in 2011...
September 2015: Academic Pediatrics
https://www.readbyqxmd.com/read/26218687/management-of-children-with-solid-organ-injuries-after-blunt-torso-trauma
#19
MULTICENTER STUDY
David H Wisner, Nathan Kuppermann, Arthur Cooper, Jay Menaker, Peter Ehrlich, Josh Kooistra, Prashant Mahajan, Lois Lee, Lawrence J Cook, Kenneth Yen, Kathy Lillis, James F Holmes
BACKGROUND: Management of children with intra-abdominal solid organ injuries has evolved markedly. We describe the current management of children with intra-abdominal solid organ injuries after blunt trauma in a large multicenter network. METHODS: We performed a planned secondary analysis of a prospective, multicenter observational study of children (<18 years) with blunt torso trauma. We included children with spleen, liver, or kidney injuries identified by computed tomography, laparotomy/laparoscopy, or autopsy...
August 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25701216/a-comparison-of-acuity-levels-between-3-freestanding-and-a-tertiary-care-ed
#20
COMPARATIVE STUDY
Erin L Simon, Mitch Kovacs, Zhenyu Jia, Dave Hayslip, Kseniya Orlik, Nicholas Jouriles
INTRODUCTION: Freestanding emergency departments (FEDs) have grown in popularity. They often provide emergent care in areas distant from other EDs. Investigations and research to characterize the operation and dynamics of FEDs are needed. This study characterizes the severity of illness seen at FEDs and compares it with a hospital-based urban tertiary care ED using the emergency severity index (ESI), a quantification of patient acuity. METHODS: Patient ESI levels were analyzed retrospectively over 1 year for a single hospital system with 1 main urban hospital-based ED and 3 FEDs...
April 2015: American Journal of Emergency Medicine
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