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Non-urgent emergency visits

Kimberly A Kilfoyle, Roxanne Vrees, Christina A Raker, Kristen A Matteson
BACKGROUND: Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting. OBJECTIVE: To identify socio-demographic factors associated with non-urgent emergency department use in pregnancy. STUDY DESIGN: This is a cross-sectional study of women recruited during their postpartum hospitalization. Data regarding prenatal care and emergency department visits was collected from medical records; participants completed a survey with questions regarding demographics and emergency department use...
October 20, 2016: American Journal of Obstetrics and Gynecology
David Salisbury, Simon J Driver, Megan Reynolds, Monica Bennett, Laura B Petrey, Anne Marie Warren
OBJECTIVE: To investigate trends of hospital-based health care utilization after admission to a Level 1 trauma center following acute traumatic brain injury (TBI). DESIGN: Retrospective review. SETTING: Large urban trauma hospital and a hospital council data registry consisting of 88 member institutions (>150 hospitals) covering 15,000 square miles. PARTICIPANTS: All patients admitted to a Level I trauma center between January 2006 - June 2014 who experienced an acute TBI based on ICD-9 coding...
October 6, 2016: Archives of Physical Medicine and Rehabilitation
Debbie L Becker, Ayman Chit, Carlos A DiazGranados, Michael Maschio, Eddy Yau, Michael Drummond
Seasonal influenza infects approximately 10-20% of Canadians each year, causing an estimated 12,200 hospitalizations and 3,500 deaths annually, mostly occurring in adults ≥65 years old (seniors). A 32,000-participant, randomized controlled clinical trial (FIM12; NCT01427309) showed that high-dose inactivated influenza vaccine (IIV-HD) is superior to standard-dose vaccine (SD) in preventing laboratory-confirmed influenza illness in seniors. In this study, we performed a cost-utility analysis (CUA) of IIV-HD versus SD in FIM12 participants from a Canadian perspective...
September 26, 2016: Human Vaccines & Immunotherapeutics
K K Lehm, M S Andersen, I S Riddervold
OBJECTIVE: In Denmark, calls to the Danish emergency number 1-1-2 concerning medical emergencies are received by an emergency medical communication center (EMCC). At the EMCC, health care professionals (nurses, paramedics, and physicians) decide the necessary response, depending on the level of emergency as indicated by the Danish Index for Emergency Care. The index states 37 main criteria (symptoms) and five levels of emergency, descending from A (life threatening) to E (not serious)...
September 14, 2016: Prehospital Emergency Care
Rosemary McKenzie, David Dunt, Allison Yates
OBJECTIVE: To determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service. METHODS: A descriptive study of users' of an after hours helpline self-reported ED attendance and compliance with GP recommendation, based on routinely collected service data and telephone survey results for 2783 callers in 2011-2012. The outcome measure was self-reported health service utilisation following advice from a GP on an after hours helpline...
October 2016: Emergency Medicine Australasia: EMA
Camilla Kjellstadli Thoresen, Hogne Sandvik, Steinar Hunskaar
OBJECTIVE: To investigate how cancer patients in Norway use primary care out-of-hours (OOH) services and describe different contact types and procedures. DESIGN: A retrospective cross-sectional registry study using a billing registry data source. SETTING: Norwegian primary care OOH services in 2014. SUBJECTS: All patients' contacts in OOH services in 2014. Cancer patients were identified by ICPC-2 diagnosis. MAIN OUTCOME MEASURES: Frequency of cancer patients' contacts with OOH services, contact types, diagnoses, procedures, and socio-demographic characteristics...
September 2016: Scandinavian Journal of Primary Health Care
Sven Eirik Ruud, Per Hjortdahl, Bård Natvig
BACKGROUND: Emergency room (ER) use is increasing in several countries. Variability in the proportion of non-urgent ER visits was found to range from 5 to 90 % (median 32 %). Non-urgent emergency visits are considered an inappropriate and inefficient use of the health-care system because they may lead to higher expenses, crowding, treatment delays, and loss of continuity of health care provided by a general practitioner. Urgency levels of doctor-walk-in patient encounters were assessed based on their region of origin in a diverse Norwegian population...
2016: BMC Emergency Medicine
Mattia Bellan, Rossella Molinari, Luigi Castello, Daniele Sola, Antonello Gibbin, Giulia Guaschino, Roberta Pedrazzoli, Alessia Puma, Mario Pirisi, Gian Carlo Avanzi, Pier Paolo Sainaghi
Non-traumatic musculoskeletal complaints are often dealt with by emergency room (ER) physicians. We aimed to quantify how many patients with such complaints have conditions requiring immediate recognition and treatment, versus specialist referral, versus primary care. We retrieved the clinical records of all the patients admitted to the ER department of our hospital along 1 year. Pediatric (age <14 years) and obstetrics/gynecology cases were excluded. Data from all patients visiting the ER for non-traumatic musculoskeletal complaints were classified as follows: true emergencies (i...
June 17, 2016: Clinical Rheumatology
Joji Inamasu, Keisuke Ito, Natsuki Hattori, Yuichi Hirose
Intracerebral hemorrhage is a well-known complication resulting from warfarin use. By contrast, warfarin-associated intraspinal hematoma is very rare. The intraspinal hematoma may exhibit delayed progression and patients may present with atypical symptoms, occasionally resulting in diagnostic delay. A 65-year-old man with non-valvular atrial fibrillation, arterial hypertension and benign prostatic hyperplasia who used warfarin for prevention of systemic embolism, visited our emergency department (ED) with a complaint of acute urinary retention...
May 26, 2016: Keio Journal of Medicine
Monica Reed Chase, Howard S Friedman, Prakash Navaratnam, Kim Heithoff, Ross J Simpson
BACKGROUND: There is growing concern about appropriate disease management for peripheral artery disease (PAD) because of the rapidly expanding population at risk for PAD and the high burden of illness associated with symptomatic PAD. A better understanding of the potential economic impact of symptomatic PAD relative to a matched control population may help improve care management for these patients. OBJECTIVE: To compare the medical resource utilization, costs, and medication use for patients with symptomatic PAD relative to a matched control population...
June 2016: Journal of Managed Care & Specialty Pharmacy
M H Schmiedhofer, J Searle, A Slagman, M Möckel
Background: The increasing utilization of Emergency Departments (ED) by outpatients with acute but non-urgent conditions contributes to ED crowding. This study aims to explore the motives of patients categorized as non-urgent for visiting the ED. Methods: A qualitative study based on semi-structured interviews was conducted at 2 ED's at Charité Berlin. A total of 40 patients categorized as non-urgent were interviewed. Data were analyzed using Qualitative Content Analysis. Results: In addition to unavailable appointments or having to wait a long time for an appointment with general practitioners and specialists, patients stated better time-flexibility, the University Hospital's quality of care and the availability of multidisciplinary care as reasons to seek medical care in the ED...
April 22, 2016: Das Gesundheitswesen
Arístides Rivas García, Gema Manrique Martín, Laura Butragueño Laiseca, Sofía Mesa García, Alfonso Campos Segura, Vanessa Fernández Iglesia, Rubén Moreno Sánchez, Juan Mariano Aguilar Mulet
OBJECTIVE: To determine the prevalence of frequent Paediatric Emergency Departments users and to analyse their characteristics, comparing initial consultations and re-consultations. METHODS: This is a multicentre retrospective cohort study of all patients who made 10 or more visits to the Paediatric Emergency Departments of 5 public hospitals between 1 January 2013 and 31 December 2013. An analysis was performed on the patient demographics and clinical data of the first consultation and consecutive re-consultations...
April 15, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Gregory S Corwin, Devin M Parker, Jeremiah R Brown
BACKGROUND: There is limited information on where and how often Medicare beneficiaries seek care for non-urgent conditions when a physician office visit is not available. Emergency departments are often an alternative site of care, and urgent care centers have now also emerged to fill this need. The purpose of the study was to characterize the site of care for Medicare beneficiaries with non-urgent conditions; the relationship between physician office, urgent care center, and emergency department utilization; and specifically the role of urgent care centers...
September 2016: American Journal of Medicine
Theresa N Duong, Lindsey Malik, Sandhya Venugopal, Ezra A Amsterdam
No abstract text is available yet for this article.
July 2016: American Journal of Medicine
Keane K Lee, Jingrong Yang, Adrian F Hernandez, Anthony E Steimle, Alan S Go
BACKGROUND: Readmission within 30 days after hospitalization for heart failure (HF) is a major public health problem. OBJECTIVE: To examine whether timing and type of post-discharge follow-up impacts risk of 30-day readmission in adults hospitalized for HF. DESIGN: Nested matched case-control study (January 1, 2006-June 30, 2013). SETTING: A large, integrated health care delivery system in Northern California. PARTICIPANTS: Hospitalized adults with a primary diagnosis of HF discharged to home without hospice care...
April 2016: Medical Care
Alejandro Molina-López, Jeremy Bernardo Cruz-Islas, Mauricio Palma-Cortés, Diana Patricia Guizar-Sánchez, César Yehú Garfias-Rau, Martha Patricia Ontiveros-Uribe, Ana Fresán-Orellana
BACKGROUND: Classification of Psychiatric Emergency Presentations (PEP) is not sufficiently clear due to their inherent high inter-subjectivity and lack of validated triage instruments. In order to improve current classification of psychiatric emergency presentations (PEP) at Emergency Departments, we implemented and validated the Color-Risk Psychiatric Triage (CRPT), an instrument for classifying PEP risk by sorting one to five color/risk levels and one to thirty-two possible conditions arranged by risk...
2016: BMC Psychiatry
Kathleen S W Zoltowski, Rakesh D Mistry, David C Brousseau, Travis Whitfill, Paul L Aronson
OBJECTIVE: Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. METHODS: This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey...
May 2016: Academic Pediatrics
Yun Seong Kim, Chang Il Ju, Seok Won Kim, Hyeun Sung Kim
Spinal epidural lipomatosis (SEL) is a rare condition that presents as a back pain with progressive neurologic symptoms. Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies. We report a rare case of cauda equina syndrome caused by SEL in a non-obese healthy young man without any evident traumatic episode. A healthy 19-year-old man, who had experienced lower back pain for two months, visited our emergency room because of the sudden development of motor weakness and voiding difficulty...
December 2015: Korean Journal of Spine
Phek Hui Jade Kua, Li Wu, E-Lin Tessa Ong, Zi Ying Lim, Jinmian Luther Yiew, Xing Hui Michelle Thia, Sharon Cohan Sung
INTRODUCTION: A significant percentage of paediatric emergency department (ED) attendances worldwide are nonurgent, adversely affecting patient outcomes and healthcare systems. This study aimed to understand the reasons behind nonurgent ED visits, in order to develop targeted and effective preventive interventions. METHODS: In-depth interviews were conducted with 49 caregivers to identify the decision-making factors related to taking children to the ED of KK Women's and Children's Hospital, Singapore...
June 2016: Singapore Medical Journal
Simone Dahrouge, William Hogg, Jaime Younger, Elizabeth Muggah, Grant Russell, Richard H Glazier
PURPOSE: The purpose of this study was to determine the relationship between the number of patients under a primary care physician's care (panel size) and primary care quality indicators. METHODS: We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofessional primary health care practices in Ontario, Canada between April 2008 and March 2010, encompassing 4,195 physicians with panel sizes ≥1,200 serving 8...
January 2016: Annals of Family Medicine
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