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Non-urgent emergency visits

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https://www.readbyqxmd.com/read/29748341/general-practitioners-providing-non-urgent-care-in-emergency-department-a-natural-experiment
#1
Olalekan A Uthman, Clare Walker, Sudakshina Lahiri, David Jenkinson, Victor Adekanmbi, Wendy Robertson, Aileen Clarke
OBJECTIVE: To examine whether care provided by general practitioners (GPs) to non-urgent patients in the emergency department differs significantly from care provided by usual accident and emergency (A&E) staff in terms of process outcomes and A&E clinical quality indicators. DESIGN: Propensity score matched cohort study. SETTING: GPs in A&E colocated within the University Hospitals Coventry and Warwickshire NHS Trust between May 2015 and March 2016...
May 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678177/healthcare-resource-use-and-economic-burden-attributable-to-respiratory-syncytial-virus-in-the-united-states-a-claims-database-analysis
#2
Caroline Amand, Sabine Tong, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system. METHODS: This retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013...
April 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29543941/utilization-of-ophthalmologist-consultation-for-emergency-care-at-a-university-hospital
#3
Sophia Y Wang, Mariam S Hamid, David C Musch, Maria A Woodward
Importance: Nearly 2 million patients visit emergency departments (EDs) because of eye concerns annually in the United States. How hospitals currently assign these patients to treatment is important for designing systems that equitably allocate resources for eye care in urgent settings. Objective: To investigate factors associated with ophthalmology consultation for eye-related adult ED encounters to assess possible disparities by sex, race/ethnicity, language preference, or residential distance from the medical center...
April 1, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29530174/do-out-of-hours-general-practitioner-services-and-emergency-departments-cost-more-by-collaborating-or-by-working-separately-a-cost-analysis
#4
Sjoerd Broekman, Elisabeth Van Gils-Van Rooij, Berthold Meijboom, Dingenus De Bakker, Christoffel Yzermans
INTRODUCTION In the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in urgent care collaborations (UCCs) in which the two services share one combined entrance and joint triage. AIM The objective of this study is to determine if UCCs are cost-effective compared to the usual care setting where out-of-hours GP services and EDs work separately. METHODS This observational study compared UCCs with the usual care setting on costs by performing linear regression analyses...
September 2017: Journal of Primary Health Care
https://www.readbyqxmd.com/read/29496439/patient-perspectives-on-emergency-department-self-referral-after-bariatric-surgery
#5
Haley Stevens, Emily Wells, Rachel Ross, Amanda Stricklen, Amir A Ghaferi
BACKGROUND: Reducing avoidable emergency department (ED) visits is an increasingly important target of quality improvement and cost containment efforts in bariatric surgery. Administrative and clinical registry data provide an incomplete picture of the factors contributing to postoperative ED utilization. Patient-centered interviews can help identify intervention opportunities. OBJECTIVES: We sought to understand the circumstances surrounding patient self-referral to the ED after elective, primary bariatric surgery...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29464673/comparison-of-disease-modifying-therapies-for-the-management-of-multiple-sclerosis-analysis-of-healthcare-resource-utilization-and-relapse-rates-from-us-insurance-claims-data
#6
Jacqueline Nicholas, Aaron Boster, Ning Wu, Wei-Shi Yeh, Monica Fay, Jon Kendter, Ming-Yi Huang, Andrew Lee
BACKGROUND: Data on comparative healthcare resource utilization and costs associated with the newer oral disease-modifying therapies (DMTs) for managing relapsing-remitting multiple sclerosis (MS) in routine clinical practice are limited. The purpose of this study was to estimate healthcare resource utilization, costs, and relapse rates in the year after initiating treatment with dimethyl fumarate (DMF), interferon (IFN)-β, glatiramer acetate (GA), teriflunomide, or fingolimod in routine clinical practice for patients with MS who did not receive a DMT in the previous year...
March 2018: PharmacoEconomics open
https://www.readbyqxmd.com/read/29453155/evaluation-of-the-triage-performed-by-registered-nurses-in-the-hospital-cl%C3%A3-nico-universitario-%C3%A2-lozano-blesa%C3%A2-emergency-service-saragossa-spain
#7
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29420459/vital-signs-asthma-in-children-united-states-2001-2016
#8
Hatice S Zahran, Cathy M Bailey, Scott A Damon, Paul L Garbe, Patrick N Breysse
BACKGROUND: Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Although asthma cannot be cured, most of the time, asthma symptoms can be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for asthma education and appropriate medical care. METHODS: CDC analyzed asthma data from the 2001-2016 National Health Interview Survey for children aged 0-17 years to examine trends and demographic differences in health outcomes and health care use...
February 9, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29396593/impact-of-opioid-use-on-health-care-utilization-and-survival-in-patients-with-newly-diagnosed-stage-iv-malignancies
#9
Dylan Zylla, Grant Steele, Alice Shapiro, Sara Richter, Pankaj Gupta
PURPOSE: Patients with advanced cancers frequently experience pain. Opioids are commonly prescribed to treat cancer-related pain, but their use might be associated with undesirable consequences including adverse effects and tumor progression, resulting in increased heath care utilization and shorter survival. We examined these possibilities in a large cohort of patients diagnosed with ten common advanced malignancies. METHODS: We identified 1386 newly diagnosed patients with stage IV non-hematologic malignancies from 2005 to 2013 and ascertained opioid utilization within 90 days of starting anti-cancer treatment using electronic medical record and tumor registry data...
February 2, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29299519/expeditious-emergency-room-referral-pathway-improves-patient-access-to-otolaryngology-care
#10
Jeffrey Johnson, Zi Yang Jiang, Daniel Martinez, David Smith, Elizabeth Curtis, David Robinson, Ibrahim Alava
Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29240568/the-epidemiology-of-pediatric-head-injury-treated-outside-of-hospital-emergency-departments
#11
Cheryl K Zogg, R Sterling Haring, Likang Xu, Joseph K Canner, Hatim A AlSulaim, Zain G Hashmi, Ali Salim, Lilly D Engineer, Adil H Haider, Jeneita M Bell, Eric B Schneider
BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17 years) patients presenting in outpatient settings with those of patients seeking nonhospitalized emergency department care. METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department...
March 2018: Epidemiology
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#12
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
December 2017: Injury
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#13
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform health care, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to health care reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate nonemergency care stream in a large academic primary care clinic serving 19,000 patients (90% Medicaid)...
April 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/28992158/avoidable-emergency-department-visits-a-starting-point
#14
Renee Y Hsia, Matthew Niedzwiecki
Objective: To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits. Design/setting: We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. Participants: We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28990409/hiv-primary-care-by-the-infectious-disease-physician-in-the-united-states-extending-the-continuum-of-care
#15
Seetha Lakshmi, Susan E Beekmann, Philip M Polgreen, Allan Rodriguez, Maria L Alcaide
Models of care for people living with HIV (PLWH) have varied over time due to long term survival, development of HIV-associated non-AIDS conditions, and HIV specific primary care guidelines that differ from those of the general population. The objectives of this study are to assess how often infectious disease (ID) physicians provide primary care for PLWH, assess their practice patterns and barriers in the provision of primary care. We used a 6-item survey electronically distributed to ID physician members of Emerging Infections Network (EIN)...
May 2018: AIDS Care
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#16
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28960043/the-clinical-differences-between-urgent-visits-and-non-urgent-visits-in-emergency-department-during-the-neonatal-period
#17
Hyung Jun Yang, Woochan Jeon, Hee Jung Yang, Jae Ryoung Kwak, Hyo Yeon Seo, Ji Sook Lee
As neonates are brought to the emergency department (ED) for various complaints, it is challenging for emergency physicians to clinically determine the urgency of the visit. We sought to explore clinical characteristics associated with urgent visits to the ED. We conducted a retrospective study by reviewing medical records of neonatal visits to a tertiary pediatric regional emergency center for 5 years. Cases of patients who were discharged after checking only chest or abdominal X-ray or discharged without workup, were classified as non-urgent visits...
November 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28910250/the-1-of-emergency-room-visits-for-non-traumatic-dental-conditions-in-british-columbia-misconceptions-about-the-numbers
#18
Mario Brondani, Syed H Ahmad
In Canada, about 1% of all emergency room (ER) visits in a given year are made by patients with a primary diagnosis of a non-traumatic, non-urgent and yet preventable condition, such as tooth decay. This percentage is typically dismissed as irrelevant. Using 2013-2014 British Columbia data on ER use from the Canadian Institute for Health Information, however, we argue that the 1% figure (and its associated cost) has to be considered beyond its percentage value. In 2013-2014 alone, 12 357 non-traumatic dental visits were made to ERs in BC representing 1% of the total number of ER visits at a cost of $154...
September 14, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28893200/an-after-hours-gp-clinic-in-regional-australia-appropriateness-of-presentations-and-impact-on-local-emergency-department-presentations
#19
Kristy Payne, Tegan Dutton, Kate Weal, Maree Earle, Ross Wilson, Jannine Bailey
BACKGROUND: After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations is equivocal. This study explored outcomes of the Bathurst After Hours General Practice Clinic (BAHGPC). Specifically it examined: clients' perceived urgency of, and satisfaction with their presentation to the BAHGPC; general practitioners' perception of the appropriateness of presentations to the BAHGPC; and whether the frequency of non-urgent and semi-urgent emergency department presentations at Bathurst Base Hospital has changed since the opening of the BAHGPC...
September 11, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28890140/-impact-of-the-elderly-patient-in-the-emergency-department
#20
Manuel Bermúdez Menéndez de la Granda, German Guzmán Gutiérrez, María Fernández Fernández, Juan José Solano Jaurrieta
INTRODUCTION: The aging of the population, chronic diseases, and non-urgent visits to the Emergency departments (ED) are considered the reasons for the increase of the demand of care. The aim of this study is to analyse the impact of the older population in the ED, when compared to a younger population. MATERIAL AND METHODS: An observational, descriptive and retrospective study including an analysis of the 92,627 patients that attended the ED in Hospitals from Health Area IV belonging to the Principality of Asturias Health Services during 2009...
September 7, 2017: Revista Española de Geriatría y Gerontología
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