scholarly journals Use of a Community Center Primary Care Clinic and Subsequent Emergency Department Visits Among Unhoused Women

2021 ◽  
Vol 4 (3) ◽  
pp. e213134
Author(s):  
Jenell Stewart ◽  
Kathryn M. Stadeli ◽  
Kristjana H. Ásbjörnsdóttir ◽  
Margaret L. Green ◽  
Giana H. Davidson ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Clinic ◽  
Emergency Department Visits ◽  
Community Center ◽  
Care Clinic

Use of Health Care Services by Inner-city Infants in an Early Discharge Program

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 686-691
Author(s):  
William O. Cooper ◽  
Uma R. Kotagal ◽  
Harry D. Atherton ◽  
Carrie A. Lippert ◽  
Elizabeth Bragg ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Inner City ◽  
Primary Care Clinic ◽  
Early Discharge ◽  
Emergency Department Visits ◽  
Care Clinic ◽  
Children's Hospital ◽  
Care Services ◽  
Children’S Hospital

Objective. To assess the use of health care services by inner-city infants enrolled in an early discharge program who received care in a tertiary care children's hospital primary care clinic. Design. Retrospective cohort study. Setting. Large, metropolitan university hospital and a children's hospital. Patients. Term infants cared for in a single full-term nursery, before and after implementation of a coordinated early discharge program, who received primary care at the children's hospital. Intervention. The coordinated Early Discharge Program was characterized by in-hospital visits by hospitalbased coordinating nurses, home visits by nurses from a home nursing agency, and communication with physicians for necessary adjustments in postdischarge care. Methods. After linking birth hospital records and the children's hospital medical records, a retrospective chart review was performed to obtain maternal demographic information and birth hospital length of stay, as well as the infants' attendance at primary care clinic, immunizations, emergency department visits, and rehospitalization. Main Outcome Measures. Number of primary care visits in the first 3 months of life, completion of one series of immunizations by 3 months of life, and number of emergency department visits and rehospitalization during the first 3 months of life. Results. The early discharge group (n = 253) had a significantly shorter birth hospital length of stay (35 ± 24 hours, mean ± SD) when compared with the control group (n = 212) (52 ± 14 hours). The early discharge group was also younger than the control group at the first primary care visit, with significantly more infants visiting the primary care clinic in the first month of life. There was also a significant difference between the groups in the mean number of emergency department visits (early discharge = .61 visits/patient, control = .79 visits/patient) and the proportion of patients with no emergency department visits during the first 3 months of life (early discharge = 57%, control = 43%). There was no difference between the two groups in the proportion of infants completing one series of immunizations or in the number of infants rehospitalized during the study period. Conclusions. Coordinated early discharge with home nursing visits for inner-city infants may result in earlier use of primary care services. Furthermore, there is a significant decrease in use of the emergency department during the first 3 months of life, and no increase in rehospitalization.

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

Presentation to Either the Pediatric Emergency Department or Primary Care Clinic for Acute Illness

2014 ◽  
Vol 30 (3) ◽  
pp. 146-150 ◽  
Author(s):  
Natalie Nokoff ◽  
Andrew M. Brunner ◽  
James G. Linakis ◽  
Siraj Amanullah
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Clinic ◽  
Pediatric Emergency ◽  
Acute Illness ◽  
Pediatric Emergency Department ◽  
Care Clinic

scholarly journals Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department

2017 ◽  
Vol 8 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Sonya Gabrielian ◽  
Jennifer C. Chen ◽  
Beena P. Minhaj ◽  
Rishi Manchanda ◽  
Lisa Altman ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Clinic ◽  
Care Clinic

Pediatric Emergency Department Resource Utilization among Children with Primary Care Clinic Contact in the Preceding 2 Days: A Cross-Sectional Study

2017 ◽  
Vol 188 ◽  
pp. 245-251.e2
Author(s):  
Christina K. Grech ◽  
Molly A. Laux ◽  
Heather L. Burrows ◽  
Michelle L. Macy ◽  
Elaine S. Pomeranz
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Resource Utilization ◽  
Primary Care Clinic ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Pediatric Emergency Department ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Clinic

Independent Parental Administration of Prednisone in Acute Asthma: A Double-Blind, Placebo-Controlled, Crossover Study

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 224-229
Author(s):  
Cameron C. Grant ◽  
Anne K. Duggan ◽  
Catherine DeAngelis
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Single Dose ◽  
Acute Asthma ◽  
Primary Care Clinic ◽  
Double Blind ◽  
Care Clinic ◽  
Double Blind Placebo ◽  
Outpatient Visits ◽  
Asthma Attack

Objective. To determine the effectiveness of a single dose of prednisone administered by a parent to a child early in an asthma attack. Design. A randomized, double-blind, placebo-controlled, crossover study with children enrolled for 12 months (6 months prednisone, 6 months placebo). Setting. A primary-care clinic and emergency department of an inner-city teaching hospital from March 1992 through May 1993. Children. Children 2 to 14 years of age enrolled in this clinic who had made two or more outpatient (emergency department or primary-care clinic) visits for acute asthma in the preceding year. Selection. There were 204 eligible children, of whom 86 were contacted and enrolled; of these, 78 (91%) completed the study. Intervention. Capsules containing prednisone (2 mg/kg up to 60 mg) or placebo. Parents were instructed to give their child one capsule for an asthma attack that had not improved after a dose of the child's regular acute asthma medicine. Measurements. Parents were interviewed every 3 months. Computerized patient records and chart reviews were used to verify parent reports. Outcome measures were the numbers of outpatient visits and hospitalizations for treatment of acute asthma. Results. Neither the total number of attacks nor the number for which medicine was used differed significantly by arm of study. There was a larger number of attacks resulting in outpatient visits when children were in the group that received prednisone (1.1 ± 0.59 versus 0.59 ± 0.86). This trend was less pronounced but persisted when limited to attacks for which the medicine was given (0.58 ± 0.99 versus 0.35 ± 0.55). Neither the number of attacks resulting in admission nor the number of hospital days differed significantly by arm of study. Conclusions. A single dose of prednisone available for use at home early in an asthma attack was associated with an increase in outpatient visits made for acute asthma. When prednisone was given for an attack, there was no reduction in outpatient visits. This intervention can not be recommended for children with asthma. These results should be confirmed in other pediatric populations.

Use of the emergency department by children enrolled in a primary care clinic

1985 ◽  
Vol 1 (2) ◽  
pp. 61-65
Author(s):  
CATHERINE DeANGELIS ◽  
MPH, PATRICIA FOSARELLI ◽  
ANNE KASZUBA DUGGAN
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Clinic ◽  
Care Clinic
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