scholarly journals Healthcare utilization and satisfaction with treatment before and after direct discharge from the Emergency Department of simple stable musculoskeletal injuries in the Netherlands

2022 ◽  
Author(s):  
Thijs H. Geerdink ◽  
Jelle F. Spierings ◽  
Henk Jan Schuijt ◽  
Hubert A. J. Eversdijk ◽  
Johanna M. van Dongen ◽  
...  
Keyword(s):  
Emergency Department ◽  
The Netherlands ◽  
Healthcare Utilization ◽  
Musculoskeletal Injuries ◽  
Before And After ◽  
Satisfaction With Treatment ◽  
Direct Discharge

scholarly journals The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota

2020 ◽  
Author(s):  
Elizabeth A. Samuels ◽  
Lilla Orr ◽  
Elizabeth B. White ◽  
Altaf Saadi ◽  
Aasim I. Padela ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Emergency Department ◽  
Healthcare Utilization ◽  
The United States ◽  
Emergency Department Visits ◽  
Executive Order ◽  
Before And After ◽  
Muslim Majority ◽  
The Impact

AbstractObjectiveDetermine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States.MethodsWe conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses.ResultsIn early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations.ConclusionsIncreases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.

scholarly journals Healthcare Utilization Due to Suicide Attempts among Homeless Youth in New York State

2021 ◽  
Author(s):  
Rie Sakai-Bizmark ◽  
Hiraku Kumamaru ◽  
Dennys Estevez ◽  
Emily H Marr ◽  
Edith Haghnazarian ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Length Of Stay ◽  
Suicide Attempt ◽  
Healthcare Utilization ◽  
Regression Models ◽  
Homeless Youth ◽  
Suicide Attempts ◽  
New York State ◽  
Individual Characteristics

Abstract Suicide remains the leading cause of death among homeless youth. We assessed differences in healthcare utilization between homeless and non-homeless youth presenting to the emergency department or hospital after a suicide attempt. New York Statewide Inpatient and Emergency Department Databases (2009–2014) were used to identify homeless and non-homeless youth ages 10 to 17 who utilized healthcare services following a suicide attempt. To evaluate associations with homelessness, we used logistic regression models for mortality, use of violent means, intensive care unit utilization, log-transformed linear regression models for hospitalization cost, and negative binomial regression models for length of stay. All models were adjusted by individual characteristics with a hospital random effect and year fixed effect. We identified 18,026 suicide attempts with healthcare utilization rates of 347.2 (95% Confidence Interval [CI]: 317.5, 377.0) and 67.3 (95%CI: 66.3, 68.3) per 100,000 person-years for homeless and non-homeless youth, respectively. Length of stay for homeless youth was statistically longer than non-homeless youth (Incidence Rate Ratio 1.53; 95%CI: 1.32, 1.77). All homeless youth who visited the emergency department after a suicide attempt were subsequently hospitalized. This could suggest a higher acuity upon presentation among homeless youth compared with non-homeless youth. Interventions tailored to homeless youth should be developed.

Use of Ophthalmic Sonography to Evaluate for Intraocular Foreign Body in Both Outpatient and Emergency Department/Urgent Care Patients

2021 ◽  
pp. 875647932110332
Author(s):  
Patrick J. Fish
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Outpatient Setting ◽  
Intraocular Foreign Body ◽  
Urgent Care ◽  
Posterior Chamber ◽  
Emergency Department Setting ◽  
Before And After ◽  
Glass Metal

Intraocular foreign bodies (IOFB) present differently depending on the type of material (wood, glass, metal) for the IOFB, extent of the injury, and location of the injury. IOFB and the injury can cause a perforation or penetration of the globe which can require more extensive treatment including surgery. Proper evaluation of the IOFB and injury can help to determine extent of the injury, the prognosis of the vision, and health of the eye before and after treatment but may be difficult for the physician depending on the view of the posterior chamber being compromised by media or simply by patient sensitivity. The extent of the injury may also prevent proper evaluation due to swelling, lacerations on the lids, or pain. Proper ophthalmic sonography can provide a quick evaluation of the globe for any IOFB in both the outpatient setting as well as emergency department setting. Evaluation via sonography may allow the physician to accurately diagnose and properly treat the patient to help restore and prevent further loss of vision.

scholarly journals Changes in Online Psychoactive Substance Trade via Telegram during the COVID-19 Pandemic

2021 ◽  
pp. 1-6
Author(s):  
Matthijs Blankers ◽  
Daan van der Gouwe ◽  
Lavinia Stegemann ◽  
Laura Smit-Rigter
Keyword(s):  
Social Media ◽  
The Netherlands ◽  
Relative Increase ◽  
Lysergic Acid ◽  
Lysergic Acid Diethylamide ◽  
Psychoactive Substance ◽  
Before And After ◽  
Other Substances

<b><i>Background:</i></b> In this article, we present an evaluation of online psychoactive substance trade via Telegram, a free encrypted social media messenger service. The evaluation took place during the COVID-19 pandemic, which allowed us to monitor the effects of the spring 2020 lockdown in the Netherlands on substance trade via Telegram. <b><i>Objective:</i></b> The objective of this study was to evaluate whether changes in psychoactive substance trade on Telegram markets in the Netherlands can be observed during the COVID-19 pandemic. <b><i>Results:</i></b> Between December 2, 2019, and June 29, 2020, a total of 70,226 posts appeared in two analyzed Telegram groups. A total of 5,643 posts were psychoactive substance related. Based on the analyzed posts, Telegram is mostly a ‘“sellers” market as only a minority of the posts (6.3%) could be identified as a request for a substance. The proportion of posts related to specific substances varied between the periods before, during, and after the lockdown. The proportion of posts on the stimulants ecstasy, cocaine, and amphetamine was lower during the lockdown than before and after. For psychedelics – ketamine, lysergic acid diethylamide (LSD), and 2,5-dimethoxy-4-bromophenethylamine (2C-B) – and other substances, there was a relative increase in the number of posts during the lockdown, which was maintained after the lockdown. <b><i>Conclusions:</i></b> Telegram analysis shows that in the Netherlands, online psychoactive substance trade may have been affected during the COVID-19 pandemic. The direction of this effect was different for different classes of substances.

scholarly journals Paediatric attendances of the emergency department in a major Irish tertiary referral centre before and after expansion of free GP care to children under 6: a retrospective observational study

2021 ◽  
Vol 5 (1) ◽  
pp. e000862
Author(s):  
Irina Korotchikova ◽  
Sukainah Al Khalaf ◽  
Ewa Sheridan ◽  
Rory O'Brien ◽  
Colin P Bradley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Observational Study ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Period 2 ◽  
Time Period ◽  
Before And After ◽  
Gp Care

ObjectivesTo examine the characteristics of paediatric attendances to the emergency department (ED) in Cork University Hospital (CUH) before and after the expansion of free general practitioner (GP) care to children under the age of 6 years.DesignThis is a retrospective observational study that used a large administrative dataset.SettingThe study was conducted in major Irish tertiary referral centre that serves a total population of over 1.1 million. It is a public hospital, owned and managed by the health service executive.ParticipantsChildren aged 0–15 years who attended CUH ED during the study period of 6 years (2012–2018) were included in this study (n=76 831).InterventionsFree GP care was expanded to all children aged 0–5 years in July 2015.Main outcome measuresPaediatric attendances to CUH ED were examined before (Time Period 1: July 2012–June 2015) and after (Time Period 2: July 2015–June 2018) the expansion of free GP care to children under 6. Changes in GP referral rates and inpatient hospital admissions were investigated.ResultsPaediatric presentations to CUH ED increased from 35 819 during the Time Period 1 to 41 012 during the Time Period 2 (14.5%). The proportion of the CUH ED attendances through GP referrals by children under 6 increased by over 8% in the Time Period 2 (from 10 148 to 14 028). Although the number of all children who attended CUH ED and were admitted to hospital increased in Time Period 2 (from 8704 to 9320); the proportion of children in the 0–5 years group who attended the CUH ED through GP referral and were subsequently admitted to hospital, decreased by over 3%.ConclusionThe expansion of free GP care has upstream health service utilisation implications, such as increased attendances at ED, and should be considered and costed by policy-makers.

scholarly journals Predicting emergency department visits in a large teaching hospital

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Nathan Singh Erkamp ◽  
Dirk Hendrikus van Dalen ◽  
Esther de Vries
Keyword(s):  
Emergency Department ◽  
The Netherlands ◽  
Teaching Hospital ◽  
Time Trend ◽  
Prediction Models ◽  
Emergency Department Visits ◽  
Weather Data ◽  
Negative Consequences ◽  
Weather Variables ◽  
Ed Visits

Abstract Background Emergency department (ED) visits show a high volatility over time. Therefore, EDs are likely to be crowded at peak-volume moments. ED crowding is a widely reported problem with negative consequences for patients as well as staff. Previous studies on the predictive value of weather variables on ED visits show conflicting results. Also, no such studies were performed in the Netherlands. Therefore, we evaluated prediction models for the number of ED visits in our large the Netherlands teaching hospital based on calendar and weather variables as potential predictors. Methods Data on all ED visits from June 2016 until December 31, 2019, were extracted. The 2016–2018 data were used as training set, the 2019 data as test set. Weather data were extracted from three publicly available datasets from the Royal Netherlands Meteorological Institute. Weather observations in proximity of the hospital were used to predict the weather in the hospital’s catchment area by applying the inverse distance weighting interpolation method. The predictability of daily ED visits was examined by creating linear prediction models using stepwise selection; the mean absolute percentage error (MAPE) was used as measurement of fit. Results The number of daily ED visits shows a positive time trend and a large impact of calendar events (higher on Mondays and Fridays, lower on Saturdays and Sundays, higher at special times such as carnival, lower in holidays falling on Monday through Saturday, and summer vacation). The weather itself was a better predictor than weather volatility, but only showed a small effect; the calendar-only prediction model had very similar coefficients to the calendar+weather model for the days of the week, time trend, and special time periods (both MAPE’s were 8.7%). Conclusions Because of this similar performance, and the inaccuracy caused by weather forecasts, we decided the calendar-only model would be most useful in our hospital; it can probably be transferred for use in EDs of the same size and in a similar region. However, the variability in ED visits is considerable. Therefore, one should always anticipate potential unforeseen spikes and dips in ED visits that are not shown by the model.

scholarly journals Comparison of fit factors among healthcare providers working in the Emergency Department Center before and after training with three types of N95 and higher filter respirators

Medicine ◽  
2019 ◽  
Vol 98 (6) ◽  
pp. e14250 ◽  
Author(s):  
Hongjung Kim ◽  
Juncheol Lee ◽  
Sanghyun Lee ◽  
Jaehoon Oh ◽  
Boseung Kang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Providers ◽  
Before And After

scholarly journals A Structured Curriculum for Interprofessional Training of Emergency Medicine Interns

2019 ◽  
Vol 21 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Ashley Rider ◽  
Tiffany Anaebere ◽  
Mariko Nomura ◽  
David Duong ◽  
Charlotte Wills
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Interprofessional Education ◽  
Hospital Setting ◽  
Scope Of Practice ◽  
Registered Nursing ◽  
Interprofessional Training ◽  
Before And After ◽  
Team Based Care ◽  
Improve Health

Interprofessional education (IPE) has been shown to improve health outcomes and patient satisfaction. IPE is now represented in the Accreditation Council for Graduate Medical Education’s emergency medicine (EM) milestones given the team-based nature of EM. The Highland Allied Health Rotation Program (H-AHRP) was developed by residents to enhance and standardize IPE for EM residents in a single hospital setting. H-AHRP was incorporated into the orientation month for interns starting in the summer of 2016. EM interns were paired with emergency department preceptors in registered nursing (RN), respiratory therapy (RT), pharmacy (PH), laboratory (LAB), and social work (SW) in either a four-hour shadowing experience (RN, RT, PH) or lecture-based overview (LAB, SW). We conducted a survey before and after the program. Overall, the EM interns reported an improved understanding of the scope of practice and day-to-day logistics after working with the preceptors. They found the program helpful to their future as physicians and would recommend it to other residencies. The H-AHRP program allows for the early incorporation of IPE into EM training, enhances interns’ understanding of both the scope and logistics of their colleagues, and is a well-received effort at improving team-based care.

scholarly journals Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Phase ◽  
Mainland China ◽  
Hospital Setting ◽  
Academic Hospital ◽  
Significant Difference ◽  
Before And After ◽  
Life Threatening ◽  
The Mean ◽  
Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

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