Demographic factors influencing nonurgent emergency department utilization among a Medicaid population

Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.

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Demographic Factors Influencing Discharge Against Medical Advice (AMA) in Patients with Upper Gastrointestinal Bleeding and Abdominal Pain: A Study of 170 Emergency Department Discharges Against Medical Advice

The American Journal of Gastroenterology ◽

10.14309/00000434-201310001-01655 ◽

2013 ◽

Vol 108 ◽

pp. S496

Author(s):

Arunkumar Muthusamy ◽

Rajesh Krishnamoorthi ◽

Palaniappan Manickam ◽

Mitchell Cappell

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Demographic Factors ◽

Medical Advice ◽

Against Medical Advice ◽

Factors Influencing ◽

Discharge Against Medical Advice ◽

Upper Gastrointestinal

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Hospital and demographic factors influence emergency department triage of patients with mini-strokes

PsycEXTRA Dataset ◽

10.1037/e504282010-025 ◽

2008 ◽

Keyword(s):

Emergency Department ◽

Demographic Factors ◽

Emergency Department Triage

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Patterns of psychiatric emergency department utilization among community-dwelling Medicare beneficiaries under 65.

Psychological Services ◽

10.1037/ser0000092 ◽

2017 ◽

Vol 14 (3) ◽

pp. 387-396

Author(s):

Jingjing Qian ◽

Saranrat Wittayanukorn ◽

Richard A. Hansen

Keyword(s):

Emergency Department ◽

Community Dwelling ◽

Psychiatric Emergency ◽

Emergency Department Utilization ◽

Medicare Beneficiaries

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Factors influencing decision making for implementing e-health in light of the COVID-19 outbreak in Gulf Cooperation Council countries

International Health ◽

10.1093/inthealth/ihab003 ◽

2021 ◽

Author(s):

Fahad M Al-Anezi

Keyword(s):

Decision Making ◽

United Arab Emirates ◽

Healthcare Access ◽

Demographic Factors ◽

Quality Of Healthcare ◽

Healthcare Services ◽

Gulf Cooperation Council ◽

Factors Influencing ◽

Electronic Health ◽

Novel Coronavirus

Abstract Background Electronic health (e-health) approaches such as telemedicine, mobile health, virtual healthcare and electronic health records are considered to be effective in increasing access to healthcare services, reducing operational costs and improving the quality of healthcare services during the coronavirus disease 2019 (COVID-19) outbreak, a pandemic resulting from the spread of a novel coronavirus discovered in December 2019. In this context, the aim of this study was to identify the most important factors influencing decision making on the implementation of e-health in Gulf Cooperation Council (GCC) member states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates), which are in the process of digitizing healthcare services. Methods This study reviewed the literature to identify the important factors influencing decision making on e-health. In addition, a questionnaire-based survey was conducted in order to identify the most important criteria to be considered in decision making on e-health. The survey link was forwarded to 978 healthcare practitioners and 42 experts (purposive sampling), from which a final sample of 892 (864 practitioners and 28 experts) was achieved, reflecting a response rate of 87.45%. Results Of the 44 factors identified under seven themes (strategic, quality, management, technology, function characteristics, economic, sociocultural and demographic factors), 22 factors were identified to be the most important criteria. Conclusions Findings from this study suggest that decision making in relation to e-health is a complex process that requires consideration of various factors. It was also found that attention should be paid to sociocultural and demographic factors, which may need to be considered in increasing healthcare access during the COVID-19 outbreak.

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Assessment of a multi-center tele-urgent care program to decrease emergency department referral rates in the Veterans Health Administration

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211024843 ◽

2021 ◽

pp. 1357633X2110248

Author(s):

Charlie M Wray ◽

Myla Junge ◽

Salomeh Keyhani ◽

Janeen E Smith

Keyword(s):

Emergency Department ◽

Emergency Department Visit ◽

Care Program ◽

Urgent Care ◽

Emergency Department Utilization ◽

Emergency Department Care ◽

Referral Rates ◽

Care Assessment ◽

The Impact ◽

Care Evaluation

The use of emergency departments for non-emergent issues has led to overcrowding and decreased the quality of care. Telemedicine may be a mechanism to decrease overutilization of this expensive resource. From April to September 2020, we assessed (a) the impact of a multi-center tele-urgent care program on emergency department referral rates and (b) the proportion of individuals who had a subsequent emergency department visit within 72 h of tele-urgent care evaluation when they were not referred to the emergency department. We then performed a chart review to assess whether patients presented to the emergency department for the same reason as was stated for their tele-urgent care evaluation, whether subsequent hospitalization was needed during that emergency department visit, and whether death occurred. Among the 2510 patients who would have been referred to in-person emergency department care, but instead received tele-urgent care assessment, one in five (21%; n = 533) were subsequently referred to the emergency department. Among those not referred following tele-urgent care, 1 in 10 (11%; n = 162) visited the emergency department within 72 h. Among these 162 individuals, most (91%) returned with the same or similar complaint as what was assessed during their tele-urgent care visit, with one in five requiring hospitalization (19%, n = 31) with one individual (0.01%) dying. In conclusion, tele-urgent care may safely decrease emergency department utilization.

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Patients with first versus multiple episodes of self-harm: how do their profiles differ?

Annals of General Psychiatry ◽

10.1186/s12991-021-00351-5 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Philippe Golay ◽

Louise Ostertag ◽

Alessandra Costanza ◽

Bénédicte Van der Vaeren ◽

Yves Dorogi ◽

...

Keyword(s):

Emergency Department ◽

Personality Disorder ◽

Suicide Attempt ◽

Professional Activity ◽

Suicidal Risk ◽

Factors Influencing ◽

Several Variables ◽

French Speaking ◽

Self Harm ◽

Multiple Episodes

Abstract Background Self-harm (SH) is among the strongest predictors of further episodes of SH, suicide attempt, and death by suicide. People who repeteadly harm themselves are at even higher risk for suicide. Factors influencing the repetition are important to identify when assessing suicidal risk and thereafter to offer specific interventions. Therefore, this study aimed to compare first versus multiple episodes characteristics in a large sample of patients in french-speaking Switzerland. Method We used the database from the French-speaking Swiss program for monitoring SH. Data of the psychiatric assessment of all adults admitted for SH were collected in the emergency department of four Swiss city hospitals between December 2016 and October 2019. Results 1730 episodes of SH were included. Several variables were significantly associated with multiple episodes, including diagnosis (over representation of personality disorders and under representation of anxiety disorders), professional activity (Invalidity insurance more frequent) and prior psychiatry care. Conclusions Patients suffering from a personality disorder and those with invalidity insurance are at risk for multiple episodes of SH and should be targeted with specific interventions.

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