scholarly journals LO091: Non-urgent presentations to the emergency department: patients’ reasons for presentation

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S61-S61
Author(s):  
L. Krebs ◽  
R. Chetram ◽  
S.W. Kirkland ◽  
T. Nikel ◽  
B. Voaklander ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Concern ◽  
Patient Centeredness ◽  
Care Needs ◽  
Appropriateness Of Care ◽  
Access To Health ◽  
Access To Primary Care ◽  
Emergency Department Patients

Introduction: Some low acuity Emergency Department (ED) presentations are considered non-urgent or convenience visits and potentially avoidable with improved access to primary care. This study explored self-reported reasons why non-urgent patients presented to the ED. Methods: Patients, 17 years and older, were randomly selected from electronic registration records at three urban EDs in Edmonton, Alberta (AB), Canada during weekdays (0700 to 1900). A 47-item questionnaire was completed by each consenting patient, which included items on whether the patient believed the ED was their best care option and the rationale supporting their response. A thematic content analysis was performed on the responses, using previous experience and review of the literature to identify themes. Results: Of the 2144 eligible patients, 1408 (65.7%) questionnaires were returned, and 1402 (65.4%) were analyzed. For patients who felt the ED was their best option (n = 1234, 89.3%), rationales included: safety concerns (n = 309), effectiveness of ED care (n = 284), patient-centeredness of ED (n = 277), and access to health care professionals in the ED (n = 204). For patients who felt the ED was not their best care option (n = 148, 10.7%), rationales included a perception that: access to health professionals outside the ED was preferable (n = 39), patient-centeredness (particularly timeliness) was lacking in the ED (n = 26), and their health concern was not important enough to require ED care (n = 18). Conclusion: Even during times when alternative care options are available, the majority of non-urgent patients perceived the ED to be the most appropriate location for care. These results highlight that simple triage scores do not accurately reflect the appropriateness of care and that understanding the diverse and multi-faceted reasons for ED presentation are necessary to implement strategies to support non-urgent, low acuity care needs.

scholarly journals Forum: equity in access to health care. Introduction

2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
Care Access ◽  
Unethical Practices ◽  
Access To Health ◽  
Care Systems ◽  
Equity In Access

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.

Videoconferencing and Dietitian Services: In Rural Ontario Communities

2012 ◽  
Vol 73 (4) ◽  
pp. 176-180
Author(s):  
Diana Stenlund
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Services ◽  
Future Research ◽  
Short Supply ◽  
Care Services ◽  
Alternative Approach ◽  
Access To Health

Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.

scholarly journals Content Validation of a Novel Screening Tool to Identify Emergency Department Patients With Significant Palliative Care Needs

2015 ◽  
Vol 22 (7) ◽  
pp. 823-837 ◽  
Author(s):  
Naomi George ◽  
Nina Barrett ◽  
Laura McPeake ◽  
Rebecca Goett ◽  
Kelsey Anderson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Screening Tool ◽  
Content Validation ◽  
Care Needs ◽  
Emergency Department Patients ◽  
Palliative Care Needs

scholarly journals Gender Differences in Access to Health Care among the Elderly: Evidence from Southeast Asia

2021 ◽  
Vol 38 (02) ◽  
pp. 59-92
Author(s):  
YANA VAN DER MEULEN RODGERS ◽  
JOSEPH E. ZVEGLICH
Keyword(s):  
Health Care ◽  
Gender Difference ◽  
Southeast Asia ◽  
Access To Health Care ◽  
Household Survey ◽  
The Elderly ◽  
The Philippines ◽  
Viet Nam ◽  
Care Needs ◽  
Access To Health

Populations become increasingly feminized with age. Since older women are more vulnerable to poverty, they may find it more difficult than men to access health care. This study examines factors that may constrain older persons in Southeast Asia from meeting their health-care needs when sick. Our analysis of household survey data from Cambodia, the Philippines, and Viet Nam shows that women are more likely to have reported sickness or injury than men, a difference that is meaningful and statistically significant. While women in Cambodia and the Philippines are more likely to seek treatment than men, the gender difference is reversed in Viet Nam where the stigma and discrimination associated with some diseases may more strongly deter women. The probability of seeking treatment rises with age more sharply for women than men in all countries. However, for the subsample of elders, the gender difference is not significant.

Supporting older military veterans in the rural US

2018 ◽  
Vol 19 (4) ◽  
pp. 286-297
Author(s):  
Bret Hicken ◽  
Kimber Parry
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Veterans Health ◽  
Health Administration ◽  
Care Needs ◽  
Content Type ◽  
Access To Health ◽  
The Us

Purpose The purpose of this paper is to provide an overview of rural older veterans in the US and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas. Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans. Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas. Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans.

The Importance of Telemedicine in Global Health Care

2017 ◽  
pp. 860-880
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Global Health ◽  
Technology Acceptance ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Gas Industry ◽  
Access To Health ◽  
Care Systems ◽  
Global Health Care ◽  
Acceptance Model

The chapter explains the challenges facing health care systems; the overview of telemedicine; the technological devices of telemedicine systems; telemedicine and chronic diseases; telemedicine and technology acceptance model (TAM); the applications of telemedicine in the oil and gas industry; and the importance of telemedicine in global health care. Telemedicine brings the health care value through its ability for the remote visits with patients, immediate access to health care professionals, real-time access to health data, and health monitoring capabilities. Telemedicine is an effective health care measure that can manage the new and affordable technology with the potential to deliver the convenient and effective care to patients, and provides an alternative way for the health care organizations to deliver the essential health outcomes. The chapter argues that applying telemedicine has the potential to increase health care performance and gain sustainable competitive advantage in global health care.

The Importance of Telemedicine in Global Health Care

2017 ◽  
pp. 157-177 ◽  
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Global Health ◽  
Technology Acceptance ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Gas Industry ◽  
Access To Health ◽  
Care Systems ◽  
Global Health Care ◽  
Acceptance Model

The chapter explains the challenges facing health care systems; the overview of telemedicine; the technological devices of telemedicine systems; telemedicine and chronic diseases; telemedicine and technology acceptance model (TAM); the applications of telemedicine in the oil and gas industry; and the importance of telemedicine in global health care. Telemedicine brings the health care value through its ability for the remote visits with patients, immediate access to health care professionals, real-time access to health data, and health monitoring capabilities. Telemedicine is an effective health care measure that can manage the new and affordable technology with the potential to deliver the convenient and effective care to patients, and provides an alternative way for the health care organizations to deliver the essential health outcomes. The chapter argues that applying telemedicine has the potential to increase health care performance and gain sustainable competitive advantage in global health care.

scholarly journals LO37: Prevalence of cigarette smoking amongst adult emergency department patients

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S20-S21
Author(s):  
A. Tolmie ◽  
R. Erker ◽  
T. Oyedokun ◽  
E. Sullivan ◽  
T. Graham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cigarette Smoking ◽  
Intervention Program ◽  
Smoking Prevalence ◽  
Health Concern ◽  
Chi Square ◽  
Smoking Cessation Counselling ◽  
Chief Complaints ◽  
Statistics Canada ◽  
Emergency Department Patients

Introduction: Tobacco smoking is a priority public health concern, and a leading cause of death and disability globally. While the smoking prevalence in Canada is approximately 13-18%, the proportion of smokers among emergency department (ED) patients has been found to be significantly higher. This disparity primes the emergency department as a critical environment to provide smoking cessation counselling and support. Methods: A verbal questionnaire was administered to adult patients (18+) presenting to Royal University, Saskatoon City, and St. Paul's Hospital ED's. Patients were excluded if they were underage, too ill, or physically/mentally unable to complete the questionnaire independently. Patients’ smoking habits were also correlated with Fagerstrom tobacco dependence scores, chief complaints, Canadian Triage Acuity Scale (CTAS) scores, and willingness to partake in ED specific cessation counselling. Data were analyzed using IBM SPSS software to determine smoking prevalence and compared to Statistics Canada data using chi-square tests. Results: In total, 1190 eligible patients were approached, and 1078 completed the questionnaire. Adult Saskatoon ED patients demonstrated a cigarette smoking prevalence of 19.6%, which is significantly higher than the general adult Saskatchewan public at 15.1% (p < 0.0001). Comparing smoking and non-smoking cohorts, there are no significant differences in CTAS scores (p = 0.60). Of the proposed cessation interventions, ED cessation counselling was most popular among patients (62.4%), followed by receiving a pamphlet (56.2%), and being contacted by a smokers’ quit line (49.5%). Out of the smoking cohort, 51.4% indicated they want to quit smoking, and would be willing to partake in ED-specific cessation counselling, if available. Additionally, 88.1% of current smokers started smoking when they were less than 19 years old. Conclusion: The higher smoking prevalence demonstrated in ED patients highlights the need for a targeted intervention program that is feasible for the fast-paced environment. Quit attempts have been demonstrated to be more efficacious with repeated interventions, which could be achieved by training ED staff to conduct brief motivational interviews and faxing referrals to a smokers' quit line for follow-up. Furthermore, pediatric ED's could be a valuable location for cigarette smoking screening, as the majority began smoking in their adolescence.

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