Mass Gathering Medicine: A Predictive Model for Patient Presentation and Transport Rates

2001 ◽  
Vol 16 (3) ◽  
pp. 150-158 ◽  
Author(s):  
Paul Arbon ◽  
Franklin H.G. Bridgewater ◽  
Colleen Smith
Keyword(s):  
Health Care ◽  
Environmental Factors ◽  
Predictive Model ◽  
Regression Models ◽  
Health Care Services ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
Public Events ◽  
Care Services ◽  
Patient Presentation

AbstractIntroduction:This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to firstaid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings.Objective:To develop a data set and predictive model that can be applied across venues and types of mass gathering events that is not venue or event specific. Data collected will allow informed event planning for future mass gatherings for which health care services are required.Methods:Mass gatherings were defined as public events attended by in excess of 25,000 people. Over a period of 12 months, 201 mass gatherings attended by a combined audience in excess of 12 million people were surveyed through-out Australia. The survey was undertaken by St. John Ambulance Australia personnel. The researchers collected data on the incidence and type of patients presenting for treatment and on the environmental factors that may influence these presentations. A standard reporting format and definition of event geography was employed to overcome the event-specific nature of many previous surveys.Results:There are 11,956 patients in the sample. The patient presentation rate across all event types was 0.992/1,000 attendees, and the transportation-to-hospital rate was 0.027/1,000 persons in attendance. The rates of patient presentations declined slightly as crowd sizes increased. The weather (particularly the relative humidity) was related positively to an increase in the rates of presentations. Other factors that influenced the number and type of patients presenting were the mobility of the crowd, the availability of alcohol, the event being enclosed by a boundary, and the number of patient-care personnel on duty.Three regression models were developed to predict presentation rates at future events.Conclusions:Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.

Patient Presentation Trends at 15 Mass-Gathering Events in South Australia

2018 ◽  
Vol 33 (4) ◽  
pp. 368-374 ◽  
Author(s):  
Olga Anikeeva ◽  
Paul Arbon ◽  
Kathryn Zeitz ◽  
Murk Bottema ◽  
Adam Lund ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
South Australia ◽  
Well Being ◽  
Mass Gathering ◽  
Care Providers ◽  
Mass Gatherings ◽  
Being There ◽  
The Impact ◽  
Patient Presentation

AbstractIntroductionMass gatherings are complex events that present a unique set of challenges to attendees’ health and well-being. There are numerous factors that influence the number and type of injuries and illnesses that occur at these events, including weather, event and venue type, and crowd demographics and behavior.ProblemWhile the impact of some factors, such as weather conditions and the availability of alcohol, on patient presentations at mass gatherings have been described previously, the influence of many other variables, including crowd demographics, crowd behavior, and event type, is poorly understood. Furthermore, a large number of studies reporting on the influence of these variables on patient presentations are based on anecdotal evidence at a single mass-gathering event.MethodsData were collected by trained fieldworkers at 15 mass gatherings in South Australia and included event characteristics, crowd demographics, and weather. De-identified patient records were obtained from on-site health care providers. Data analysis included the calculation of patient proportions in each variable category, as well as the total number of patient presentations per event and the patient presentation rate (PPR).ResultsThe total number of expected attendees at the 15 mass gatherings was 303,500, of which 146 presented to on-site health care services. The majority of patient presentations occurred at events with a mean temperature between 20°C and 25°C. The PPR was more than double at events with a predominantly male crowd compared to events with a more equal sex distribution. Almost 90.0% of patient presentations occurred at events where alcohol was available.Conclusion:The results of the study suggest that several weather, crowd, and event variables influence the type and number of patient presentations observed at mass-gathering events. Given that the study sample size did not allow for these interactions to be quantified, further research is warranted to investigate the relationships between alcohol availability, crowd demographics, crowd mobility, venue design, and injuries and illnesses.Anikeeva O, Arbon P, Zeitz K, Bottema M, Lund A, Turris S, Steenkamp M. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368–374.

scholarly journals The Relations between Disability and Environmental Factors: A Pilot Study in Iranian Older Adults

2016 ◽  
Vol 8 (12) ◽  
pp. 87 ◽  
Author(s):  
Mohammadreza Shahbazi ◽  
Mahshid Foroughan ◽  
Mahdi Rahgozar ◽  
Reza Salmanroghani
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Environmental Factors ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
World Health ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Care Services ◽  
Health Organization

<p><strong>OBJECTIVE: </strong>This study explored disability and its correlations with the environmental factors in a group of Iranian older adults.</p><p><strong>MATERIALS &amp; METHODS</strong><strong>:</strong> A cross sectional study was performed. One hundred participants receiving adult day care services in Kahrizak center in Iran were selected by using the complete enumeration method. The World Health Organization Disability Assessment Schedule 2 (WHODAS II) and the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaires were used to collect data.</p><p><strong>RESULTS:</strong> The mean score of disability was 20.61±13.66, and the scores were higher in women compared to men (P=0.001). Among the CHIEF-25 items‚ the most frequently perceived barrier by the participants was transportation followed by home design and unavailability of health care services. There was a significant association between the disability scores and the environmental factors (P&lt;0.001). Also, significant relationships were found between the disability and all the subscales investigated in the study (polices‚ physical/structural‚ attitude/support‚ services/assistance) (P&lt;0.001).<strong></strong></p><p><strong>CONCLUSION: </strong>Appropriate transportation‚ availability to health care services and removing physical/structural barriers should be taken in consideration.</p>

Mass-gathering Events: The Role of Advanced Nurse Practitioners in Reducing Referrals to Local Health Care Agencies

2016 ◽  
Vol 31 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Anthony E. Kemp
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Nurse Practitioners ◽  
Health Care Services ◽  
Local Health ◽  
Medical Team ◽  
Mass Gathering ◽  
Care Services ◽  
Local Health Care

AbstractIntroductionThe introduction of advanced practitioner roles has challenged the traditional boundaries of health care. While studies have been undertaken to understand the role of physicians in respect of mass-gathering medicine, the role of advanced nurse practitioners (ANPs) has not been investigated.ProblemDoes the presence of an ANP reduce the referral rates of patients presenting for medical care at mass-gathering events to external health care resources?MethodsA prospective observational study was undertaken to determine whether the presence of an ANP would reduce the patient referral rate to external health care services by first aiders and paramedics working within an event medical team. Patients identified as requiring referral were reviewed by an ANP as part of the on-site medical provision for four mass-gathering events in the south of England. Additionally, information was gathered identifying which patients would have been transported to hospital by ambulance compared to those actually transported following ANP review. Statistical analysis was undertaken for three key measures (referrals to all local health resources, referrals to hospital-based acute services, and transfers to hospital by ambulance).ResultsA rounded total of 842,000 people attended four mass-gathering events held over 14 days. Of these, 652 presented for medical care, many self-referring.Using a one-tailed Fisher’s Exact Test and Phi analysis, this study demonstrated statistically significant reductions in the overall referral of patients to all external health care resources (P<.001; φ=0.44), to the emergency department (ED; P<.001; φ=0.43), and a reduction in ambulance transport (P<.001; φ=0.42). Effect size analysis demonstrated a medium-sized effect evident for all of the above, which was also demonstrated in economic terms.The event medical team would have referred 105 (16.3%) of the 652 patient presentations to external health care services; 47 (7.2%) would have been transported by ambulance. In comparison, the ANP referred 23 patients (3.5%) with 11 (1.7%) being transported by ambulance. It also was noted that the first aiders and paramedics could be more selective in their referral habits that were focused primarily on the ED.ConclusionsAppropriately trained and experienced ANPs working within event medical teams have a positive impact on referral rates from mass-gathering events.KempAE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.

Development of a Mass-Gathering Triage Tool: An Australian Perspective

2016 ◽  
Vol 32 (1) ◽  
pp. 101-105 ◽  
Author(s):  
Matt Cannon ◽  
Rebecca Roitman ◽  
Jamie Ranse ◽  
Julia Morphet
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Health Care Professionals ◽  
First Responders ◽  
Service Organizations ◽  
Mass Gathering ◽  
Publication Type ◽  
Mass Gatherings ◽  
Patient Presentation

AbstractMany health service organizations deploy first responders and health care professionals to mass gatherings to assess and manage injuries and illnesses. Patient presentation rates (PPRs) to on-site health services at a mass gathering range from 0.48-170 per 10,000 participants. Transport to hospital rates (TTHRs) range from 0.035-15 per 10,000 participants. The aim of this report was to outline the current literature pertaining to mass-gathering triage and to describe the development of a mass-gathering triage tool for use in the Australian context by first responders. The tool is based on the principles of triage, previous mass-gathering triage tools, existing Australian triage systems, and Australian contextual considerations. The model is designed to be appropriate for use by first responders.CannonM, RoitmanR, RanseJ, MorphetJ. Development of a mass-gathering triage tool: an Australian perspective. Prehosp Disaster Med. 2017;32(1): 101–105.

Impact of Patients Presenting with Alcohol and/or Drug Intoxication on In-Event Health Care Services at Mass-Gathering Events: An Integrative Literature Review

2018 ◽  
Vol 33 (5) ◽  
pp. 539-542 ◽  
Author(s):  
Makayla Bullock ◽  
Jamie Ranse ◽  
Alison Hutton
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Literature Review ◽  
Health Care Services ◽  
National Institutes Of Health ◽  
Mass Gathering ◽  
Inclusion Criteria ◽  
Music Festivals ◽  
Care Services ◽  
The Impact

AbstractBackgroundThere is a growing body of literature relating to mass-gathering events. A common thread amongst this literature, particularly the literature relating to music festivals, is the incidence of patients presenting with substance and/or alcohol intoxication. However, the impact of alcohol and/or drugs on the provision of in-event health care services has not been explored in detail.AimThe goal of this review was to develop an understanding of the impact of alcohol and/or drugs on in-event health care services at mass-gathering events.MethodThis paper used integrative review as a methodology. The articles included in this literature review were sourced by searching databases inclusive of Medline (Ovid; US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), Scopus (Elsevier; Amsterdam, Netherlands), PsycINFO (Ovid; American Psychological Association; Washington DC, USA), and Pub Med (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA). Identified manuscripts that met the inclusion criteria were thematically analyzed.ResultsIn total, 12 manuscripts met the inclusion criteria for this review. A thematic analysis of these manuscripts identified three main themes: (i) predictive factors, (ii) patient presentation rates, and (iii) levels of care.Conclusion:Substance use and/or intoxication can place a strain on in-event medical services at mass-gathering events. Of the various types of mass-gathering events, music festivals appear to be the most affected by substance use and intoxication.BullockM, RanseJ, HuttonA.Impact of patients presenting with alcohol and/or drug intoxication on in-event health care services at mass-gathering events: an integrative literature review. Prehosp Disaster Med. 2018;33(5):539–542.

scholarly journals A Review of the Condition of OPD Patients in Arba’een On-foot Pilgrimage in 2019

2021 ◽  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Mass Movement ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Mass Gathering ◽  
Cross Sectional ◽  
Mass Gatherings ◽  
Health History ◽  
The Way

Background: The annual religious ritual of Arba’een is the global largest mass gathering of pilgrims from different countries participating in a mass movement on an 80-km pathway to visit the Shrine of Imam Hussein, the grandson of Prophet Muhammad. The provision of health care for such a mass movement has always been an important vital issue for the health care system. Objectives: The current study investigated the common illnesses in addition to the quantity of health care services offered by temporary clinics and health stations located on the way to the shrine to such a mass gathering of on-feet pilgrims in Iraq in Arba’een 2019. Methods: This cross-sectional study was conducted at temporary clinics and health stations where pilgrims in need of nursing, midwifery, and pharmaceutical care were provided with services by general and expert physicians on the way from Najaf to Karbala in Iraq during a week in October 2019. Results: Imam Reza Temporary Clinic offered services to a total of 26,875 patients, including 9,934 females (36.96%) and 16,941 males (63.04%), on all days of the week. The most common chief complaint reported by the patients were musculoskeletal problems (n=11,945; 21.99%), foot blisters (n=11,372; 20.94%), and skin lesions (n=10,662; 19.62%). Conclusions: The present study highlighted the need for providing more organized services, especially in emergency health care, and necessity of paying further and closer attention to the significance of the health history of those pilgrims attending such religious mass gatherings in previous years.

Race and gender as factors in access to health insurance and utilization of health care services

2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Race And Gender ◽  
Care Services ◽  
Access To Health ◽  
And Gender
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