scholarly journals EMERGENCY ROOM AND PRIMARY CARE SERVICES UTILIZATION AND ASSOCIATED ALCOHOL AND DRUG USE IN THE UNITED STATES GENERAL POPULATION

1999 ◽  
Vol 34 (4) ◽  
pp. 581-589 ◽  
Author(s):  
C. J. Cherpitel
Keyword(s):  
United States ◽  
Primary Care ◽  
Drug Use ◽  
General Population ◽  
Emergency Room ◽  
The United States ◽  
Alcohol And Drug Use ◽  
Services Utilization ◽  
Care Services ◽  
Primary Care Services

scholarly journals Strengthening Integrated Care Through Population-Focused Primary Care Services: International Experiences Outside the United States

2017 ◽  
Vol 38 (1) ◽  
pp. 413-429 ◽  
Author(s):  
Rene Loewenson ◽  
Sarah Simpson
Keyword(s):  
United States ◽  
Primary Care ◽  
Population Health ◽  
The United States ◽  
Learning Networks ◽  
Middle Income ◽  
Care Services ◽  
Primary Care Services ◽  
Community Roles ◽  
A Site

Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health–oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles. It presents ways in which early first contact and continuity of PC, PC coordination of referral, multidisciplinary team approaches, investment in PC competencies, and specific payment and incentive models have all supported comprehensive approaches. These experiences locate PC as a site of innovation, where information technology and peer-to-peer learning networks support learning from practice.

Contacts with health services during the year prior to suicide death in France (2013-2015)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Laanani ◽  
C Imbaud ◽  
P Tuppin ◽  
C Poulalhon ◽  
F Jollant ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
General Population ◽  
Health Services ◽  
Emergency Room ◽  
General Practitioners ◽  
National Health ◽  
Physical Conditions ◽  
Care Services ◽  
Primary Care Services

Abstract Background This study was designed to describe contacts with health services during the year before suicide death in France, and to compare the prevalent mental and physical conditions in these people to those of the general population. Methods Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals, national health insurance general scheme beneficiaries (i.e. 76% of the population living in France), aged 15 years or older, who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population. Results The study included 19,144 suicide decedents. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room (46.2% of suicide decedents consulted a general practitioner during the month before death, 16.7% attended an emergency room). During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold (SPR 95% CI: 7.7-8.1) more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3, 95% CI: 3.1-3.6) and epilepsy (SPR=2.7, 95% CI: 2.4-3.0). Conclusions General practitioners and emergency departments have frequent contacts with suicide decedents during the last weeks before death and are at the forefront of suicide risk identification and prevention in individuals with mental, but also physical conditions. Key messages Mental and physical conditions are more common among suicide decedents than in the general population, and contacts with primary care services are frequent in the last weeks prior to suicide. Primary care services (general practitioners and emergency rooms) should be targeted for suicide preventive interventions.

Competition and Primary Care in the United States: Separating Fact from Fancy

1986 ◽  
Vol 16 (1) ◽  
pp. 57-69 ◽  
Author(s):  
Laura Siminoff
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Care ◽  
Health Care Costs ◽  
The United States ◽  
Health Care Sector ◽  
Competitive Strategies ◽  
Care Services ◽  
Primary Care Services ◽  
Care Costs

Competitive strategies have been advocated as the solution for the economic ills of the U.S. economy. During the 1980s many economists and health care practitioners are arguing that a competitive strategy will bring down health care costs; these plans emphasize the existence of perverse incentives which reward cost reducing behavior with less revenue. Competitive strategies assume the existence of a “health care marketplace.” Historically, the United States health care sector has not conformed to the ideal of the competitive market because of the special characteristics involved in the production and consumption of health care. Consumers have the least power in the health care sector and yet most competitive proposals are explicitly directed at changing consumer behavior, especially in the area of primary care. Much evidence indicates that competitive plans inhibit consumers from using primary care services, increase long-term health care costs, and ultimately require more government regulatory action.

Impact of alcohol and drug use on bicycle and electric scooter injuries and hospital admissions in the United States

Trauma ◽  
2021 ◽  
pp. 146040862110443
Author(s):  
Nikan K Namiri ◽  
Austin W Lee ◽  
Gregory M Amend ◽  
Jason Vargo ◽  
Benjamin N Breyer
Keyword(s):  
United States ◽  
Drug Use ◽  
Head Trauma ◽  
Hospital Admissions ◽  
Body Part ◽  
The United States ◽  
Severe Injuries ◽  
Injury Surveillance System ◽  
Alcohol And Drug Use ◽  
Awareness Campaigns

Introduction Bicycles and electric scooters (e-scooters) are convenient and accessible means of transportation. Participant safety is contingent on available infrastructure and safe riding practices including not riding while intoxicated. Understanding national prevalence and injury characteristics of bicycle and e-scooter riders who ride while intoxicated may promote awareness campaigns for safe riding practices and decrease morbidity. Methods The National Electronic Injury Surveillance System (NEISS) provides national estimates of injuries that present to emergency departments across the United States. We obtained case information on admitting status, body part injured, diagnosis of injury, age, sex, alcohol usage, and drug usage. We then queried NEISS for injuries related to bicycles and e-scooters in 2019. Results A weighted total of 270,571 (95% confidence interval (CI): 204,517–336,625) bicycle injuries occurred in the United States during 2019; alcohol and drug use were associated with 7% (95% CI: 6–9) and 2% (95% CI: 2–3) of all injuries, respectively. Twenty-four percent (CI: 18--31) of alcohol- and 29% (95% CI: 20–41) of drug-related bicycle injuries resulted in hospital admissions, compared to 15% (95% CI: 12–17) of non–alcohol- and 15% (95% CI: 13–18) of non–drug-related injuries ( p < .001 and p = .002, respectively). A total of 28,702 (95% CI: 13,975–43,428) e-scooter injuries occurred in 2019; alcohol and drug use were associated with 8% (95% CI: 5–12) and 1% (95% CI: 1–2) of injuries, respectively. Sixty percent (95% CI: 47–72) of alcohol-related e-scooter injuries resulted in head trauma, compared to 28% (95% CI: 24–32) of non–alcohol-related injuries ( p < .001). Conclusions Intoxication is associated with increasingly severe injuries, hospital admissions, and head trauma in bicycle and e-scooter riders. The findings support awareness campaigns to educate riders about risky practices, improve non-auto infrastructure, and promote helmet usage.

Alcohol and Drug Use and Abuse among Indian-Americans: A Review of Issues and Sources

1976 ◽  
Vol 6 (3) ◽  
pp. 256-272 ◽  
Author(s):  
C. Adrian Heidenreich
Keyword(s):  
United States ◽  
Drug Use ◽  
Urban Areas ◽  
The United States ◽  
Alcohol And Drug Use ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Prevention And Treatment ◽  
Alcohol And Drug Abuse ◽  
Local Levels

There is much concern that alcohol and drug abuse are among the top problems in the United States generally, and also a “high priority” health and social problem among Indians. For that reason, there have been numerous programs of education, prevention, and treatment directed toward and developed in Indian communities. Nevertheless, many personnel at both national and local levels and in both rural and urban areas lack adequate acquaintance with pertinent conceptual issues and sources on alcohol and drug use and abuse among Indians specifically. The purpose of this article is to help remedy that lack by reviewing the range of literature and presenting an overview of some of the major perspectives which should inform any approach to Indian alcohol and drug use and abuse.

Sign in / Sign up

Export Citation Format

Share Document