scholarly journals LB18. Healthcare Utilization for Acute Respiratory Illness by Race/Ethnicity across Ambulatory, Emergency, and Hospital Settings

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S814-S815
Author(s):  
Alexandra M Mellis ◽  
Matthew Gilmer ◽  
Carrie Reed
Keyword(s):  
Emergency Department ◽  
Ambulatory Care ◽  
Ethnic Group ◽  
Healthcare Utilization ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Emergency Visits ◽  
Healthcare Settings ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Given the disproportionate impact of COVID-19 among racial/ethnic minority groups across the United States on emergency visits, hospitalizations, and deaths, we examined healthcare utilization more broadly for acute respiratory illness (ARI across healthcare settings by racial/ethnic group. Methods Using data on 33,992,254 unique nonpharmacy healthcare encounters from the IBM Explorys Electronic Health Record database from January 1, 2020–May 1, 2021, across healthcare settings (ambulatory care or telehealth, emergency department, and hospitalizations) with nonmissing bridged racial/ethnic data. Encounters were classified as ARI based on ICD-10 and SNOMED codes and aggregated by month and US Census region. We estimated the population denominator as the total number of persons by bridged racial/ethnic group with encounters recorded during 2019. We both estimated the rate of ARI visits per 100,000 persons across healthcare settings and the rate ratio of ARI visits to non-ARI visits. We performed comparisons of these values by race/ethnicity, taking White persons as referent, using Poisson generalized estimating equations clustered within geographic regions. Results A total of 244,137 (6.5% of 3,745,135) hospitalizations, 237,873 (18% of 1,305,474) emergency visits, and 1,636,383 (5.7% of 28,941,645) ambulatory visits were associated with ARIs. We observed similar rates of ARI visits across race/ethnicity groups in all settings combined and in ambulatory settings, but higher rates of ARI hospitalization among Hispanic persons (IRR [95% CI]: 2.5 [1.7–3.7]) and higher rates of ARI emergency department visits among Black persons (2.5 [1.9–3.2]) (Figure). We also observed differences in the relative proportion of care received for ARI vs. other visits types by setting, for example with Black persons utilizing higher rates of hospital visits for ARI vs non-ARI care (2.2 [1.7–2.7]) but lower rates of ambulatory care for ARI (0.9 [0.7–0.96]). ARI Visits Per 100k Persons Conclusion Population rates of ARI visits and relative proportions of ARI vs. non ARI visits differed between racial/ethnic groups by setting. Understanding how utilization of care varies for ARI across settings can inform future monitoring efforts for health equity. Disclosures All Authors: No reported disclosures

scholarly journals Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during 4 influenza seasons: 2010–2011 to 2013–2014

2019 ◽  
Vol 40 (8) ◽  
pp. 889-896 ◽  
Author(s):  
Lili Jiang ◽  
Allison McGeer ◽  
Shelly McNeil ◽  
Kevin Katz ◽  
Mark Loeb ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Multivariable Analysis ◽  
Respiratory Illness ◽  
Respiratory Viruses ◽  
Onset Date ◽  
Adjusted Relative Risk ◽  
Acute Respiratory Illness ◽  
Illness Onset ◽  
Factors Associated ◽  
Healthcare Settings

AbstractBackground:Healthcare workers (HCWs) are at risk of acquiring and transmitting respiratory viruses while working in healthcare settings.Objectives:To investigate the incidence of and factors associated with HCWs working during an acute respiratory illness (ARI).Methods:HCWs from 9 Canadian hospitals were prospectively enrolled in active surveillance for ARI during the 2010–2011 to 2013–2014 influenza seasons. Daily illness diaries during ARI episodes collected information on symptoms and work attendance.Results:At least 1 ARI episode was reported by 50.4% of participants each study season. Overall, 94.6% of ill individuals reported working at least 1 day while symptomatic, resulting in an estimated 1.9 days of working while symptomatic and 0.5 days of absence during an ARI per participant season. In multivariable analysis, the adjusted relative risk of working while symptomatic was higher for physicians and lower for nurses relative to other HCWs. Participants were more likely to work if symptoms were less severe and on the illness onset date compared to subsequent days. The most cited reason for working while symptomatic was that symptoms were mild and the HCW felt well enough to work (67%). Participants were more likely to state that they could not afford to stay home if they did not have paid sick leave and were younger.Conclusions:HCWs worked during most episodes of ARI, most often because their symptoms were mild. Further data are needed to understand how best to balance the costs and risks of absenteeism versus those associated with working while ill.

Disproportionate Minority Contact

Sexual Abuse ◽  
2016 ◽  
Vol 29 (3) ◽  
pp. 291-308 ◽  
Author(s):  
Rebecca L. Fix ◽  
Melissa A. Cyperski ◽  
Barry R. Burkhart
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Ethnic Group ◽  
Sexual Offenders ◽  
Justice System ◽  
Risk Scores ◽  
Disproportionate Minority Contact ◽  
Sexual Offenses ◽  
Race Ethnicity ◽  
Racial Ethnic

The overrepresentation of racial/ethnic minorities within the criminal justice system relative to their population percentage, a phenomenon termed disproportionate minority contact, has been examined within general adult and adolescent offender populations; yet few studies have tested whether this phenomenon extends to juvenile sexual offenders (JSOs). In addition, few studies have examined whether offender race/ethnicity influences registration and notification requirements, which JSOs are subject to in some U.S. states. The present study assessed for disproportionate minority contact among general delinquent offenders and JSOs, meaning it aimed to test whether the criminal justice system treats those accused of sexual and non-sexual offenses differently by racial/ethnic group. Furthermore, racial/ethnic group differences in risk, legal classification, and sexual offending were examined for JSOs. Results indicated disproportionate minority contact was present among juveniles with non-sexual offenses and JSOs in Alabama. In addition, offense category and risk scores differed between African American and European American JSOs. Finally, registration classifications were predicted by offending characteristics, but not race/ethnicity. Implications and future directions regarding disproportionate minority contact among JSOs and social and legal policy affecting JSOs are discussed.

scholarly journals Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

2019 ◽  
Vol 22 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Andrea H Weinberger ◽  
Cristine D Delnevo ◽  
Jiaqi Zhu ◽  
Misato Gbedemah ◽  
Joun Lee ◽  
...  
Keyword(s):  
United States ◽  
Black Women ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Mixed Race ◽  
The United States ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Over Time

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

scholarly journals Using routine emergency department data for syndromic surveillance of acute respiratory illness before and during the COVID-19 pandemic in Germany, week 10-2017 and 10-2021

2021 ◽  
Author(s):  
T Sonia Boender ◽  
Wei Cai ◽  
Madlen Schranz ◽  
Theresa Kocher ◽  
Birte Wagner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Syndromic Surveillance ◽  
Virus Disease ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Case Definitions ◽  
Emergency Department Data ◽  
Duration Magnitude ◽  
Icd 10

Introduction: To better assess the epidemiological situation of acute respiratory illness in Germany over time, we used emergency department data for syndromic surveillance before and during the COVID-19 pandemic. Methods: We included routine attendance data from emergency departments who continuously transferred data between week 10-2017 and 10-2021, with ICD-10 codes available for >75% of the attendances. Case definitions for acute respiratory illness (ARI), severe ARI (SARI), influenza-like illness (ILI), respiratory syncytial virus disease (RSV) and Coronavirus disease 2019 (COVID-19) were based on a combination of ICD-10 codes, and/or chief complaints, sometimes combined with information on hospitalisation and age. Results: We included 1,372,958 attendances from eight emergency departments. The number of attendances dropped in March 2020, increased during summer, and declined again during the resurge of COVID-19 cases in autumn and winter of 2020/2021. A pattern of seasonality of acute respiratory infections could be observed. By using different case definitions (i.e. for ARI, SARI, ILI, RSV) both the annual influenza seasons in the years 2017-2020 and the dynamics of the COVID-19 pandemic in 2020-2021 were apparent. The absence of a flu season during the fall and winter of 2020/2021 was visible, in parallel to the resurge of COVID-19 cases. The proportion of SARI among ARI cases peaked in April-May 2020 and November 2020-January 2021. Conclusion: Syndromic surveillance using routine emergency department data has the potential to monitor the trends, timing, duration, magnitude and severity of illness caused by respiratory viruses, including both influenza and SARS-CoV-2.

Physician Intervention and Patient Risk Perception among Smokers with Acute Respiratory Illness in the Emergency Department

2001 ◽  
Vol 32 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Beth C. Bock ◽  
Bruce Becker ◽  
Rosa Monteiro ◽  
Robert Partridge ◽  
Steve Fisher ◽  
...  
Keyword(s):  
Emergency Department ◽  
Risk Perception ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Patient Risk ◽  
Physician Intervention

scholarly journals Patient-Physician Relational Continuity and Health System Utilization Among Albertans

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Tanmay Patil ◽  
Rizwan Shahid ◽  
Alka Patel ◽  
Scott Oddie
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Chronic Disease ◽  
Health System ◽  
Ambulatory Care ◽  
Healthcare Utilization ◽  
Emergency Department Visits ◽  
System Utilization ◽  
Relational Continuity ◽  
Online Mapping

IntroductionThe Office of the Auditor General report on Chronic Disease Management in 2014 identified that in Alberta there are no processes to identify individuals with chronic diseases who do not have or cannot find a Primary Health Care (PHC) physician, and provide them with ongoing care. Objectives and ApproachLinked provincial administrative data (Practitioner Claims, National Ambulatory Care Reporting System, Discharge Abstract Database, Clinical Risk Groupers) to identify Albertans with chronic disease who do not have any contact or have low relational continuity with primary care physicians, and examine their healthcare utilization (Hospitalizations, Ambulatory Care Sensitive Conditions, 30-day Hospital Readmissions, Emergency Department visits, and Family practice Sensitive conditions). Usual Provider Continuity index was used to measure relational continuity. Used GIS software to combine findings from secondary data analysis and produced an interactive Online Mapping Application. Ongoing spatial and regression analysis will examine relationship between relational continuity and healthcare utilization. ResultsThe majority of individuals in Alberta with no or low primary care visits were men (62.6%), did not have a chronic disease (94.9%), and belonged to the healthy or healthcare non-user status. Albertans were grouped based on patient-physician relational continuity, and it was seen that the likelihood of emergency department visits and 30-day readmissions declined with increase in continuity, however similar results were not seen in case of hospitalizations. To promote utilization of findings an Online Mapping Application was used to present population groups and their characteristics. Univariate and multivariate analysis will be conducted to examine relation between relational continuity and healthcare utilization, especially usage that could be avoided through regular contact with primary care, while controlling for socio-demographic and health related factors. Conclusion/ImplicationsThe results emphasize that the focus should not be on those with no or low number of primary care visits. Strategies focused on linking patients to PHC services and fostering patient-provider relationship are critical to meet the health needs of Albertans and create efficiencies in health system utilization.

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