scholarly journals Pathways to reduced emergency department and urgent care center use: Lessons from the comprehensive primary care initiative

2020 ◽  
Vol 55 (6) ◽  
pp. 1003-1012
Author(s):  
Lori Timmins ◽  
Deborah Peikes ◽  
Nancy McCall
Author(s):  
Jolanta Klukowska-Rötzler ◽  
Maria Eracleous ◽  
Martin Müller ◽  
David S. Srivastava ◽  
Gert Krummrey ◽  
...  

BACKGROUND: We investigated whether immigrants from Southeast Europe (SE) and Swiss patients have different reasons for visiting the emergency department (ED). METHODS: Our retrospective data analysis for the years 2013-2017 describes the pattern of ED consultations for immigrants from SE living in Switzerland (Canton Bern), in comparison with Swiss nationals, with a focus on type of referral and reason for admission. RESULTS: A total of 153,320 Swiss citizens and 12,852 immigrants from SE were included in the study. The mean age was 51.30 (SD=21.13) years for the Swiss patients and 39.70 (SD=15.87) years for the SE patients. For some countries of origin (Albania, Bosnia and Herzegovina, and Turkey), there were highly statistically significant differences in sex distribution with the predominance for male. SE immigrants had a greater proportion of patients in the lower triage level (level 3: SE: 67.3% vs. Swiss: 56.0%) and a greater proportion of patients in the high triage level than the Swiss population (level 1: SE: 3.4% vs. Swiss: 8.8%,). SE patients of working age (16-65 years) were six times more often admitted by ambulance than older (≥65 years) SE patients, whereas in the Swiss population this ratio was similar. In both groups, fast track service was primarily used for patients of working age (<65) and more than three times more often in the SE than the Swiss group (SE: 39.1%, Swiss: 12.6%). CONCLUSION: We identified some indications in access to primary care in Emergency Department for immigrants highlighting the need for attention to the role of organizational characteristics of primary health care in the Switzerland. The authors have highlighted the need for professional support to improve the quality of healthcare for immigrants. In the future, more primary care services and general practitioners will need to be provided with a migrant background.


2020 ◽  
Vol 48 (5) ◽  
pp. 272-275
Author(s):  
Jerel Chacko ◽  
Mikhail Podlog ◽  
Joseph Basile ◽  
Ahad Anjum ◽  
Elias Youssef ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Dylan Dean

A 12-year-old boy was brought to an urgent care center for fever, back pain, and abnormal gait. In addition to back pain, the patient was found to be persistently febrile but also had decreased perianal sensation and bowel incontinence. He was therefore referred to the emergency department where his back pain improved without medication but he was still febrile with bowel incontinence and persistently decreased perianal sensation. An MRI was ordered to evaluate possible cauda equina syndrome and revealed a perirectal abscess. The child ultimately underwent an exam under anesthesia with pediatric surgery and had a drain placed. This case highlights a unique presentation of perirectal abscess masquerading as cauda equina syndrome. A discussion of important considerations in emergency room diagnosis and management is presented.


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