scholarly journals Epidemiology of paediatric pain-related visits to emergency departments in the USA: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046497
Author(s):  
Jana L Anderson ◽  
Lucas Oliveira J. e Silva ◽  
Shealeigh A. Funni ◽  
Fernanda Bellolio ◽  
Molly Moore Jeffery
Keyword(s):  
Emergency Departments ◽  
Private Insurance ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Data Set ◽  
Lower Odds ◽  
The Usa ◽  
Prevalence Of Pain ◽  
Ed Visits

ObjectiveTo describe the epidemiology of paediatric pain-related visits to emergency departments (EDs) across the USA.DesignCross-sectional study.SettingA representative sample of US ED visits using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS).ParticipantsPaediatric (age ≤18 years) ED visits in the 2017 NHAMCS data set.Data analysisEach visit was coded as pain-related or non-pain-related using the ‘reason for visit’ variable. Weighted proportions were calculated with 95% CIs. Logistic regression was used to compare odds of pain-related visits.Outcome measuresPrevalence of pain-related visits among paediatric ED visits.ResultsThere were an estimated 35 million paediatric ED visits in the USA in 2017, 55.6% (CI 53.3% to 57.8%) were pain related, which equates to 19.7 million annual visits. The prevalence of pain-related visits reached more than 50% of visits at age 6–7 and plateaued at relatively high proportions. Children of races other than white or black had lower odds of having a pain-related visit (OR 0.48, CI 0.29 to 0.81) than white children, as did children who were black, though the difference was not statistically significant (OR 0.88, CI 0.73 to 1.06). Relative to children covered by private insurance, children with Medicaid or CHIP (Children’s Health Insurance Program) coverage had lower odds of a pain-related visit (OR 0.75, CI 0.60 to 0.93). Injuries represented 46.5% (CI 42.0% to 51.0%) of pain-related visits. Pain scores were reported in less than 50% of pain-related visits.ConclusionPain is the reason for visit in 55.6% of paediatric ED visits across the USA. The prevalence of pain-related visits peak before adolescence and it continues relatively high until the age 18. Injury, racial disparities in pain and poor pain score reporting should remain major topics of study in the paediatric population.

Visits to the Emergency Department during the 2020 COVID-19 Outbreak in Thailand

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S1-S4
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Emergency Departments ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Patient Age ◽  
Cross Sectional ◽  
Front Door ◽  
The Past ◽  
Ed Visits

Background: The emergency department (ED) can be thought of as the “front door” to the 2019 coronavirus (COVID-19) pandemic. However, there have yet been no studies conducted examining ED patients in this situation. Objective: To determine the numbers of ED visits by level urgency during the COVID-19 pandemic. Materials and Methods: This was a cross-sectional study. The sample consisted of patients who presented at the Srinagarind Hospital ED from January 13 to April 21, 2020 (the date of the first confirmed case of COVID-19 in Thailand according to the Ministry of Public Health and day 100). We compared these data with those from the same period over the past three years. Results: In 2020, the total number of ED visits was 13,263, with a mean patient age of 50.14+6.40 years. Over half of these patients (56.2%; n = 7,467) were female. Most visits (50.6%) occurred between 4.00 PM to 0.00 AM (afternoon shift). The majority of were walk-ins (84.2%) and ESI 3 (non-urgent; 79.9%). The average numbers of ESI 3 patients who visited the ED over the same period in 2017 to 2020 were 152.3, 171.5, 153.0 and 105.9 per day, respectively (p<0.001). Conclusion: During the COVID-19 pandemic, the number of ED visits, specifically those of ESI 3 patients, was significantly lower than during the same period in previous years. Keywords: COVID-19, Emergency departments, Pandemics, Triage

scholarly journals Changing Rates of Self-Harm and Mental Disorders by Sex in Youths Presenting to Ontario Emergency Departments: Repeated Cross-Sectional Study

2019 ◽  
Vol 64 (11) ◽  
pp. 789-797 ◽  
Author(s):  
William Gardner ◽  
Kathleen Pajer ◽  
Paula Cloutier ◽  
Roger Zemek ◽  
Lisa Currie ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Confidence Interval ◽  
Emergency Departments ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Self Harm ◽  
Ed Visits ◽  
Observational Design

Objective: To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. Methods: This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. Results: Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from –0.18 youths/1000/year (confidence interval [CI], –0.24 to –0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 ( P < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 ( P < 0.001). Females were more likely to have self-harm ( P < 0.001) and mental health visits ( P < 0.001). Rates of increase after 2009 were greater for females for both self-harm ( P < 0.001) and mental health ( P < 0.001). Conclusions: Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents’ self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.

scholarly journals PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110304
Author(s):  
Ravindra Ganesh ◽  
Aditya K. Ghosh ◽  
Mark A. Nyman ◽  
Ivana T. Croghan ◽  
Stephanie L. Grach ◽  
...  
Keyword(s):  
Health Status ◽  
Social Roles ◽  
Disease Process ◽  
Cross Sectional Study ◽  
Large Sample Size ◽  
Sectional Study ◽  
Cross Sectional ◽  
Data Set ◽  
Patient Reported ◽  
The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

scholarly journals Caregiver-reported delay in presentation to pediatric emergency departments for fear of contracting COVID-19: a multi-national cross-sectional study

CJEM ◽  
2021 ◽  
Author(s):  
Adrienne L. Davis ◽  
Alia Sunderji ◽  
Shashidhar R. Marneni ◽  
Michelle Seiler ◽  
Jeanine E. Hall ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Mask-wearing and control of SARS-CoV-2 transmission in the USA: a cross-sectional study

2021 ◽  
Vol 3 (3) ◽  
pp. e148-e157 ◽  
Author(s):  
Benjamin Rader ◽  
Laura F White ◽  
Michael R Burns ◽  
Jack Chen ◽  
Joseph Brilliant ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Usa ◽  
And Control

scholarly journals Louisiana Medicaid access for treatment and care for hepatitis C virus (LA-MATCH) project: A cross-sectional study protocol

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257437
Author(s):  
Hasheemah Afaneh ◽  
Susanne Straif-Bourgeois ◽  
Evrim Oral ◽  
Ashley Wennerstrom ◽  
Olivia Sugarman ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Fixed Cost ◽  
Sectional Study ◽  
Hcv Treatment ◽  
Cross Sectional ◽  
Data Set ◽  
Direct Acting Antiviral ◽  
Louisiana State University

Introduction This article presents the Louisiana Hepatitis C Elimination Program’s evaluation protocol underway at the Louisiana State University Health Sciences Center–New Orleans. With the availability of direct-acting antiviral (DAA) agents, the elimination of Hepatitis C (HCV) has become a possibility. The HCV Elimination Program was initiated by the Louisiana Department of Health (LDH) Office of Public Health (OPH), LDH Bureau of Health Services Financing (Medicaid), and the Louisiana Department of Public Safety and Corrections (DPSC) to provide HCV treatment through an innovative pricing arrangement with Asegua Therapeutics, whereby a fixed cost is set for a supply of treatment over five years. Materials and methods A cross-sectional study design will be used. Data will be gathered from two sources: 1) an online survey administered via REDCap to a sample of Medicaid members who are receiving HCV treatment, and 2) a de-identified data set that includes both Medicaid claims data and OPH surveillance data procured via a Data Use Agreement between LSUHSC-NO and Louisiana Medicaid. Discussion The evaluation will contribute to an understanding of the scope and reach of this innovative treatment model, and as a result, an understanding of areas for improvement. Further, this evaluation may provide insight for other states considering similar contracting mechanisms and programs.

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