scholarly journals Temporal analysis of determinants for respiratory emergency department visits in a large German hospital

2018 ◽  
Vol 5 (1) ◽  
pp. e000338 ◽  
Author(s):  
Anne Caroline Krefis ◽  
Jana Fischereit ◽  
Peter Hoffmann ◽  
Hans Pinnschmidt ◽  
Christina Sorbe ◽  
...  
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Environmental Variables ◽  
Respiratory Diseases ◽  
Emergency Department Visits ◽  
Environmental Data ◽  
Time Lags ◽  
Linear Quadratic ◽  
Ed Visits ◽  
Day Of The Week

IntroductionAssociations between air pollutants, meteorological conditions and respiratory diseases have been extensively shown. The aim of this study was to investigate associations between daily meteorological data, data on air pollution and emergency department (ED) visits depending on the day of the week, season and year (study period from 2013 to 2015).MethodsHighly correlated environmental data entered a categorical principal components analysis (CATPCA). We analysed cross-correlation functions between the time series of the respective daily environmental factors and daily ED visits. Time lags with peak correlations of environmental variables obtained by the CATPCA on ED visits together with day of the week, year, running day (linear, quadratic and cubic), season and interaction terms entered the univariate analysis of variance (UNIANOVA) model.ResultsThe analyses demonstrated main effects on ED visits for the day of the week with highest admission rates on Mondays (B=10.69; ƞ2=0.333; p<0.001). A significant time trend could be observed showing increasing numbers of ED visits per each year (p<0.001). The variable ‘running day’ (linear, quadratic and cubic) indicated a significant non-linear effect over time. The variable season showed significant results with winter, spring and summer recording fewer ED visits compared with the reference season autumn. Environmental variables showed no direct associations with respiratory ED visits.DiscussionED visits were significantly associated with temporal variables. Our data did not show direct associations between environmental variables and ED visits.In times of rapid urbanisation, increases in respiratory diseases, temperature and air pollution, our analyses can help focus future studies and enhance strategies to reduce increasing numbers of respiratory diseases and ED visits. Because the potential costs of medical care in hospitals can be high compared with physicians, public health recommendations for reducing the increasing ED visits should be promoted and evaluated.

scholarly journals Trends in emergency department visits in Lubbock from 2011-2017

2019 ◽  
Vol 7 (27) ◽  
pp. 50-54
Author(s):  
Sarah Jaroudi ◽  
Shengping Yang ◽  
Gilbert Berdine
Keyword(s):  
Emergency Department ◽  
Medical Center ◽  
Emergency Department Visits ◽  
Local Data ◽  
Factors Affecting ◽  
Long Term Trends ◽  
Ed Visits ◽  
Day Of The Week ◽  
Relationship Of

To determine trends in daily emergency department (ED) visits, a preliminary retrospective study was done to analyze the relationship of long-term trends, day of week, and month of year to ED volume at University Medical Center in Lubbock, TX. Local data were collected from January 1, 2011, through December 31, 2017. An increase in ED visits from 2011 to 2014 was followed by a decrease in ED visits from 2014 to 2017. The best fit third order polynomial was “ ” with y=number of ED visits and x=cumulative day. The busiest day of the week was Monday with an average of 235.6 visits per day. Throughout the week, ED visits decreased to a minimum value of 201.9 visits per day on Saturday. The differences between each day of the week were significant (p < 0.001). Seasonal trends were present with peaks during February and September. The differences among months were significant (p < 0.001).  The total variance of the ED visit data was decreased after adjusting for the long-term trend, day of week, and month of year. These adjustments remove noises not relevant to the study goal and are necessary for further studies testing hypotheses about factors affecting ED visits that may not be uniformly distributed over time. 

scholarly journals Impact of Air Pollution and Trans-Boundary Haze on Nation-Wide Emergency Department Visits and Hospital Admissions in Singapore

2020 ◽  
Vol 49 (2) ◽  
pp. 78-87
Author(s):  
Sze Ling Chan ◽  
Andrew FW Ho ◽  
Huicong Ding ◽  
Nan Liu ◽  
Arul Earnest ◽  
...  
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Hospital Admissions ◽  
Time Of Day ◽  
Emergency Department Visits ◽  
Public Hospitals ◽  
Patient Acuity ◽  
Ed Visits ◽  
The Impact ◽  
Respiratory Conditions

Introduction: Air pollution is associated with adverse health outcomes. However, its impact on emergency health services is less well understood. We investigated the impact of air pollution on nation-wide emergency department (ED) visits and hospital admissions to public hospitals in Singapore. Materials and Methods: Anonymised administrative and clinical data of all ED visits to public hospitals in Singapore from January 2010 to December 2015 were retrieved and analysed. Primary and secondary outcomes were defined as ED visits and hospital admissions, respectively. Conditional Poisson regression was used to model the effect of Pollutant Standards Index (PSI) on each outcome. Both outcomes were stratified according to subgroups defined a priori based on age, diagnosis, gender, patient acuity and time of day. Results: There were 5,791,945 ED visits, of which 1,552,187 resulted in hospital admissions. No significant association between PSI and total ED visits (Relative risk [RR], 1.002; 99.2% confidence interval [CI], 0.995–1.008; P = 0.509) or hospital admissions (RR, 1.005; 99.2% CI, 0.996–1.014; P = 0.112) was found. However, for every 30-unit increase in PSI, significant increases in ED visits (RR, 1.023; 99.2% CI, 1.011–1.036; P = 1.24 × 10˗6) and hospital admissions (RR, 1.027; 99.2% CI, 1.010–1.043; P = 2.02 × 10˗5) for respiratory conditions were found. Conclusion: Increased PSI was not associated with increase in total ED visits and hospital admissions, but was associated with increased ED visits and hospital admissions for respiratory conditions in Singapore. Key words: Epidemiology, Healthcare utilisation, PSI, Public health, Time series

scholarly journals Air Pollution and Emergency Department Visits for Disease of the Genitourinary System

2021 ◽  
Vol 15 ◽  
pp. 117863022110253
Author(s):  
Mieczysław Szyszkowicz ◽  
Stephanie Schoen ◽  
Nicholas de Angelis
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Air Quality ◽  
Ambulatory Care ◽  
Ambient Air ◽  
Environmental Data ◽  
Ambient Air Pollution ◽  
Quality Data ◽  
Genitourinary System ◽  
Ed Visits

The aim of this study is to determine associations between ambient air pollution and the number of emergency department (ED) visits for diseases of the genitourinary tract in Toronto, Canada. We used the National Ambulatory Care Reporting System (NACRS) database to obtain the related ED visits and developed statistical models using daily data on ED visits, temperature, relative humidity, and outdoor air pollution concentration levels. The NACRS database contains data on hospital-based and community-based ambulatory care. The environmental data were retrieved from the National Air Pollution Surveillance (NAPS) program. The NAPS is the main source of ambient air quality data in Canada. We considered 2 air quality health indexes and 6 air pollutants: daily means of fine particulate matter PM2.5, O3, CO, NO2, SO2, and also maximum 8-hour average ozone. For every air pollutant, we fit 270 models (15 lags × 18 strata). We found that same-day air pollution concentrations have the highest number of statistically significantly positive associations with ED visits for genitourinary health outcomes. A total of 133 positive associations were identified over the 14 days lag. In subgroup (strata) analysis, females older than 60 years of age were found to have the most positive associations. In particular, nitrogen dioxide was found to be highly associated with ED visits for females over 60; an increase in NO2 was associated with an increased relative risk (RR) of ED visits when lagged over 0, 1, and 2 days (RR = 1.040 [95% confidence interval: 1.028, 1.052], 1.020 [1.009, 1.032], and 1.025 [1.013, 1.036], respectively). The values of risks are reported for a 1 interquartile range increase in concentration (8.8 ppb). Our results suggest that urban ambient air pollution affect the number of ED visits due to genitourinary system conditions.

scholarly journals The air quality health index and emergency department visits for injury

2020 ◽  
Vol 130 (1) ◽  
pp. 52-56
Author(s):  
Mieczysław Szyszkowicz
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Air Quality ◽  
Ambient Air ◽  
Emergency Department Visits ◽  
Health Index ◽  
Study Results ◽  
Quality Health ◽  
Ed Visits ◽  
Air Quality Health Index

Abstract Introduction. The purpose of this study was to investigate the associations of ambient air quality with emergency department (ED) visits for injury. Aim. To explore correlations between ED visits for injury and ambient air pollution. Materials and methods. Considered health outcomes are ED visits for injury (ICD-9 codes: 800-999) in Edmonton, Canada, for the period from April 1998 to March 2002 (1,444 days). Air pollution concentration in the ambient air is represented as a daily maximum of the Air Quality Health Index (AQHI). The AQHI value encapsulates levels of three urban ambient air pollutants (ozone, nitrogen dioxide and fine particulate matter), weighted by constant risk coefficients. A time-stratified casecrossover design, using conditional logistic regression and conditional Poisson regression, was realized to assess the associations. The risk, reported as odds ratio and relative risk, was estimated using log-linear models and parametric non-linear concentrationresponse functions. Results. The strongest effects were observed for young male patients in the cold season (October-March). Lagged exposures were found to have positive statistically significant associations. Discussion. The study results indicate that air quality was associated with increased risk of daily ED visits for injury. This study determined concentration-response functions which allow one to assess the effects for various levels of the AQHI.

scholarly journals Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy: A Cohort Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S333-S334
Author(s):  
So Lim Kim ◽  
Angela Everett ◽  
Susan J Rehm ◽  
Steven Gordon ◽  
Nabin Shrestha
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admission ◽  
Vascular Access ◽  
Antimicrobial Therapy ◽  
Cleveland Clinic ◽  
Emergency Department Visits ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Ed Visits ◽  
Access Complications

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) carries risk of vascular access complications, antimicrobial adverse effects, and worsening of infection. Both OPAT-related and unrelated events may lead to emergency department (ED) visits. The purpose of this study was to describe adverse events that result in ED visits and risk factors associated with ED visits during OPAT. Methods OPAT courses between January 1, 2013 and December 31, 2016 at Cleveland Clinic were identified from the institution’s OPAT registry. ED visits within 30 days of OPAT initiation were reviewed. Reasons and potential risk factors for ED visits were sought in the medical record. Results Among 11,440 OPAT courses during the study period, 603 (5%) were associated with 1 or more ED visits within 30 days of OPAT initiation. Mean patient age was 58 years and 57% were males. 379 ED visits (49%) were OPAT-related; the most common visit reason was vascular access complication, which occurred in 211 (56%) of OPAT-related ED visits. The most common vascular access complications were occlusion and dislodgement, which occurred in 99 and 34 patients (47% and 16% of vascular access complications, respectively). In a multivariable logistic regression model, at least one prior ED visit in the preceding year (prior ED visit) was most strongly associated with one or more ED visits during an OPAT course (OR 2.96, 95% CI 2.38 – 3.71, p-value &lt; 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P &lt; 0.001), and having a PICC (p 0.05). 549 ED visits (71%) resulted in discharge from the ED within 24 hours, 18 (2%) left against medical advice, 46 (6%) were observed up to 24 hours, and 150 ED visits (20%) led to hospital admission. Prior ED visit was not associated with hospital admission among patients who visited the ED during OPAT. Conclusion OPAT-related ED visits are most often due to vascular access complications, especially line occlusions. Patients with a prior ED visit in the preceding year have a 3-fold higher odds of at least one ED visit during OPAT compared with patients without a prior ED visit. A strategy of managing occlusions at home and a focus on patients with prior ED visits could potentially prevent a substantial proportion of OPAT-related ED visits. Disclosures All authors: No reported disclosures.

scholarly journals Predictors of Urgent Cancer Care Clinic and Emergency Department Visits for Individuals Diagnosed with Cancer

2021 ◽  
Vol 28 (3) ◽  
pp. 1773-1789
Author(s):  
Kathleen Decker ◽  
Pascal Lambert ◽  
Katie Galloway ◽  
Oliver Bucher ◽  
Marshall Pitz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mixed Models ◽  
Cancer Care ◽  
Median Number ◽  
Emergency Department Visits ◽  
Planning Service ◽  
Care Clinic ◽  
Future Studies ◽  
Acute Complications ◽  
Ed Visits

In 2013, CancerCare Manitoba (CCMB) launched an urgent cancer care clinic (UCC) to meet the needs of individuals diagnosed with cancer experiencing acute complications of cancer or its treatment. This retrospective cohort study compared the characteristics of individuals diagnosed with cancer that visited the UCC to those who visited an emergency department (ED) and determined predictors of use. Multivariable logistic mixed models were run to predict an individual’s likelihood of visiting the UCC or an ED. Scaled Brier scores were calculated to determine how greatly each predictor impacted UCC or ED use. We found that UCC visits increased up to 4 months after eligibility to visit and then decreased. ED visits were highest immediately after eligibility and then decreased. The median number of hours between triage and discharge was 2 h for UCC visits and 9 h for ED visits. Chemotherapy had the strongest association with UCC visits, whereas ED visits prior to diagnosis had the strongest association with ED visits. Variables related to socioeconomic status were less strongly associated with UCC or ED visits. Future studies would be beneficial to planning service delivery and improving clinical outcomes and patient satisfaction.

scholarly journals Internet search and medicaid prescription drug data as predictors of opioid emergency department visits

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Sean D. Young ◽  
Qingpeng Zhang ◽  
Jiandong Zhou ◽  
Rosalie Liccardo Pacula
Keyword(s):  
Emergency Department ◽  
Prescription Drug ◽  
Drug Utilization ◽  
Prediction Models ◽  
Emergency Department Visits ◽  
Treatment Preferences ◽  
Internet Search ◽  
Utilization Data ◽  
Ed Visits ◽  
Medicaid Prescription

AbstractThe primary contributors to the opioid crisis continue to rapidly evolve both geographically and temporally, hampering the ability to halt the growing epidemic. To address this issue, we evaluated whether integration of near real-time social/behavioral (i.e., Google Trends) and traditional health care (i.e., Medicaid prescription drug utilization) data might predict geographic and longitudinal trends in opioid-related Emergency Department (ED) visits. From January 2005 through December 2015, we collected quarterly State Drug Utilization Data; opioid-related internet search terms/phrases; and opioid-related ED visit data. Modeling was conducted using least absolute shrinkage and selection operator (LASSO) regression prediction. Models combining Google and Medicaid variables were a better fit and more accurate (R2 values from 0.913 to 0.960, across states) than models using either data source alone. The combined model predicted sharp and state-specific changes in ED visits during the post 2013 transition from heroin to fentanyl. Models integrating internet search and drug utilization data might inform policy efforts about regional medical treatment preferences and needs.

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