scholarly journals Inpatient and emergency department costs from sports injuries among youth aged 5–18 years

2019 ◽  
Vol 5 (1) ◽  
pp. e000491 ◽  
Author(s):  
Jessica L Ryan ◽  
Etienne E Pracht ◽  
Barbara Langland Orban
Keyword(s):  
Emergency Department ◽  
Fixed Effects ◽  
Sports Injuries ◽  
Health Care Administration ◽  
Sports Injury ◽  
American Football ◽  
Contact Sport ◽  
Older Athletes ◽  
Prevention Programmes ◽  
Ed Visits

ObjectiveTo analyse the financial costs from sports injuries among inpatients and emergency department (ED) patients aged 5–18 with a focus on Medicaid patients.MethodsFixed-effects linear regression was used to assess the association of patient factors with cost of injury from sports. Florida Agency for Health Care Administration data from 2010 to 2014 were used, which included all inpatient and ED patients aged 5–18 years who had a sports injury.ResultsOver 5 years, sports injuries in Florida youth cost $24 million for inpatient care and $87 million for ED care. Youth averaged $6039 for an inpatient visit and $439 for an ED visit in costs from sports injuries. Sports injuries for Medicaid-insured youth cost $10.8 million for inpatient visits and $44.2 million for ED visits.ConclusionOlder athletes and males consistently have higher healthcare costs from sports. Baseball, basketball, bike riding, American football, roller-skating/skateboarding and soccer are sports with high costs for both ED patients and inpatients and would benefit from prevention programmes. Injuries from non-contact sport participants are few but can have high costs. These athletes could benefit from prevention programmes as well.

Current concepts on the aetiology and prevention of sports injuries

2013 ◽  
Author(s):  
Willem van Mechelen ◽  
Evert A.L.M. Verhagen
Keyword(s):  
Sports Injuries ◽  
Sports Injury ◽  
Epidemiological Studies ◽  
Free Play ◽  
Preventive Action ◽  
Physically Active ◽  
Effective Prevention ◽  
Prevention Programmes ◽  
Sports And Physical Activity ◽  
Fitness And Health

A physically active lifestyle and active participation in sports is important, for adults as well as for children. Reasons to participate in sports and physical activity are many: pleasure and relaxation, competition, socialization, maintenance and improvement of fitness and health, etc. In general, when compared to adults, the risk for sports injury resulting from participation in sports and free play is low in children.1 Despite this relatively low risk, sports injuries in children are a fact of life, which calls for preventive action. In order to set out effective prevention programmes, epidemiological studies need to be done on incidence, severity, and aetiology of sports injuries. Also the effect of preventive measures needs to be evaluated. In the following chapters various authors will describe these aspects of sports injuries in children, regarding specific sports. This chapter describes briefly some current concepts regarding the epidemiology and prevention of sports injuries as a means of introduction to these chapters.

Epidemiology and prevention of sports injuries

2017 ◽  
Author(s):  
Joske Nauta ◽  
Willem van Mechelen ◽  
Evert ALM Verhagen
Keyword(s):  
Sports Injuries ◽  
Preventive Measure ◽  
Sports Participation ◽  
Sports Injury ◽  
Epidemiological Studies ◽  
Injury Incidence ◽  
Time Loss ◽  
Effective Prevention ◽  
School Time ◽  
Prevention Programmes

Although sports injuries in children are common, prevention of these injuries is paramount. In order to set out effective prevention programmes, epidemiological studies need to be conducted on incidence, severity, and aetiology of sports injuries. Furthermore, the effectiveness of a preventive measure must be assessed, and the eventual implementation of a programme closely evaluated. When conducting epidemiological studies in sports injuries the injury definition used can have a large impact on the outcome, especially as the aetiology of sports injuries is highly multi-causal and recursive. In addition to distinguishing between ‘sports injury’, ‘sports injury incidence’ and ‘sports participation’, the severity of the injury must be defined by taking six indices into consideration: nature of sports injuries, duration and nature of treatment, sports time loss, working/school time loss, permanent damage, and costs of sports injuries.

Sports-related Injuries Among Adolescents: When Do They Occur, and How Can We Prevent Them?

1995 ◽  
Vol 16 (5) ◽  
pp. 184-187
Author(s):  
Ellen S. Rome
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Motor Vehicle ◽  
Sports Injuries ◽  
Sports Injury ◽  
Emergency Department Visits ◽  
Mortality Data ◽  
Seek Health Care ◽  
Vehicle Accidents ◽  
School Based Health Centers

Sports injuries, as causes of frequent morbidity but infrequent mortality among teens, receive less attention than do more dramatic motor vehicle accidents, homicides, and suicides. Injury to adolescents caused by both organized and informal athletics occurs commonly, yet the precise frequency, severity, and predisposing risk factors of such injuries have not been defined well. Unlike mortality data, which can be obtained readily from death certificates or through the National Center for Health Statistics, nonfatal sports injuries often go unrecognized among injury statistics because adolescents frequently do not seek health care or tell a coach or family member about the injury. Moreover, data on injuries can exist in a variety of places outside of physicians' offices, including emergency department or hospital records, school-based health centers, or trainers' logs. Different studies also have defined injury differently, with little standardization between studies and variances in sources used for data collection. Hospital or emergency department data may differ in the degree of severity of the injury from office-based data or data on those injuries treated solely by a coach or athletic trainer. Despite these difficulties, a plethora of data exists on the topic of sports injuries and their prevention. Common Causes of Sports Injury In a Massachusetts study by Gallagher and colleagues in the 1980s, sports injuries were found to be the most common cause of injury and, overall, the second leading cause of emergency department visits and hospital admissions in the 13- to 19- year-old age group.

scholarly journals Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations

2016 ◽  
Vol 8 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Andrew J. Potter ◽  
Amal N. Trivedi ◽  
Brad Wright
Keyword(s):  
Emergency Department ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Care Service ◽  
Emergency Department Visits ◽  
Health Centers ◽  
Fee For Service ◽  
Federally Qualified Health Centers ◽  
Dual Eligibles ◽  
Ed Visits

Objective: To determine whether younger dual-eligibles receiving care at federally qualified health centers (FQHCs) have lower rates of ambulatory care sensitive (ACS) hospitalization and emergency department (ED) visits. Data Sources: We used the 100% Medicare Part A and Part B institutional claims from 2007 to 2010 for dual-eligibles younger than 65 years, enrolled in traditional fee-for-service Medicare, who received care at an FQHC or lived in a primary care service area with an FQHC. Methods: Our cross-sectional analysis used negative binomial regressions to model ACS hospitalizations and ED visits as a function of prior year FQHC use. The model adjusted for beneficiary age, gender, race, and chronic diseases, as well as county fixed effects, time trends, and race-FQHC use interactions. Results: FQHC use is associated with a decrease in ACS hospitalization rates for whites (2.8 per 1000 persons), but an increase among blacks (2.5 per 1000 persons). FQHC use is also associated with an increase in ACS ED visits, from 27 to 33 more visits per 1000 persons per year, depending on patient race. Conclusions: ACS hospital use is higher for FQHC users than nonusers, but white FQHC users have fewer ACS hospitalizations. More research is needed to understand how this relationship varies within and between centers.

scholarly journals Risk of incidental and recurrent injuries among young athletes of selected team games

2020 ◽  
Vol 3 (3) ◽  
pp. 91-102
Author(s):  
Dawid Koźlenia ◽  
Jarosław Domaradzki
Keyword(s):  
Sports Injuries ◽  
Sports Injury ◽  
American Football ◽  
Football Players ◽  
Training Volume ◽  
Young Athletes ◽  
Training Experience ◽  
Team Games ◽  
Proper Training ◽  
Recurrent Injuries

Purpose: The research aimed to assess the risk of incidental and recurrent injuries in young athletes according to the training experience, training weekly volume, and morphological features.Methods: One hundred and twenty-five male athletes were included in the study (22 American football players, 30 football players, 49 handball players, and 24 volleyball players). Injures data were collected with the questionnaire.Results: Most of the young players were injured. The basic risk factors of incidental injuries are the length of the training experience. In the case of recurrent injuries, it is also a training internship and a weekly training volume. The risk of incidental injury increases with 30% every year. In the case of recurrent injuries, the risks associated with each year of training by 28%, and 26% with an increase in training volume. The morphological did not increase injury risk.Conclusion: With the training experience, training volume, the risk of sports injury increases. Long-term activities are required in the training process with proper training loads, methods of preventing sports injuries, and regeneration techniques for the protection of young athletes from injuries.

Adolescent Violent Delinquency Associated With Increased Emergency Department Usage in Young Adulthood

2021 ◽  
pp. 0306624X2110668
Author(s):  
Jill Portnoy ◽  
Joseph A. Schwartz
Keyword(s):  
Emergency Department ◽  
Young Adulthood ◽  
Fixed Effects ◽  
Unobserved Heterogeneity ◽  
Healthcare Providers ◽  
Adolescent Delinquency ◽  
Adult Health ◽  
Fixed Effects Models ◽  
Sibling Fixed Effects ◽  
Ed Visits

Limited research has examined the extent to which adolescent delinquency predicts healthcare usage in young adulthood, including emergency department (ED) visits. This study used data from 3,310 adolescents (52.05% female; mean age at Wave I = 16.04 years) from the sibling subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health). We examined whether adolescent delinquency at Wave I predicted ED visits at Wave III using sibling fixed effects models to adjust estimates for within-family unobserved heterogeneity. Increased violent, but not nonviolent, delinquency predicted a higher number of ED visits in early adulthood in the sibling fixed effects models. To our knowledge, this is the first study to examine the relationship between delinquency and ED usage using a sibling fixed effects design. Findings demonstrate that violent adolescent delinquency may increase healthcare usage and suggest the potential role of healthcare providers in improving outcomes for delinquent youth.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

scholarly journals Handling coarsened age information in the analysis of emergency department presentations

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rhonda J. Rosychuk ◽  
Jeff W.N. Bachman ◽  
Anqi Chen ◽  
X. Joan Hu
Keyword(s):  
Emergency Department ◽  
Sample Size ◽  
Uniform Distribution ◽  
Empirical Distribution ◽  
Data Access ◽  
Recurrent Event ◽  
Fiscal Year ◽  
Recurrent Event Data ◽  
Higher Ed ◽  
Ed Visits

Abstract Background Administrative databases offer vast amounts of data that provide opportunities for cost-effective insights. They simultaneously pose significant challenges to statistical analysis such as the redaction of data because of privacy policies and the provision of data that may not be at the level of detail required. For example, ages in years rather than birthdates available at event dates can pose challenges to the analysis of recurrent event data. Methods Hu and Rosychuk provided a strategy for estimating age-varying effects in a marginal regression analysis of recurrent event times when birthdates are all missing. They analyzed emergency department (ED) visits made by children and youth and privacy rules prevented all birthdates to be released, and justified their approach via a simulation and asymptotic study. With recent changes in data access rules, we requested a new extract of data for April 2010 to March 2017 that includes patient birthdates. This allows us to compare the estimates using the Hu and Rosychuk (HR) approach for coarsened ages with estimates under the true, known ages to further examine their approach numerically. The performance of the HR approach under five scenarios is considered: uniform distribution for missing birthdates, uniform distribution for missing birthdates with supplementary data on age, empirical distribution for missing birthdates, smaller sample size, and an additional year of data. Results Data from 33,299 subjects provided 58,166 ED visits. About 67% of subjects had one ED visit and less than 9% of subjects made over three visits during the study period. Most visits (84.0%) were made by teenagers between 13 and 17 years old. The uniform distribution and the HR modeling approach capture the main trends over age of the estimates when compared to the known birthdates. Boys had higher ED visit frequencies than girls in the younger ages whereas girls had higher ED visit frequencies than boys for the older ages. Including additional age data based on age at end of fiscal year did not sufficiently narrow the widths of potential birthdate intervals to influence estimates. The empirical distribution of the known birthdates was close to a uniform distribution and therefore, use of the empirical distribution did not change the estimates provided by assuming a uniform distribution for the missing birthdates. The HR approach performed well for a smaller sample size, although estimates were less smooth when there were very few ED visits at some younger ages. When an additional year of data is added, the estimates become better at these younger ages. Conclusions Overall the Hu and Rosychuk approach for coarsened ages performed well and captured the key features of the relationships between ED visit frequency and covariates.

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 < 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P < 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 National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

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