scholarly journals Emergency department revisits and rehospitalizations among infants and toddlers for acute allergic reactions

2021 ◽  
Vol 42 (3) ◽  
pp. 247-256
Author(s):  
Lacey B. Robinson ◽  
Anna Chen Arroyo ◽  
Rebecca E. Cash ◽  
Susan A. Rudders ◽  
Carlos A. Camargo
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
New York ◽  
Health Care Utilization ◽  
Population Based ◽  
Care Utilization ◽  
Allergic Reactions ◽  
Infants And Toddlers ◽  
Ed Visits ◽  
Total Charges

Background and Objective: Allergic reactions, including anaphylaxis, are rising among children. Little is known about health care utilization among infants and toddlers. Our objective was to characterize health care utilization and charges for acute allergic reactions (AAR). Methods: We conducted a retrospective cohort study of trends in emergency department (ED) visits and revisits, hospitalizations and rehospitalizations, and charges among infants and toddlers (ages < 3 years), with an index ED visit or hospitalization for AAR (including anaphylaxis). We used data from population-based multipayer data: State Emergency Department Databases and State Inpatient Databases from New York and Nebraska. Multivariable logistic regression was used to identify factors associated with ED revisits and rehospitalizations. Results: Between 2006 and 2015, infant and toddler ED visits for AAR increased from 27.8 per 10,000 population to 35.2 (Ptrend < 0.001), whereas hospitalizations for AAR remained stable (Ptrend = 0.11). In the one year after an index AAR visit, 5.1% of these patients had at least one AAR ED revisit and 5.9% had at least one AAR rehospitalization. Factors most strongly associated with AAR ED revisits included an index visit hospitalization and receipt of epinephrine. Total charges for AAR ED visits (2009‐2015) and hospitalizations (2011‐2015) were more than $29 million and $11 million, respectively. Total charges increased more than fourfold for both AAR ED revisits for AAR rehospitalizations during the study period. Conclusion: Infants and toddlers who presented with an AAR were at risk for ED revisits and rehospitalizations for AAR within the following year. The charges associated with these revisits were substantial and seemed to be increasing.

scholarly journals Meta-Analysis: Association of Parent and Child Mental Health with Pediatric Health Care Utilization

2019 ◽  
Vol 44 (9) ◽  
pp. 1097-1110 ◽  
Author(s):  
John V Lavigne ◽  
Kathryn Mendelsohn Meyers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Child Mental Health ◽  
Internalizing Symptoms ◽  
Care Utilization ◽  
Pediatric Health ◽  
Pediatric Health Care ◽  
Ed Visits

Abstract Objective To examine the association of psychological factors and pediatric health care utilization. Method Ovid Medline and PsychInfo were searched and archival and forward searchers were conducted of relevant articles. Studies of the association between psychological risk factors and pediatric health care utilization of outpatient services, emergency department, inpatient length of stay, and costs were identified. Effect sizes were expressed in the form of the standardized mean difference. From 4,546 studies identified in the search, 69 studies met inclusion criteria. Results There were significant low-moderate associations between higher outpatient visits and general child mental health (MH) problems (mean ES [mES] = 0.35), overall psychopathology (mES = 0.44), and internalizing symptoms (mES = 0.16). Results were significant for any parent MH problem (mES = 0.18). For emergency department (ED) visits, there were significant association between more ED visits and any child MH problems (mES = 0.25), internalizing symptoms (mES = 0.24), externalizing symptoms (mES = 0.16), and Attention Deficit/Hyperactivity Disorder (mES= 0.14), as well as parent MH (mES = 0.24) and maternal depression (mES = 0.21). Increased hospitalizations were associated with any child MH problem (mES = 0.3), overall child psychopathology (mES = 0.49), child depression (ES = 0.41), and any parent MH problem (mES = 0.54). For costs, results were significant for any child MH problem (mES = 0.38). Conclusions Child and parent MH problems are significantly associated with increased HCU.

Associations Between Health and Driving in an Older Adult Cohort in Rancho Bernardo

2016 ◽  
Vol 29 (8) ◽  
pp. 1367-1387
Author(s):  
Linda L. Hill ◽  
Gail A. Laughlin ◽  
Richele Bettencourt ◽  
Elizabeth Barrett-Connor
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Older Adult ◽  
Neurological Disease ◽  
Care Utilization ◽  
Self Assessment ◽  
Driving Pattern ◽  
Temporal Relationships ◽  
Ed Visits

Objective: The purpose of this study was to identify the associations between health and health care utilization with driving patterns in a cohort of older adults. Method: In 2012, a total of 1,826 surviving participants in the Rancho Bernardo cohort were sent a health and driving pattern survey; 1,277 were returned. Results: The majority of the respondents (1,151, 91%) were still driving. Older age, female sex, hospitalizations, emergency department (ED) visits and physical therapy visits, neurological disease, depression, limited vision, and limited hearing were associated with non-driving status. A total of 809 (71%) of drivers reported no citations or crashes in the last 5 years. Discussion: The vast majority of older drivers in this cohort continued to drive, and did so safely. Health care utilization, medications, medical conditions, and self-assessment of health were associated with non-driving status. Prospective studies are needed to clarify the temporal relationships between these factors.

scholarly journals Does Gerofit Exercise Reduce Veterans’ Use of Emergency Department and Inpatient Care?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 771-771
Author(s):  
Lauren Abbate ◽  
Jiejin Li ◽  
Peter Veazie ◽  
Orna Intrator ◽  
Cathy Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Inpatient Care ◽  
Nearest Neighbor ◽  
Group Differences ◽  
Care Utilization ◽  
Ed Visits ◽  
The Relationship

Abstract Little is known about the relationship between exercise and health care utilization in older adults. This study examined hospitalizations/emergency Department (ED) visits in the 12 months prior to and during 12 months of active Gerofit participation (across 5 sites). Data were compared for each outcome to a propensity matched nearest neighbor sample from the same site [Mean, 95% CI]. Of the 226 Veterans who were active in the program for ≥12 months and enrolled in VA and Traditional Medicare for 12 months prior to Gerofit participation, hospitalizations/ED visits were greater prior to (15.3%/42.0%) than during (6.8%/37.1%) Gerofit participation. Gerofit participants were 8% less likely to have a hospitalization in the 12 months following enrollment than controls [-0.08 (-0.14, -0.02)] but no between-group differences in ED use [-0.00 (-0.11, 0.10)] were observed. Participation in Gerofit may reduce hospitalizations, but its impact on ED use is inconclusive.

Hospitalizations and emergency department use in cancer clinical trial patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 160-160
Author(s):  
Ryan David Nipp ◽  
Elizabeth Powell ◽  
Beverly Moy
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Metastatic Disease ◽  
Massachusetts General Hospital ◽  
Patient Characteristics ◽  
Care Utilization ◽  
Care Needs ◽  
Hematologic Cancer ◽  
Ed Visits

160 Background: Cancer clinical trials (CTs) often represent the best available treatment for many patients, but little is known about the health care utilization of these patients. We examined correlates of hospitalizations and emergency department (ED) use in cancer CT patients to determine those at greatest risk for these outcomes. Methods: We prospectively collected data on patient characteristics, hospitalizations and ED use among all patients enrolled in cancer CTs at Massachusetts General Hospital in 2014. We calculated the number of hospitalizations and ED visits in the 6-month interval following patients’ CT enrollment. We used linear regression with purposeful selection of covariates to identify factors associated with hospitalizations and ED use. Results: Of 1,218 CT patients (mean age = 58 years; 575 (47%) male), 781 (64%) were married and 851 (70%) had metastatic disease. All cancer types were represented, but hematologic cancers (21%) were most common. Within 6 months following CT enrollment, 519 (43%) and 327 (27%) had at least one hospitalization and ED visit, respectively. At any time during their cancer course, 177 (15%) received a palliative care (PC) consult. Controlling for presence of metastatic disease, PC consults correlated with both hospitalizations and ED visits. Having a hematologic cancer and being unmarried correlated with more hospitalizations and ED visits, respectively. Conclusions: Hospitalizations and ED visits occur in a substantial proportion of cancer CT patients. We need to better understand reasons for these high rates of health care utilization, but the correlations with PC consults suggest that CT patients have unique supportive care needs and that PC services are being targeted to a population particularly in need. [Table: see text]

Effects of the New York State Concussion Management and Awareness Act (“Lystedt Law”) on Concussion-Related Emergency Health Care Utilization Among Adolescents, 2005-2015

2017 ◽  
Vol 46 (2) ◽  
pp. 396-401 ◽  
Author(s):  
David R. Baker ◽  
Erin R. Kulick ◽  
Amelia K. Boehme ◽  
James M. Noble
Keyword(s):  
Health Care ◽  
New York ◽  
Health Care Utilization ◽  
Brain Imaging ◽  
New York State ◽  
Care Utilization ◽  
York State ◽  
Concussion Management ◽  
Imaging Utilization ◽  
Ed Visits

Background: All states have enacted legislation addressing the management of sports-related concussions (SRCs) in adolescent athletes. The effect of these laws on health care utilization is uncertain. Hypothesis/Purpose: The purpose was to evaluate the effects of New York’s 2011 Concussion Management and Awareness Act (“Lystedt Law”) on emergency department (ED) concussion health care visits (EDCHVs) and brain imaging utilization. It was hypothesized that New York concussion legislation would have a significant temporal effect on EDCHVs. Study Design: Descriptive epidemiology study. Methods: Using the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) database, trends in EDCHVs from 2005 to 2015 were identified among 12- to 18-year-old patients, comprising 5,740,403 total ED visits. Results: Overall, 208,024 EDCHVs, including 54,669 for an SRC, occurred during the study period. EDCHVs increased from 13,664 (2.74% of all ED visits) in 2005 to a peak of 21,374 (4.26%) in 2013, with greatest relative increases from 2008 to 2013. SRCs followed a similar trend: 3213 (0.64%) in 2005 to a peak of 6197 (1.24%) in 2013. Brain imaging utilization decreased by 5.3% for EDCHVs and 15.4% for SRCs (all comparisons year-by-year and for trends; P < .001). Conclusion: The period of greatest increases in EDCHVs and decreases in brain imaging utilization for SRCs preceded New York concussion legislation by several years, suggesting a minimal direct effect on emergency care–seeking behavior for concussions. Instead, increased public awareness of SRCs and imaging guidelines may have driven EDCHV trends and imaging practices.

scholarly journals Emergency department and inpatient health care utilization among patients who require interpreter services

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Jane W. Njeru ◽  
Jennifer L. St. Sauver ◽  
Debra J. Jacobson ◽  
Jon O. Ebbert ◽  
Paul Y. Takahashi ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Interpreter Services

scholarly journals Dissemination of Evidence-Based Recommendations for Sickle Cell Disease to Primary Care and Emergency Department Providers in North Carolina: A Cost Benefit Analysis

2021 ◽  
Vol 8 (1) ◽  
pp. 18-28
Author(s):  
Paula Tanabe ◽  
Audrey L. Blewer ◽  
Emily Bonnabeau ◽  
Hayden B. Bosworth ◽  
Denise H. Clayton ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
North Carolina ◽  
Sickle Cell Disease ◽  
Cost Benefit ◽  
Care Utilization ◽  
Evidence Based ◽  
Cell Disease ◽  
Ed Visits

Background: Sickle cell disease (SCD) is a genetic condition affecting primarily individuals of African descent, who happen to be disproportionately impacted by poverty and who lack access to health care. Individuals with SCD are at high likelihood of high acute care utilization and chronic pain episodes. The multiple complications seen in SCD contribute to significant morbidity and premature mortality, as well as substantial costs to the healthcare system. Objectives: SCD is a complex chronic disease resulting in the need for primary, specialty and emergency care. Many providers do not feel prepared to care for individuals with SCD, despite the existence of evidence-based guidelines. We report the development of a SCD toolbox and the dissemination process to primary care and emergency department (ED) providers in North Carolina (NC). We report the effect of this dissemination on health-care utilization, cost of care, and overall cost-benefit. Methods: The SCD toolbox was adapted from the National Heart, Lung, and Blood Institute recommendations. Toolbox training was provided to quality improvement specialists who then disseminated the toolbox to primary care providers (PCPs) affiliated with the only NC managed care coordination system and ED providers. Tools were made available in paper, online, and in app formats to participating managed care network practices (n=1800). Medicaid claims data were analyzed for total costs and benefits of the toolbox dissemination for a 24-month pre- and 18-month post-intervention period. Results: There was no statistically significant shift in the number of outpatient specialty visits, ED visits or hospitalizations. There was a small decrease in the number of PCP visits in the post-implementation period. The dissemination resulted in a net cost-savings of $361 414 ($14.03 per-enrollee per-month on average). However, the estimated financial benefit associated with the dissemination of the SCD toolbox was not statistically significant. Conclusions: Although we did not find the expected shift to increased PCP visits and decreased ED visits and hospitalizations, there were many lessons learned.

Sign in / Sign up

Export Citation Format

Share Document