scholarly journals Medical Utilization of Emergency Departments among Patients with Prostate Cancer: A Nationwide Population-Based Study in Taiwan

2021 ◽  
Vol 18 (24) ◽  
pp. 13233
Author(s):  
Jui-Ming Liu ◽  
Ren-Jun Hsu ◽  
Yu-Tang Chen ◽  
Yueh-Ping Liu
Keyword(s):  
Prostate Cancer ◽  
Emergency Department ◽  
Emergency Departments ◽  
Population Based ◽  
Emergency Department Visits ◽  
Medical Expenditure ◽  
Medical Utilization ◽  
Common Disease ◽  
Research Database ◽  
Population Based Study

(1) Background: In Taiwan, prostate cancer is a major malignancy with an increasing incidence among men. This study explores the medical utilization of emergency departments among patients with prostate cancer in Taiwan. (2) Methods: This nationwide, population-based study was conducted via a cross-sectional method based on the Registry for Catastrophic Illness Patient Database from Taiwan’s National Health Insurance Research Database. Patients with newly diagnosed prostate cancer between 1997 and 2013 were enrolled in the study and divided into four treatment-related groups. The rate of emergency department presentation, disease categorization of emergency department visits, emergency department-related medical expenditures, and temporal trends were investigated. (3) Results: A total of 18,728 patients with prostate cancer were identified between 1997 and 2013, for whom 13,098 emergency department visits were recorded. The number of emergency department visits increased during the study period. The incidence rate for the medical utilization of emergency department visits was 822 per 1000 people during the study period. The incidence rates for patients with prostate cancer in the radical prostatectomy, radiotherapy, androgen deprivation therapy, and chemotherapy groups were 549, 1611, 1101, and 372, respectively. The average medical expenditure per emergency department visit was TWD 3779.8 ± 5116.2, and the expenditure was recorded for the chemotherapy group at TWD 4690.8 ± 7043.3. The most common disease diagnoses among patients with prostate cancer who presented to the emergency department were injury/poisoning (16.79%), genitourinary disorders (10.66%), and digestive disorders (10.48%). (4) Conclusions: This nationwide population-based study examined the emergency department visits of patients with prostate cancer in Taiwan, providing useful information for improving the quality of medical care.

scholarly journals The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252441
Author(s):  
Elissa Rennert-May ◽  
Jenine Leal ◽  
Nguyen Xuan Thanh ◽  
Eddy Lang ◽  
Shawn Dowling ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Population Based ◽  
Emergency Department Visits ◽  
System Capacity ◽  
Population Based Study ◽  
Health Measures ◽  
Ed Visits ◽  
The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

scholarly journals P086: Emergency department visits for upper gastrointestinal bleeding: a population-based Alberta cohort

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S87-S87
Author(s):  
E. S. Lang ◽  
G. Kaplan ◽  
D. Tanyingoh ◽  
K. Novak ◽  
S. Veldhuyzen van Zanten ◽  
...  
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Emergency Departments ◽  
Upper Gastrointestinal Bleeding ◽  
Medical Condition ◽  
Large Population ◽  
Population Based ◽  
Emergency Department Visits ◽  
Fiscal Year ◽  
Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding (UGIB) is a common medical condition presenting to emergency departments (ED) and associated with substantial morbidity, mortality, and healthcare expenditures. Our aim was to evaluate the incidence of patients presenting to ED with UGIB in a large population-based surveillance cohort. Methods: The National Ambulatory Care Reporting System (NACRS) was used to identify all presentations to emergency departments for UGIB in Alberta from fiscal year 2010 to 2015 (n=56519) using the International Classification of Diseases Codes (ICD-10) in any diagnostic position. Baseline characteristics and UGIB incidence were calculated using descriptive statistics. Joinpoint regression models were used to calculate the average annual percent change (AAPC) with 95% confidence intervals (CI). Results: The median age of 56519 UGIB presentations was 56 years (interquartile range: 41 to 74 years), 56% were male, and 245% had at least one comorbidity. At time of disposition from the ED , 48.3% were admitted to or transferred to another hospital, 51.4% discharged, and 0.3% died in the emergency department. Further, 10.8% underwent upper endoscopy during their admission to the emergency department. The annual incidence of UGIB were 230.6 (2010), 232.8 (2011), 241.0 (2012), 242.2 (2013), 244.6 (2014), and 242.2 (2015) per 100,000 person-years. Between 2010 and 2015 the incidence of UGIB presenting to ED significantly increased overtime (AAPC=1.1; 95% CI: 0.3 to 2.0). Conclusion: UGIB is a common presentation to emergency departments and has been increasing overtime. Future studies are necessary to evaluate the underlying cause of UGIB and to determine its burden to Albertas healthcare system.

Comorbid Neck Injuries in Concussion-Related Emergency Department Visits: A Population-Based Study

2019 ◽  
Vol 100 (10) ◽  
pp. e55
Author(s):  
Mitchell Sutton ◽  
Vincy Chan ◽  
Tatyana Mollayeva ◽  
Zheng Hu ◽  
Michael Escobar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Population Based ◽  
Emergency Department Visits ◽  
Neck Injuries ◽  
Population Based Study

scholarly journals Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span

2019 ◽  
Vol 28 (4) ◽  
pp. 473-482 ◽  
Author(s):  
Mitchell Sutton ◽  
Vincy Chan ◽  
Michael Escobar ◽  
Tatyana Mollayeva ◽  
Zheng Hu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sex Differences ◽  
Life Span ◽  
Population Based ◽  
Emergency Department Visits ◽  
Neck Injury ◽  
Population Based Study

scholarly journals Reinforcement of Tobacco Control and Reduction in Medical Utilization for Asthma in Taiwan: A Population-Based Study

2019 ◽  
Vol 16 (20) ◽  
pp. 3950
Author(s):  
Huang-Ju Liang ◽  
Ming-Jiuan Wu ◽  
Jih-Shuin Jerng ◽  
Chiang-Hsing Yang
Keyword(s):  
Subgroup Analysis ◽  
Population Based ◽  
Dust Storms ◽  
Medical Utilization ◽  
Smoking Ban ◽  
Utilization Rate ◽  
Research Database ◽  
Population Based Study ◽  
Male And Female ◽  
Prevention Act

Environmental air quality can affect asthma control and the development of overt asthmatic manifestations. In this population-based study, we investigated the effect of reinforcing a smoking ban in Taiwan through the enactment of the Tobacco Hazards and Prevention Act (THPA) on healthcare utilization rate by asthmatics. Analysis was performed based on data relevant to non-hospitalized asthmatic patients with insurance claims between 2005 and 2013 from the National Health Insurance Research Database of Taiwan, reported data on Asian dust storms, and penalty rates for violations of the tobacco ban. Poisson regression showed that the risk for outpatient visits for asthma was lower after enactment of the THPA (RR = 0.98, 95% CI = 0.98–0.99), with a yearly trend of a reduced risk (RR = 0.99, 95% CI = 0.99–1.00), also lower in geographic regions with medium (RR = 0.79, 95% CI = 0.79–0.80) and high (RR = 0.91, 95% CI = 0.91–0.92) penalty rates. Subgroup analysis showed that asthma visit rates were reduced in both male and female groups after the enactment of the THPA. The risk of an asthma ER visit was increased after the enactment of the amended THPA (RR = 1.07, 95% CI = 1.05–1.09), although the yearly trend was not significant (RR = 1.00, 95% CI = 1.00–1.00). The risk of emergency room visits for asthma was significantly reduced in regions with medium (RR = 0.68, 95% CI = 0.68–0.69) and high (RR = 0.75, 95% CI = 0.74–0.76) penalty rates. Subgroup analysis showed that the visit rates were similar in both male and female groups. The effectiveness of reinforcing the smoking ban warrants further policies aimed at further reducing passive smoking.

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