scholarly journals The Impact of Covid-19 on Ophthalmological Emergency Department Visits at King Khaled Eye Specialist Hospital in Riyadh City, Saudi Arabia

Reem S Alamri ◽  
Ohoud Owaidhah ◽  

Purpose: This study aimed to assess the impact of COVID-19 on ophthalmological emergency department visits at King Khaled eye specialist hospital in Riyadh city, Saudi Arabia. Method: A Retrospective Record Review was conducted at KKESH in Riyadh city during a pandemic period from 2 March to 30 June of 2019 and same period in 2020. Data include all patients who visited the ophthalmology emergency department with all age groups.

2021 ◽  
Vol 21 (1) ◽  
Axel Kaehne ◽  
Paula Keating

Abstract Background Emergency department (ED) attendances are contributing to rising costs of the National Health Service (NHS) in England. Critically assessing the impact of new services to reduce emergency department use can be difficult as new services may create additional access points, unlocking latent demand. The study evaluated an Acute Visiting Scheme (AVS) in a primary care context. We asked if AVS reduces overall ED demand and whether or not it changed utilisation patterns for frequent attenders. Method The study used a pre post single cohort design. The impact of AVS on all-cause ED attendances was hypothesised as a substitution effect, where AVS duty doctor visits would replace emergency department visits. Primary outcome was frequency of ED attendances. End points were reduction of frequency of service use and increase of intervals between attendances by frequent attenders. Results ED attendances for AVS users rose by 47.6%. If AVS use was included, there was a more than fourfold increase of total service utilisation, amounting to 438.3%. It shows that AVS unlocked significant latent demand. However, there was some reduction in the frequency of ED attendances for some patients and an increase in time intervals between ED attendances for others. Conclusion The study demonstrates that careful analysis of patient utilisation can detect a differential impact of AVS on the use of ED. As the new service created additional access points for patients and hence introduces an element of choice, the new service is likely to unlock latent demand. This study illustrates that AVS may be most useful if targeted at specific patient groups who are most likely to benefit from the new service.

2021 ◽  
Vol 8 (1) ◽  
Lauren Alexis De Crescenzo ◽  
Barbara Alison Gabella ◽  
Jewell Johnson

Abstract Background The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the US led the Centers for Disease Control and Prevention (CDC) to propose a surveillance definition of traumatic brain injury (TBI) utilizing ICD-10-CM codes. The CDC’s proposed surveillance definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI surveillance definition. The study purpose was to evaluate the impact of the TBI surveillance definition change on monthly rates of TBI-related emergency department (ED) visits in Colorado from 2012 to 2017. Results The monthly rate of TBI-related ED visits was 55.6 visits per 100,000 persons in January 2012. This rate in the transition month to ICD-10-CM (October 2015) decreased by 41 visits per 100,000 persons (p-value < 0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. The average increase in the rate was 0.33 visits per month (p < 0.01) prior to October 2015, and 0.04 visits after. When S09.90 was included in the model, the monthly TBI rate in Colorado remained smooth from ICD-9-CM to ICD-10-CM and the transition was no longer significant (p = 0.97). Conclusion The reduction in the monthly TBI-related ED visit rate resulted from the CDC TBI surveillance definition excluding unspecified head injury, not necessarily the coding transition itself. Public health practitioners should be aware that the definition change could lead to a drastic reduction in the magnitude and trend of TBI-related ED visits, which could affect decisions regarding the allocation of TBI resources. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates that span the ICD transition.

Maria Bres Bullrich ◽  
Sebastian Fridman ◽  
Jennifer L. Mandzia ◽  
Lauren M. Mai ◽  
Alexander Khaw ◽  

Abstract:We assessed the impact of the coronavirus disease 19 (COVID-19) pandemic on code stroke activations in the emergency department, stroke unit admissions, and referrals to the stroke prevention clinic at London’s regional stroke center, serving a population of 1.8 million in Ontario, Canada. We found a 20% drop in the number of code strokes in 2020 compared to 2019, immediately after the first cases of COVID-19 were officially confirmed. There were no changes in the number of stroke admissions and there was a 22% decrease in the number of clinic referrals, only after the provincial lockdown. Our findings suggest that the decrease in code strokes was mainly driven by patient-related factors such as fear to be exposed to the SARS-CoV-2, while the reduction in clinic referrals was largely explained by hospital policies and the Government lockdown.

2021 ◽  
Vol 56 (S2) ◽  
pp. 64-64
Sandra Decker ◽  
Michael Dworsky ◽  
Teresa Gibson ◽  
Rachel Henke ◽  
Kimberly McDermott

2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Joseph S. Guarisco ◽  
Stefoni A. Bavin

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

CJEM ◽  
2014 ◽  
Vol 16 (06) ◽  
pp. 467-476 ◽  
Pat G. Camp ◽  
Seamus P. Norton ◽  
Ran D. Goldman ◽  
Salomeh Shajari ◽  
M. Anne Smith ◽  

Abstract Objective: Communication between emergency department (ED) staff and parents of children with asthma may play a role in asthma exacerbation management. We investigated the extent to which parents of children with asthma implement recommendations provided by the ED staff. Method: We asked questions on asthma triggers, ED care (including education and discharge recommendations), and asthma management strategies used at home shortly after the ED visit and again at 6 months. Results: A total of 148 children with asthma were recruited. Thirty-two percent of children were not on inhaled corticosteroids prior to their ED visit. Eighty percent of parents identified upper respiratory tract infections (URTIs) as the primary trigger for their child’s asthma. No parent received or implemented any specific asthma strategies to reduce the impact of URTIs; 82% of parents did not receive any printed asthma education materials. Most (66%) parents received verbal instructions on how to manage their child’s future asthma exacerbations. Of those, one-third of families were told to return to the ED. Parents were rarely advised to bring their child to their family doctor in the event of a future exacerbation. At 6 months, parents continued to use the ED services for asthma exacerbations in their children, despite reporting feeling confident in managing their child’s asthma. Conclusion: Improvements are urgently needed in developing strategies to manage pediatric asthma exacerbations related to URTIs, communication with parents at discharge in acute care, and using alternate acute care services for parents who continue to rely on EDs for the initial care of mild asthma exacerbations.

Karen E Skinner ◽  
Amin Haiderali ◽  
Min Huang ◽  
Lee S Schwartzberg

Aim: Evaluation of monthly cost during metastatic triple-negative breast cancer (mTNBC) treatment. Patients & methods: Retrospective electronic medical record review of US females aged ≥18 years diagnosed with mTNBC between 1 January 2010 and 31 January 2016. Mean monthly costs per patient were evaluated from start of mTNBC treatment until transfer to hospice, end of record or 3 months prior to death. Results: The mean monthly cost of first line was $21,908 for 505 treated patients; 50.2% of cost was attributable to hospitalization and emergency department visits, and 32.7% to anticancer therapy. Similar patterns were observed for subsequent lines of therapy. Conclusion: The majority of costs were attributable to hospitalization and emergency department services, suggesting a need for effective interventions to reduce utilization of costly services.

2019 ◽  
Vol 4 (6) ◽  

The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p< 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan.

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