A Profile of US Emergency Departments in 2001

Sullivan, Ashley F.; Richman, Ilana B.; Ahn, C.; Auerbach, Bruce S.; Pallin, Daniel J.; Schafermeyer, Robert W.; Clark, Sunday; Camargo, Carlos A.

doi:10.1016/j.annemergmed.2006.08.020

Cited by 116 publications

(122 citation statements)

References 13 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…Perhaps the most striking difference among EDs is the high proportion of non-hospital-based EDs. This differs significantly from the us, the country where most of the data on ED profiling exists, and from preliminary data of other countries in our international survey [14][15][16]. A second striking finding in the study is the difference in resources and capabilities between hospital-based and non-hospital-based EDs.…”

Section: Discussioncontrasting

confidence: 47%

See 1 more Smart Citation

A Profile of Emergency Departments in Slovenia

Jaklic

Wen

Sullivan

et al. 2012

ISRN Emergency Medicine

Self Cite

View full text Add to dashboard Cite

Objectives. Emergency departments (EDs) are the basic unit of emergency medicine (EM), but there is often significant heterogeneity and differences in ED organization. We sought to describe and characterize EDs in Slovenia. Methods. All EDs open 24/7 to the general public were surveyed using the National ED Inventories survey instrument. Staff were asked about ED characteristics with reference to calendar year 2007. Results. Fifty-five EDs participated (81% response). All EDs treated children and adults. Eleven (20%) of the EDs were hospital based and 44 (80%) were non-hospital based. The median number of annual visits for hospital-based EDs was 21,400 (interquartile range, 19,900-34,200) and 5,000 (interquartile range, 1,100-9,300) for nonhospital-based EDs. All hospital-based EDs had triage to service, and only one was an independent department. Most respondents (76%, 95% CI 64-89%) thought their ED was at good balance or capacity. While hospital-based EDs had high availability of technological resources and ability to treat virtually all emergency types 24/7, these characteristics were less frequent in nonhospital-based EDs. Conclusions. The organization of emergency care in Slovenia is complex, with some variation in the layout, characteristics, and capabilities of its EDs. This initial study establishes a benchmark for future investigations into intra-country comparisons of different types of EDs.

show abstract

Section: Discussioncontrasting

confidence: 47%

“…Survey questions were drawn, in part, from work done in thousands of us. EDs [14]. Survey design was agreed upon by four external consultants, all of whom were clinically active physicians in Slovenia.…”

Section: Methodsmentioning

confidence: 99%

A Profile of Emergency Departments in Slovenia

Jaklic

Wen

Sullivan

et al. 2012

ISRN Emergency Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Methods for derivation of this database have been previously described. 5 Briefly, NEDI-USA combines data from three sources: Verispan Marketing Group's Hospital Market Profiling Solution Database (Yardley, PA), the American Hospital Association Annual Survey of Hospitals (Chicago, IL), and information collected independently by Emergency Medicine Network staff (Boston, MA). Emergency departments (EDs) were defined as emergency care facilities that are open 24 hours per day, 7 days per week, and available for use by the general public; ''urgent care'' facilities known to be closed at certain hours or days were excluded.…”

Section: Study Design and Populationmentioning

confidence: 99%

Assessment of Emergency Physician Workforce Needs in the United States, 2005

Camargo

Ginde

Singer

et al. 2008

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objective was to estimate emergency physician (EP) workforce needs, taking into account the diversity of U.S. emergency departments (EDs) and various projections of EP supply and demand.Methods: The 2005 National ED Inventory-USA (http://www.emnet-usa.org/) provided annual visit volumes for 4,828 U.S. EDs. The authors calculated annual supply based on existing emergency medicine (EM) board-certified EPs, adding newly board-certified EPs, and subtracting board-certified EPs who died or retired. Demand was estimated at each ED by dividing the number of visits by the average EP volume (based on 2.8 patients ⁄ hour, 40 hours ⁄ week, and 34% nonclinical time). The models assumed that at least 1 EP should be present 24 ⁄ 7 in each ED, which would require at least 5.35 full-time equivalents (FTEs) per ED. Based on annual EP attrition estimates, results for best-case, worst-case, and intermediate scenarios were calculated.Results: In 2005, there were approximately 22,000 EM board-certified EPs, but 40,030 EPs would be needed to staff all 4,828 EDs (55% of demand met). A total of 2,492 (52%) EDs had a visit volume that required the minimum number (5.35) FTEs, of which 47% were rural. In the unrealistic (no attrition), best-case scenario, it would take until 2019 to staff all EDs with board-certified EPs. In the worst-case scenario (12% attrition), supply would never meet demand. Our intermediate scenario (2.5% attrition) suggested that board-certified EPs would satisfy workforce needs in 2038. The report states that ''although, ideally, all EDs [emergency departments] would be staffed by residency trained, board certified EPs, this is highly unlikely to occur in the near to middle term, if ever. Therefore alternative staffing models must be developed.'' Staffing EDs creates unique challenges due to the mandate to provide round-the-clock care and the inability to restrict patient demand for services. The most recent national EP workforce projection, based on 1999 data, 2 questioned the ability to supply an adequate number of emergency medicine (EM) residency-trained, board-certified EPs. Given the rising volume of ED visits, up to 115 million in 2005,3 and changes in the political landscape, 4 a reassessment of EP workforce needs is warranted.Our objective was to estimate EP workforce needs, taking into account the diversity of U.S. EDs and various projections of EP supply and demand. We hypothesized that the supply of EM residency-trained, board-certified EPs would be insufficient to meet demand for several decades.

show abstract

“…Nevertheless, other explanations are possible. For example, EDs in the South tend to see lower visit volumes 10 and may have distinct staffing arrangements that could contribute to antibiotic overuse. Roumie et al demonstrated that nonphysician ED clinicians, as compared with emergency physicians, often provide more antibiotics for respiratory conditions in which antibiotics are not indicated.…”

Section: Discussionmentioning

confidence: 99%

Declining Antibiotic Prescriptions for Upper Respiratory Infections, 1993–2004

Vanderweil

Pelletier

Hamedani

et al. 2007

Academic Emergency Medicine

Self Cite

View full text Add to dashboard Cite

Objectives: To examine antibiotic prescribing trends for U.S. emergency department (ED) visits with upper respiratory tract infections (URIs) between 1993 and 2004.Methods: Data were compiled from the National Hospital Ambulatory Medical Care Survey (NHAMCS). URI visits were identified by using ICD-9-CM code 465.9, whereas antibiotics were identified using the National Drug Code Directory class Antimicrobials. A multivariate logistic regression model revealed sociodemographic and geographic factors that were independently associated with receipt of an antibiotic prescription for URIs.Results: There were approximately 23.4 million ED visits diagnosed as URIs between 1993 and 2004. Although the proportion of URI diagnoses remained relatively stable (p trend = 0.26), a significant decrease in provision of antibiotic prescriptions for URIs occurred during this 12-year period, from a maximum of 55% in 1993, to a minimum of 35% in 2004. Patients who were prescribed antibiotics were more likely to be white than African American and to have been treated in EDs located in the southern United States.Conclusions: Antibiotic prescribing for URIs continues to decrease, a favorable trend that suggests that national efforts to reduce inappropriate antibiotic usage are having some success. Nevertheless, the frequency of antibiotic treatment for URI in the ED remains high (35%). Future efforts to reduce inappropriate antibiotic prescribing may focus on patients and physicians in southern U.S. EDs. Additional work is needed to address continued evidence of race-related disparities in care.

show abstract

A Profile of US Emergency Departments in 2001

Cited by 116 publications

References 13 publications

A Profile of Emergency Departments in Slovenia

A Profile of Emergency Departments in Slovenia

Assessment of Emergency Physician Workforce Needs in the United States, 2005

Declining Antibiotic Prescriptions for Upper Respiratory Infections, 1993–2004

Contact Info

Product

Resources

About