Mortality of the users of a hospital emergency department

Gunnarsdóttir, Oddný Sigurborg; Rafnsson, Vilhjálmur

doi:10.1136/emj.2005.026690

Cited by 40 publications

(34 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These non-causative discharge diagnoses predicted increased mortality in a rather similar way to the findings of the previous study of users of the emergency department who were discharged home and who had higher mortality than the general population, without regard to discharge diagnosis (16). However, mortality from all causes was even higher for those with a discharge diagnosis of mental and behavioral disorders, and it is well known that cohorts with various mental disorders have an increased risk of premature death compared to the general population, also found among individuals with schizophrenia in an Icelandic cohort (21,22).…”

Section: Discussionsupporting

confidence: 64%

“…During this inclusion period, 31,586 visits were made to the ED by 20,296 individuals who were discharged home and who were all entered into the study at the time of discharge. The material has been dealt with in previous studies, so only a brief description will be given here (16,17). All residents of Iceland are included in the National Registry under a unique personal identification number allocated at birth (a 10-digit number that includes the day, month, and year of birth).…”

Section: Methodsmentioning

confidence: 99%

“…A previous mortality study of ED users who were discharged home after diagnosis and treatment showed that frequent visits to the ED also predicted high mortality, particularly due to drug intoxication, suicide, and probable suicide (16).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Non-Causative Discharge Diagnosis from the Emergency Department and Risk of Suicide

Gunnarsdóttir

Rafnsson

2010

The Journal of Emergency Medicine

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 64%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Non-Causative Discharge Diagnosis from the Emergency Department and Risk of Suicide

Gunnarsdóttir

Rafnsson

2010

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…These patients are often of low socioeconomic status, 3,4 have multiple medical, psychiatric and social disorders 5,6 and have a high mortality. 7 Frequent use of the health care system contributes to longer wait times and affects the quality of care. 4,8 Disproportionate use of health care services by a segment of the population has been identified as a challenge in many countries, including Canada.…”

mentioning

confidence: 99%

Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: a systematic review and meta-analysis

Tricco

Antony

Ivers

et al. 2014

CMAJ

131

101

View full text Add to dashboard Cite

Background: Frequent users of health care services are a relatively small group of patients who account for a disproportionately large amount of health care utilization. We conducted a metaanalysis of the effectiveness of interventions to improve the coordination of care to reduce health care utilization in this patient group. Methods:We searched MEDLINE, Embase and the Cochrane Library from inception until May 2014 for randomized clinical trials (RCTs) assessing quality improvement strategies for the coordination of care of frequent users of the health care system. Articles were screened, and data abstracted and appraised for quality by 2 reviewers, independently. Random effects meta-analyses were conducted. Results:We identified 36 RCTs and 14 companion reports (total 7494 patients). Significantly fewer patients in the intervention group than in the control group were admitted to hospital (relative risk [RR] 0.81, 95% confidence interval [CI] 0.72-0.91). In subgroup analyses, a similar effect was observed among patients with chronic medical conditions other than mental illness, but not among patients with mental illness. In addition, significantly fewer patients 65 years and older in the intervention group than in the control group visited emergency departments (RR 0.69, 95% CI 0.54-0.89). Interpretation:We found that quality improvement strategies for coordination of care reduced hospital admissions among patients with chronic conditions other than mental illness and reduced emergency department visits among older patients. Our results may help clinicians and policy-makers reduce utilization through the use of strategies that target the system (team changes, case management) and the patient (promotion of self-management). AbstractSee related commentary, www.cmaj.ca/lookup

show abstract

“…Furthermore, frequent emergency service attendance has been associated with elevated risk of mortality (Gunnarsdottir & Rafnsson, 2006;Stoove, Dietze, & Jolley, 2009). To identify frequent emergency service attendees who also use drugs could be one way to identify the population at risk.…”

Section: Introductionmentioning

confidence: 99%

Emergency service use is common in the year before death among drug users who die from an overdose

Gjersing

Jonassen

Bramness

et al. 2016

Journal of Substance Use

View full text Add to dashboard Cite

AimsThis study compares the characteristics of those who were or were not attended by the emergency services in the year before death. It describes the reasons for emergency service attendance and the prevalence of such attendance. It reports the number of days between the last emergency service attendance and death and examines contact with other health and social services and the association of this with emergency service attendance. Finally, it examines the association between frequency of emergency service attendance and frequency of contact with other services. MethodsA retrospective registry study where all overdose fatalities (n=231) in Oslo, Norway (2006Norway ( -2008 were identified through the National Cause of Death Registry and linked with data from other health and social services. ResultsOverall, 61% were emergency service attendees and 18% were frequent attendees. Somatic complaints were the most common reason for attendance. Attendees were more known to a number of other services compared to the non-attendees. Furthermore, there was an association between frequency of emergency service attendance and frequency of contact with other services. ConclusionsScreening for drug use among emergency service attendees may be a way to identify those at risk of overdose death and enable the introduction of additional interventions.

show abstract

Mortality of the users of a hospital emergency department

Cited by 40 publications

References 18 publications

Non-Causative Discharge Diagnosis from the Emergency Department and Risk of Suicide

Non-Causative Discharge Diagnosis from the Emergency Department and Risk of Suicide

Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: a systematic review and meta-analysis

Emergency service use is common in the year before death among drug users who die from an overdose

Contact Info

Product

Resources

About