National Hospital Ambulatory Medical Care Survey: 2019 Emergency Department Summary Tables

Cairns, Christopher; Kang, Kai

doi:10.15620/cdc:115748

Cited by 99 publications

(109 citation statements)

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“…The proportion of hospital stays followed by a readmission within 30 days remained relatively constant between 2008 and 2018 (23% in 2007 versus 22% in 2018) 657 Emergency department. Overall, 1.4% of all emergency department visits were for people with Alzheimer's or another dementia 658 . There are 1,545 emergency department visits per 1,000 Medicare beneficiaries with Alzheimer's or other dementias per year, including emergency department visits that result in a hospital admission 594 .…”

Section: Use and Costs Of Health Care Long‐term Care And Hospicementioning

confidence: 99%

2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,432

664

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This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes -costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI 700

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Section: Use and Costs Of Health Care Long‐term Care And Hospicementioning

confidence: 99%

2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,432

664

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“…Approximately 4% of all adult emergency department (ED) visits in the US are for cancer-related complaints [8,9]. Although this may not seem to be a high proportion, it represents a substantial number of visits amongst the extraordinary variety of conditions treated in EDs.…”

Section: Introductionmentioning

confidence: 99%

Recognizing the emergency department’s role in oncologic care: a review of the literature on unplanned acute care

et al. 2022

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Background The global prevalence of cancer is rapidly increasing and will increase the acute care needs of patients with cancer, including emergency department (ED) care. Patients with cancer present to the ED across the cancer care continuum from diagnosis through treatment, survivorship, and end-of-life. This article describes the characteristics and determinants of ED visits, as well as challenges in the effort to define preventable ED visits in this population. Findings The most recent population-based estimates suggest 4% of all ED visits are cancer-related and roughly two thirds of these ED visits result in hospitalization—a 4-fold higher ED hospitalization rate than the general population. Approximately 44% of cancer patients visit the ED within 1 year of diagnosis, and more often have repeat ED visits within a short time frame, though there is substantial variability across cancer types. Similar patterns of cancer-related ED use are observed internationally across a range of different national payment and health system settings. ED use for patients with cancer likely reflects a complex interaction of individual and contextual factors—including provider behavior, health system characteristics, and health policies—that warrants greater attention in the literature. Conclusions Given the amount and complexity of cancer care delivered in the emergency setting, future research is recommended to examine specific symptoms associated with cancer-related ED visits, the contextual determinants of ED use, and definitions of preventable ED use specific to patients with cancer.

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“…1,2 ED visits for "chest pain" alone numbered more than 7 million during 2018 in the United States. 3 Over the years, a decreasing percentage of patients presenting to the ED with symptoms of possible ACS are ultimately found to have an acute cardiac event 4 and less than 5% of all chest pain visits are diagnosed with any emergent diagnosis, of which ACS is a subset. 5 The recent availability of high-sensitivity cardiac troponin (hs-Tn) in the United States changes the landscape of the evaluation of patients with possible ACS.…”

Section: Introductionmentioning

confidence: 99%

“…Evaluation for acute coronary syndrome (ACS) has long been a major consumer of emergency department resources 1,2 . ED visits for “chest pain” alone numbered more than 7 million during 2018 in the United States 3 . Over the years, a decreasing percentage of patients presenting to the ED with symptoms of possible ACS are ultimately found to have an acute cardiac event 4 and less than 5% of all chest pain visits are diagnosed with any emergent diagnosis, of which ACS is a subset 5 …”

Section: Introductionmentioning

confidence: 99%

Impact of a rapid high‐sensitivity troponin pathway on patient flow in an urban emergency department

et al. 2022

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Study Objective: To evaluate whether the introduction of a 1-hour high-sensitivity cardiac troponin-T (hs-TnT) pathway for patients who present to the emergency department (ED) with suspected acute coronary syndrome (ACS) improves ED patient flow without changing the rate of "missed" major adverse cardiac events (MACE), compared to use of conventional cardiac troponin with an associated 3-hour pathway.Methods: This was a prospective, uncontrolled observational study conducted before and after implementation of a 1-hour hs-TnT pathway at a high-volume urban ED.Patients undergoing evaluation for ACS in the ED were enrolled during their initial visit and clinical outcomes were assessed at 30 and 90 days. Throughput markers were extracted from the electronic medical record and compared. The primary outcome was provider-to-disposition decision time.Results: A total of 1892 patients were enrolled, 1071 patients while using conventional troponin and 821 after introduction of hs-TnT. With the new assay and pathway, median interval between troponin tests decreased from 4.7 hours (interquartile range [IQR] 3.9-5.7 hours) to 2.3 hours (IQR 1.5-3.4 hours) (P < 0.001). However, there was no difference in median provider-to-disposition decision time, which measured 4.7 hours (IQR 2.9-7.2) and 4.8 hours (IQR 3.1-7.1) (P = 0.428) respectively. Total 30day MACE rate in discharged patients was low in both groups, occurring in only 4/472 (0.85%) encounters in the first cohort and 4/381 (1.0%) encounters in the second. Conclusion:Introduction of a 1-hour hs-TnT ACS evaluation pathway reduced the troponin collection interval but did not reduce provider to disposition time. There was no difference in rate of 30-day MACE in patients discharged from the ED.

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National Hospital Ambulatory Medical Care Survey: 2019 Emergency Department Summary Tables

Cited by 99 publications

References 0 publications

2022 Alzheimer's disease facts and figures

2022 Alzheimer's disease facts and figures

Recognizing the emergency department’s role in oncologic care: a review of the literature on unplanned acute care

Impact of a rapid high‐sensitivity troponin pathway on patient flow in an urban emergency department

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