Specialist availability in emergencies: contributions of response times and the use of ad hoc coverage in New York State

Rabin, Elaine; Patrick, Lisa

doi:10.1016/j.ajem.2015.12.059

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…5,23 In a recent study, only 29%, of the hospitals surveyed had a facial surgeon available for craniofacial trauma. 24 Rabin and Patrick 25 found that large academic hospitals were 44 times more likely to have specialists available for emergencies compared with community hospitals. Community hospitals were also more likely to share coverage with other hospitals within their region.…”

Section: Discussionmentioning

confidence: 99%

Does the Geographical Distribution of Facial Trauma Surgeons Correspond to Facial Trauma Burden? A Nationwide Population-Level Analysis

Rios-Diaz

Kosyk

Cunning

et al. 2021

Journal of Craniofacial Surgery

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It is unknown if craniofacial trauma services are inequitably distributed throughout the US. The authors aimed to describe the geographical distribution of craniofacial trauma, surgeons, and training positions nationwide. State-level data were obtained on craniofacial trauma admissions, surgeons, training positions, population, and income for 2016 to 2017. Normalized densities (per million population [PMP]) were ascertained. State/ regional-level densities were compared between highest/lowest. Risk-adjusted generalized linear models were used to determine independent associations. There were 790,415 craniofacial trauma admissions (x? ¼ 2330.6 PMP), 28,004 surgeons (x? ¼ 83.5 PMP), and 746 training positions (x? ¼ 1.9 PMP) nationwide. There was significant state-level variation in the density PMP of trauma (median 1999.5 versus 2983.5, P < 0.01), surgeon (70.8 versus 98.8, P < 0.01), training positions (0 versus 3.4, P < 0.01) between lowest/highest quartiles. Surgeon distribution was positively associated with income and training positions density (P < 0.01). Subanalysis revealed that there was an increase of 6.7 plastic and reconstructive surgeons/PMP for every increase of 1000 trauma admissions/PMP (P < 0.01). There is an uneven state-level distribution of facial trauma surgeons across the US associated with income. Plastic surgeon distribution corresponded closer to craniofacial trauma care need than that of ENT and OMF surgeons. Further work to close the gap between workforce availability and clinical need is necessary.

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Section: Discussionmentioning

confidence: 99%

Does the Geographical Distribution of Facial Trauma Surgeons Correspond to Facial Trauma Burden? A Nationwide Population-Level Analysis

Rios-Diaz

Kosyk

Cunning

et al. 2021

Journal of Craniofacial Surgery

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“…[2] Accessing orthopedic specialists in the ED setting can be challenging and approximately 25% of visits to the ED are due to diseases of the musculoskeletal system or musculoskeletal injuries. [3,4] However, many MUCCs restrict access to patients based on insurance type which may limit care options for patients. [2,5] Prior research has demonstrated that urgent care centers (UCCs) may delay care for patients presenting with emergent surgical conditions.…”

Section: Introductionmentioning

confidence: 99%

Evaluating musculoskeletal urgent care center triage and transfer of emergency conditions for emergency surgical assessment and intervention

et al. 2022

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Musculoskeletal urgent care centers (MUCCs) are an alternative to emergency departments (EDs) for patients to seek care for low acuity orthopedic injuries such as ankle sprains or joint pain, but are not equipped to manage orthopedic emergencies that require a higher level of care provided in the ED. This study aims to evaluate telephone and online triage practices as well as ED transfer procedures for MUCCs for patients presenting with an orthopedic condition requiring urgent surgical intervention. We called 595 MUCCs using a standardized script presenting as a critical patient with symptoms of lower extremity compartment syndrome. We compared direct ED referral frequency and triage frequency for MUCCs for patients insured by either Medicaid or by private insurance. We found that patients presenting with an apparent compartment syndrome were directly referred to the ED by < 1 in 5 MUCCs. Additionally, < 5% of patients were asked additional triage questions that would increase clinician suspicion for compartment syndrome and allow MUCCs to appropriately direct patients to the ED. MUCCs provide limited telephone and online triage for patients, which may result in delays of care for life or limb threatening injuries that require ED resources such as sedation, reductions, and emergency surgery. However, when MUCCs did conduct triage, it significantly increased the likelihood that patients were appropriately referred to the ED. Level of Evidence : Level II, prognostic study.

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Availability of on-call specialists in Rhode Island Emergency Departments

Kohli

Bennett

Zabbo

et al. 2017

The American Journal of Emergency Medicine

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Specialist availability in emergencies: contributions of response times and the use of ad hoc coverage in New York State

Cited by 4 publications

References 18 publications

Does the Geographical Distribution of Facial Trauma Surgeons Correspond to Facial Trauma Burden? A Nationwide Population-Level Analysis

Does the Geographical Distribution of Facial Trauma Surgeons Correspond to Facial Trauma Burden? A Nationwide Population-Level Analysis

Evaluating musculoskeletal urgent care center triage and transfer of emergency conditions for emergency surgical assessment and intervention

Availability of on-call specialists in Rhode Island Emergency Departments

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