Trends in the use and capacity of California's emergency departments, 1990-1999

Lambe, Susan; Washington, Donna L.; Fink, Arlène; Herbst, Katherine W.; Liu, Honghu; Fosse, Jessica Scura; Asch, Steven M.

doi:10.1067/mem.2002.122433

Cited by 158 publications

(104 citation statements)

References 6 publications

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“…2,3 Initiation of mechanical ventilation in the ED is common, and because of the long ED length of stays (LOSs) for critically ill patients, mechanical ventilation hours provided have also increased. [4][5][6][7][8][9][10][11][12][13] Despite these trends, there remain relatively few data on ED-based mechanical ventilation practices. 14 ARDS exacts a signifi cant toll on patients who are mechanically ventilated in terms of mortality, long-term survivor morbidity, and health-care use.…”

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confidence: 99%

Mechanical Ventilation and ARDS in the ED

Fuller

Mohr

Miller

et al. 2015

Chest

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confidence: 99%

Mechanical Ventilation and ARDS in the ED

Fuller

Mohr

Miller

et al. 2015

Chest

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“…15 Measures of actual ED capacity (number of beds or stations within hospitals) were not available at the national level. 16 Enrollment in health maintenance organizations (HMOs) for insured people (public and private) was measured for each person based on the response to a question in the survey.…”

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What Accounts For Differences In The Use Of Hospital Emergency Departments Across U.S. Communities?

Cunningham

2006

Health Affairs

121

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Increases in the use of hospital emergency departments (EDs) might contribute to crowding at some EDs, higher health care costs, and lower-quality primary care. This study examines the extent to which differences in populations and health system factors account for variations in ED use across U.S. communities. Contrary to popular perceptions, communities with high ED use have fewer numbers of uninsured, Hispanic, and noncitizen residents. Outpatient capacity constraints also contribute to high ED use. However, high ED use in some communities also likely reflects generic preferences for EDs as a source of care for nonurgent problems. 1 About one-third of ED visits are classified as nonurgent or semi-urgent, which suggests that the care sought during many of these visits could be provided in other settings. Although the causes of ED overcrowding might have more to do with inadequate inpatient capacity at hospitals, increases in ED use contribute to overcrowding, which can lead to longer waiting times and more ambulance diversions to other facilities.2 Growing use of the ED for nonurgent medical problems can also increase health care costs and negatively affect quality of, continuity of, and patients' satisfaction with care. n Explanations for increased ED use. Numerous explanations for the increase in ED use by the U.S. population have been offered. These include changes in the population that have increased demand for EDs, and health system changes that have constrained capacity of other outpatient care. Increases in the number of uninsured people, who lack access to other types of outpatient care, are often cited. D a t a W a t c h

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“…2011, Vol. 34, Nº 3, septiembre-diciembre introDucciÓn La demanda de asistencia sanitaria urgente presenta en los últimos años un crecimiento descontrolado, que provoca crecientes dificultades para una provisión de servicios de calidad [1][2][3][4] . Existe discrepancia sobre lo que se considera un uso adecuado de los servicios de urgencia, tanto desde la perspectiva del paciente como de los profesionales sanitarios 5,6 .…”

Section: Methodsunclassified

Identificación de problemas y propuestas para mejorar la atención de las urgencias extrahospitalarias en Navarra: un estudio Delphi

Pérez-Ciordia

Brugos

Guillén-Grima

et al. 2011

Anales Sis San Navarra

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Fundamento. Las urgencias extrahospitalarias de Navarra sufrieron modificaciones en la organización hace dos años, destacando la creación del servicio de urgencias rural (SUR) que coexiste geográficamente con el servicio normal de urgencias. El objetivo del estudio es conocer la opinión de expertos sobre los problemas y las recomendaciones de mejora que afectan a las urgencias extrahospitalarias.Metodología. Se realizó un estudio Delphi con la participación de 37 expertos (médicos y enfermeras). Por medio del correo electrónico se realizan 3 rondas de cuestionarios sucesivos. El último cuestionario identifica el grado de acuerdo con las ideas del grupo y se identifican los 15 problemas y recomendaciones más relevantes, seleccionando aquellas ideas que alcancen, al menos, el 50 % de acuerdo y una prioridad superior al percentil 25. Agrupamos las ideas mediante análisis de clúster jerárquico.resultados. Se identifican 4 clúster de problemas, destacando entre ellos que "la población utiliza las urgencias para patología banal, como una consulta más" con una puntuación de 297 puntos. De las recomendaciones, con 3 clúster identificados, destaca la "necesidad de diseñar un plan estratégico de atención a las urgencias con unos recursos acorde a las necesidades" (310 puntos de prioridad) y "enviar mensajes claros a la población sobre uso correcto de urgencias" (192 puntos de prioridad). conclusión. El método Delphi identifica problemas y áreas de mejora a través del consenso.Palabras clave. Delphi. Urgencias. Servicios de Salud. aBstract Background. Two years ago there were alterations to outpatient A and E departments in Navarre; in particular, a rural A and E service (Servicio de Urgencias Rural, SUR) was set up, which coexists geographically with the normal A and E service. The aim of this study is to determine the opinion of experts on problems and recommendations for improvements that affect outpatient A and E services. Methodology.A Delphi study was carried out with the participation of 37 experts (doctors and nurses). Three successive rounds of questionnaires were completed using email. The final questionnaire identified degree of agreement with the group's ideas, and the 15 most relevant problems and recommendations were identified; those ideas that were selected achieved at least 50% agreement and their priority was above 25%. We grouped the ideas using a hierarchic cluster analysis.results. Four cluster problems were identified; the most outstanding amongst them being "the population uses A and E for banal pathologies, just like any other consultation" with a score of 297 points. Outstanding amongst the recommendations, with 3 identified clusters, were the "need to design a strategic plan for A and E care with resources appropriate to the needs" (310 priority points) and "sending clear messages to the population on the correct use of A and E" (192 priority points).conclusion. The Delphi method identifies problems and improvement areas through consensus.

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Trends in the use and capacity of California's emergency departments, 1990-1999

Cited by 158 publications

References 6 publications

Mechanical Ventilation and ARDS in the ED

Mechanical Ventilation and ARDS in the ED

What Accounts For Differences In The Use Of Hospital Emergency Departments Across U.S. Communities?

Identificación de problemas y propuestas para mejorar la atención de las urgencias extrahospitalarias en Navarra: un estudio Delphi

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