Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Observational StudyImpact of COVID-19 State of Emergency restrictions on presentations to two Victorian emergency departments.
To determine if COVID-19 State of Emergency (SOE) restrictions were associated with a reduction in presentations to two urban EDs in Melbourne, Victoria. ⋯ SOE restrictions were associated with a significant reduction in ED presentations across a range of triage categories and diagnoses. Public health messaging should emphasise the importance of timely ED attendance for acute illness and injury.
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Emerg Med Australas · Dec 2020
Observational StudyOxycodone prescribing in the emergency department during the opioid crisis.
Misuse of prescription opioids is a significant public health issue in Australia. There has been a rapid rise in prescription opioid use, with an associated increase in overdose and death. The over-prescribing of oral opioids, especially oxycodone, in the ED has been identified as a contributor to this problem overseas. It is unclear if similar practice occurs in the Australian ED. The primary aim of our study was to identify the incidence of oral oxycodone administration to patients within the ED. The secondary outcome was to identify the incidence of oxycodone prescribed to patients on discharge from the ED into the community. ⋯ There is a higher incidence of oxycodone prescribing in the Australian ED than previously recognised. An overuse of oxycodone may be contributing to adverse patient outcomes and a public health crisis. Hospitals should consider appropriate steps to reduce the incidence of opioid prescribing and the supply of these medications into the community.
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Emerg Med Australas · Dec 2020
Patients with mental health conditions in the emergency department: Why so long a wait?
Patients presenting with a mental health disorder (MHD) wait longer in the ED compared to those presenting for other reasons, potentially placing vulnerable patients at further risk for deterioration. The present study identified factors associated with a long ED stay for patients with a MHD. ⋯ Some factors predictive of a long ED stay for patients presenting to the ED and diagnosed with a MHD varied based on their disposition. For admissions, the most urgent presentations were likely to stay longest. Strategies to reduce ED stay for both admissions and discharges should consider addressing modifiable aspects, including the need for certain investigations, and non-modifiable aspects, including the need for further access to after-hours mental health services in hospital and in the community.
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Emerg Med Australas · Dec 2020
Lost capacity in emergency departments and its economic implications: A simulation study and economic analysis.
To determine the effect of lost bed capacity (LBC) on the overall capacity of an ED, and to estimate the costs attributable to excess stay in the ED beyond that required for actual emergency care. ⋯ A substantial amount of ED length of stay is due to patients remaining in the ED for time after their emergency care is concluded. This likely represents a substantial overall monetary cost to the Australian healthcare system.
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Emerg Med Australas · Dec 2020
Cost-benefit analysis of retrospectively identifying missed compensable billings in the emergency department.
The aim of the present study was to perform a cost-benefit analysis of retrospectively identifying missed compensable billings in a public Australian ED. ⋯ All scenarios examined led to a positive NPV favouring retrospectively identifying missed compensable billings.