Annals of emergency medicine
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Emergency departments (EDs) provide round-the-clock emergency care but also serve as a health care "safety net." We seek to determine the number, distribution, and characteristics of US EDs, with a long-term goal of improving access to emergency care. ⋯ Significant variation exists in the distribution and use of US EDs. One third of EDs have an annual visit volume less than 8,760 and, together, they account for 6% of all visits. The United States should consider classifying EDs, as it does trauma centers, to clarify the type of care available in this heterogeneous clinical setting and the distribution of different types of EDs.
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We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality. ⋯ Tables and figures can convey details and complex relationships not easily described in text. Although tables are included in most submitted and published articles, they are not presented optimally; figures are used sparingly and are also of suboptimal quality. Journals should consider improving their table and figure quality in the hope that improved graphics will empower readers to scrutinize the data, thereby dissuading authors from presenting biased analyses and misrepresented conclusions.
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We estimate ambulance revenues lost from each hour spent on ambulance diversion at an urban teaching hospital's emergency department (ED) and examine the financial impact of increased ICU capacity, which reduced diversion hours by 63%. ⋯ Ambulance patients generated substantial revenues for hospital services. Decreasing diversion time led to improved revenues. The potential for increased revenues may provide some incentive for hospitals to take greater efforts to reduce ambulance diversion.
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Observational studies of well-described patient populations presenting to emergency departments (EDs) with suspicion of acute coronary syndrome are necessary to understand the relationships between patients' signs and symptoms, cardiac risk profile, test results, practice patterns, and outcomes. We describe the methods for data collection and the ED population enrolled in a multicenter registry of patients with chest pain. ⋯ A unique description of undifferentiated ED chest pain patients with suspected acute coronary syndrome is provided. The data set can be used to generate and explore hypotheses to improve understanding of the complex relationships between presentation, treatment, testing, intervention and outcomes.