Australian health review : a publication of the Australian Hospital Association
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Comparative Study
Older patients' utilisation of emergency department resources: a cross-sectional study.
A cross-sectional study was conducted to investigate older patients' utilisation of emergency department resources. Patients aged > or = 65 years, compared with adults < 65 years, were more likely to be triaged to higher clinical urgency categories. They have a higher hospital admission rate and longer length-of-stay even after adjusting for triage category. ⋯ These groups had similar hospital admission rates and lengths-of-stay. Patients > or = 65 years presented in similar numbers during office-hours and after-hours, but after-hours attendances were more likely to be triaged to higher urgency categories. The greater emergency department resource utilisation by older people has implications for the provision of health services in an aging population.
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The Asthma Management Plan (AMP) was developed by the Thoracic Society of Australia and New Zealand in 1989 to provide a more uniform approach to asthma care, aimed at reducing mortality, morbidity and emergency presentations. The AMP is often supplemented with Asthma Clinical Pathways (CPs) within the emergency department and hospital setting. ⋯ The AMP and CP were both found to have had positive influences on asthma management. However, the study illustrates that there continue to be problems with asthma management, which would be improved by a more consistent use of these instruments.
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The objective was to determine the proportion of patients presenting to the Emergency Department (ED) in atrial fibrillation (AF) who are at high risk of thromboembolic stroke as defined by the American Heart Association and who might benefit from anticoagulation therapy. We enrolled all patients identified as having AF between 28th June 1999 and 26th March 2000. ⋯ Of these, 65 patients were at high risk for thromboembolic stroke and had no contraindication to anticoagulation therapy 43 (66%) were on Warfarin at presentation but 14 (22%) were on Aspirin and 8 (12%) were on neither. 34% of patients with chronic atrial fibrillation presenting to the ED, at high risk of thromboembolic stroke and without contra-indication to anticoagulation, were not anticoagulated on presentation. ED attendance provides an opportunity for intervention for the prevention of stroke in this group.