Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine whether telephone preauthorization for reimbursement of ED care (medical "gate-keeping") by managed care organizations (MCOs) is associated with adverse outcomes. ⋯ Adverse outcomes occur with MCO gatekeeping, Although the present study cannot ascertain whether this is a frequent event or a rare one, the safety of MCO gatekeeping deserves further study.
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To determine whether an effective telephone callback system can be successfully implemented in a busy ED and to quantify the benefits that can be obtained related to the follow-up care of elder patients. ⋯ A telephone callback system is a feasible and effective method to improve follow-up care of elder patients released from the ED.
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To characterize ambulance utilization in a pediatric population and pediatric emergency physicians' judgement of the medical need for ambulance transport. ⋯ Most pediatric ambulance transports in this sample, which excluded patients requiring immediate resuscitation or trauma team care, were judged to be medically unnecessary. Caregivers often use an ambulance as a convenience or as the only means of transportation. An alternate, less resource-intensive transportation system may be more appropriate for this population.