Articles: emergency-department.
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Adolescents frequently use the emergency department (ED) to meet their health care needs, and many use the ED as their primary source of care. The ED is therefore well situated to provide preventive health care to large numbers of adolescents. The objective of this multicenter qualitative analysis was to identify factors that influence the implementation of preventive health care interventions for adolescent patients in the ED. ⋯ Factors facilitating implementation of preventive health interventions for adolescent patients in the ED encompassed multiple CFIR domains, elucidating how the delivery of preventive health interventions for this patient population in the ED requires considering numerous factors comprehensively. These data suggest methods to enhance and facilitate implementation of preventive health interventions for adolescents in the ED.
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In ensuring the timely delivery of emergency care to Veterans, Veterans Affairs (VA) offers both emergency care services in its own facilities and, increasingly, purchases care for Veterans in non-VA (community) emergency department (ED) settings. Although in recent years emergency care coverage has become the single largest contributor to VA community care spending, no study to date has examined Veteran decision-making as it relates to ED setting choice. The purpose of this study is to identify and describe reasons why Veterans choose VA versus non-VA emergency care settings. ⋯ Our qualitative results help provide insight into how and why Veterans choose to seek emergency care. As the number of Veterans treated in non-VA EDs continues to rise, VA and non-VA ED providers as well as policy makers may benefit from understanding the challenges Veterans face when making this decision.
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Randomized Controlled Trial
Effect of Cash Benefits on Health Care Utilization and Health: A Randomized Study.
Poverty is associated with greater barriers to health care and worse health outcomes, but it remains unclear whether income support can improve health. ⋯ In this randomized study, individuals who received a cash benefit had significantly fewer emergency department visits, including those related to behavioral health and substance use, fewer admissions to the hospital from the emergency department, and increased use of outpatient subspecialty care. Study results suggest that policies that seek to alleviate poverty by providing income support may have important benefits for health and access to care.
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Most post-9/11 Veterans have completed at least 1 combat deployment-a known factor associated with adverse health outcomes. Such Veterans are known to have unmet health care needs, and the emergency department (ED) may serve as a safety net, yet little is known about whether combat status is associated with more frequent ED use. We sought to evaluate the relationship between combat status and frequency of ED use among post-9/11 Veterans and assess the most common reasons for ED visits. ⋯ Those who deployed to a combat zone had a significantly higher rate of ED use compared to those who did not. Further, mental health-related ED diagnoses appeared to be more prevalent in combat Veterans. These findings highlight the unique health care needs faced by combat Veterans and emphasize the importance of tailored interventions and support services for this specific population.