Articles: emergency-medicine.
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Multicenter Study Observational Study
Continuation of Gender Disparities in Pay Among Academic Emergency Medicine Physicians.
The objective was to identify the effects of gender and other predictors of change in the salary of academic emergency physicians over a four sequential time period of survey administration, across a sample of physicians within different emergency departments (EDs) and within states representing the four main geographical regions of the United States. ⋯ Despite previously published data showing an inappropriate gender salary gap in emergency medicine, this gap has remained essentially unchanged over the past 4 years.
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Multicenter Study
Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act.
We examine the effect of Medicaid expansion on reimbursement for emergency physicians' professional services. ⋯ In this sample, full Medicaid expansion increased payments for emergency physicians' professional services compared with reimbursement in nonexpansion states. Higher reimbursement was driven primarily by lower proportions of uninsured patients and increased reimbursement per visit for both commercially insured and self-pay patients in states with full Medicaid expansion.
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Randomized Controlled Trial Multicenter Study
Economic evaluation of the NET intervention versus guideline dissemination for management of mild head injury in hospital emergency departments.
Evidence-based guidelines for the management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available, and yet, clinical practice remains inconsistent with the guidelines. The Neurotrauma Evidence Translation (NET) intervention was developed to increase the uptake of guideline recommendations and improve the management of minor head injury in Australian emergency departments (EDs). However, the adoption of this type of intervention typically entails an upfront investment that may or may not be fully offset by improvements in clinical practice, health outcomes and/or reductions in health service utilisation. The present study estimates the cost and cost-effectiveness of the NET intervention, as compared to the passive dissemination of the guideline, to evaluate whether any improvements in clinical practice or health outcomes due to the NET intervention can be obtained at an acceptable cost. ⋯ While the NET intervention does improve the management of mTBI in the ED, it also entails a significant increase in cost and-as delivered in the trial-is unlikely to be cost-effective at currently accepted funding thresholds. There may be a scope for a scaled-up and streamlined NET intervention to achieve a better balance between costs and outcomes.
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Multicenter Study
The First National Institutes of Health Institutional Training Program in Emergency Care Research: Productivity and Outcomes.
We assess the productivity, outcomes, and experiences of participants in the National Institutes of Health/National Heart, Lung, and Blood Institute-funded K12 institutional research training programs in emergency care research. ⋯ This training program produced 43 interdisciplinary investigators in emergency care research, with demonstrated productivity in grant funding and publications.
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Multicenter Study
Comparing the Maslach Burnout Inventory to Other Well-Being Instruments in Emergency Medicine Residents.
The Maslach Burnout Inventory (MBI) is considered the "gold standard" for measuring burnout, encompassing 3 scales: emotional exhaustion, depersonalization, and personal accomplishment. Other well-being instruments have shown utility in various settings, and correlations between MBI and these instruments could provide evidence of relationships among key variables to guide well-being efforts. ⋯ Our multicenter study of EM residents demonstrated that assessments using the MBI correlate with other well-being instruments.