Articles: emergency-services.
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To identify factors associated with relapse following treatment for acute asthma among adults presenting to the emergency department (ED). ⋯ Among patients sent home from the ED following acute asthma therapy, 17% will have a relapse and PEFR does not predict who will develop this outcome. By contrast, several historical features were associated with increased risk. Further research should focus on ways to decrease the relapse rate among these high-risk patients. The clinician may wish to consider these historical factors when making ED decisions.
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Multicenter Study Comparative Study
[Patient satisfaction survey in emergency departments in acute care hospitals].
To describe patient satisfaction with emergency care of different hospitals. ⋯ This survey detect significant differences among all the centers in the study. Waiting time area showed the greater differences among them. Also the worst qualifications, followed by information to patient. Patient satisfaction questionnaires may work as aid in detecting health care problems.
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Early admission to hospital followed by correct diagnosis with minimum delay is a prerequisite for successful intervention in acute stroke. This study aimed at clarifying in detail the factors related to these delays. ⋯ Increased public awareness of the need to seek medical or other attention promptly after stroke onset, to use an ambulance with direct transportation to the acute-care hospital, and to have more effective in-hospital organization will be required for effective acute treatment options to be available to stroke patients.
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Multicenter Study
Hospital admissions through the emergency department: does insurance status matter?
To assess the effect of insurance status on the probability of admission and subsequent health status of patients presenting to emergency departments. ⋯ Uninsured patients with one of three common chief complaints appear to be less frequently admitted to the hospital than are insured patients, although health status does not appear to be affected. Whether these results reflect underutilization among uninsured patients or overutilization among insured patients remains to be determined.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Use of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia. A multicenter, controlled clinical trial.
Approximately 6 million U.S. patients present to emergency departments annually with symptoms suggesting acute cardiac ischemia. Triage decisions for these patients are important but remain difficult. ⋯ Use of ACI-TIPI was associated with reduced hospitalization among emergency department patients without acute cardiac ischemia. This result varied as expected according to the CCU and cardiac telemetry unit capacities and physician supervision at individual hospitals. Appropriate admission for unstable angina or acute infarction was not affected. If ACI-TIPI is used widely in the United States, its potential incremental impact may be more than 200000 fewer unnecessary hospitalizations and more than 100000 fewer unnecessary CCU admissions.