Articles: emergency-services.
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The organisation of the American emergency health care system has changed rapidly during recent years, but it remains very different to the system in the United Kingdom. American emergency departments are organised around an attending physician based service, rather than a consultant led service. ⋯ The problems associated with working in an attending physician based service include antisocial hours of work, sleep deprivation, decreased job satisfaction, and "burn out," all in the context of a relatively hostile medicolegal climate. Although there appear to be no easy answers to some of these problems, the A&E specialist should be aware of the potential future difficulties for A&E medicine as it develops within the United Kingdom.
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Pediatr. Clin. North Am. · Apr 1998
ReviewImpact of violence and the emergency department response to victims and perpetrator. Issues and protocols.
Research on the current epidemic of violence and its victims is limited. In the past decade, considerable attention has been focused in the area of domestic violence. Comprehensive emergency department (ED) domestic violence protocols have been developed and evaluated that address identification, treatment, safety issues, legal reporting statutes, and medical and psychosocial interventions. This article focuses on victims, perpetrators, and the occurrence of violence in the ED and describes issues and strategies for identification, intervention, and documentation.
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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.