Articles: emergency-services.
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Since minimal information exists regarding quality assurance in pediatric emergency departments, the experience of staff members of a pediatric emergency department who have recently established a quality assurance program is described. The steps of development are identified. The program is analyzed based upon initial results, and it is measured against theoretical approaches to quality assurance.
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Comparative Study
Old people in the emergency room: age-related differences in emergency department use and care.
Little is known about how the care received in emergency departments (ED) by the elderly population differs from that received by younger people. We prospectively abstracted ED records of 1620 consecutive patients visiting a large community hospital ED over a 22-day period in 1984 for demographic and medical variables. Charts of patients presenting with five specific complaints (dyspnea, chest pain, abdominal pain, syncope, and motor vehicle accidents) were also analyzed for process of care variables and, for patients hospitalized, the accuracy of the ED diagnosis. ⋯ Therapy for specific complaints showed less age effect. Although generally more diagnostic tests were performed on older patients, the ED diagnosis tended to be more accurate for younger patients. Our data indicate that the process of ED care may be substantially different for the elderly population and have implications for future planning and financing of medical care.