Articles: emergency-services.
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Pediatric emergency care · Dec 1986
Utilization of emergency services among patients of a pediatric group practice.
Pediatric group practices in university hospitals provide primary care to children who are often from indigent families. Those practices that attempt to provide care in a continuous way often encounter difficulty in attempting to change their patients' patterns of emergency department utilization. This study attempts to define the relationship between patient characteristics such as access to a telephone and inappropriate utilization of the emergency department. ⋯ However, within the cohort of emergency department utilizers, phone access was not a predictor of use. Of those who used the emergency department, babies and young children and those of indigent status were more likely to inappropriately access care than were older children and those at a higher socioeconomic level. We conclude that the demographic information of clients in a pediatric group practice can be utilized to predict inappropriate utilization of emergency department services and that this information can be used to implement programs to help foster continuity of care.
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Pediatric emergency departments were surveyed by mail to determine the following patient and physician characteristics: census, triage classification, and staffing characteristics. The average number of patient visits per department per year was 44,615 (SD +/- 15,650). Of these, the mean percentage triaged as emergent, urgent, and nonurgent was 14.6 (SD +/- 13.4%), 35.4 (SD +/- 13.1%), and 52.2 (SD +/- 8.7%), respectively. ⋯ Fifty-nine (91%) of the physicians were pediatric board certified, and five (7.6%) were emergency medicine board certified. Academic standing, salaries, clinical research requirements, teaching responsibilities, and average patient care hours were also reviewed. From these data, suggestions for the management of patient care, teaching, and clinical research are presented.
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The perceived urgency of 2000 consecutive patients attending the Accident and Emergency Department of the Royal Infirmary, Edinburgh, was assessed using a Linear Analogue Scale. Each patient was assessed by the receptionist, the receiving nurse and the treating doctor. The distribution of urgency rating produced for this patient group was shown to be comparable for each status of assessor, and to correlate with other outcome criteria such as admission and referral rates. ⋯ However, the complexity of many of these scales, together with the difficulty in usage of so many different scales, begs a reappraisal of the overall triage of patients attending the emergency department. The aim of this study was to look at the perceived urgency distribution of patients presenting to the emergency department. We wished to compare the relative assessment of urgency by various levels of treating staff and to compare those assessments with the referral and outcome of these patients to provide the basis for the development of a comparative Triage Scale.
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Psychiatrische Praxis · Nov 1986
[Psychiatric emergency care and crisis intervention--concepts, experiences and results].
Psychiatric emergencies and life crises are located at opposite ends of a broad scale of stages requiring acute help: Emergency cases need immediate medical care in order to prevent danger to life. For the same reason, immediate hospital admission and additional treatment of risks of internal medicine have to be provided, if necessary. Crises often have not only mental but also social aspects. ⋯ Suicidal attempts or intentions account for about 30% of the service users, marriage crises for about 25% and alcohol problems also for about 25%. The development of complementary care in Mannheim has led to a parallel increase in the proportion of chronically mentally ill living in complementary facilities. This clearly indicates that a 24-hour emergency and crisis intervention service is a compulsory prerequisite for the implementation of an efficient system of complementary care for the mentally ill.