Articles: emergency-services.
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An analysis was undertaken of 8,470 visits to a pediatric emergency department (ED) over a three-month period during 1975-76. The ED was busiest in the evening and on weekends. Visits were overwhelmingly for acute conditions, which varied seasonally. ⋯ The authors conclude that the documented ED usage patterns reflect the conditions of the children seen (age, medical problems, and severity of illness) and diminished availability of other services on weekends and evening. This indicates reasonable utilization of medical services and suggests the need for non-ED sources of care at times of peak ED use. These ED usage patterns in the 1970s are similar to those described in the 1960s, and together with the earlier data they provide a basis for comparison of utilization patterns during the current period of rapidly changing health-service reimbursement schemes.
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A survey of attendances in one year at a community hospital accident and emergency department in Redcar was undertaken to determine the clinical conditions treated and their severity, the number of cases referred to the major accident centre or to an appropriate specialist, and the reasons why patients chose to attend for treatment at the community hospital. Minor trauma accounted for many of the 7,557 attendances (4,916 patients); 5% were medical and non-traumatic surgical cases. ⋯ There were 1,765 patients (36%) referred for specialist care or follow-up. Nearly half of the patients gave no reason for choosing to seek treatment at the community hospital and most of the remainder attended because of difficulty in getting access to their general practitioner or practice surgery when the injury/illness occurred.
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In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol abuse, chronic alcoholism, or requesting detoxification. As a result of that study, an ER-based comprehensive approach to the management of this population was proposed. Utilizing an existing Connecticut state statute, a specific approach to manage the skid-row alcoholic arriving repeatedly in the ER was developed. I report on this ER-based model and an approach to "capturing" the skid-row alcoholic.