Publications by authors named "Madeline Feldmeier"
Importance: Ambulance offload delays are a timely and crucial issue with implications for patients, emergency medical services (EMS) agencies, hospitals, and communities. Published data on recent patterns in ambulance patient offload times (APOTs) are sparse.
Objective: To examine patterns in APOT by California local EMS agency and variation between and within local agencies.
Background: Stroke centers are critical for the timely diagnosis and treatment of acute stroke and have been associated with improved treatment and outcomes; however, variability exists in the definitions and processes used to certify and designate these centers. Our study categorizes state stroke center certification and designation processes and provides examples of state processes across the United States, specifically in states with independent designation processes that do not rely on national certification.
Methods: In this cross-sectional study from September 2022 to April 2023, we used peer-reviewed literature, primary source documents from states, and communication with state officials in all 50 states to capture each state's process for stroke center certification and designation.
Importance: The health care system has undergone major changes in the past decade, and emergency department (ED) crowding has worsened over time; however, the most recent patterns in ED capacity and use in California have yet to be studied.
Objective: To analyze patterns in ED capacity and utilization in California hospitals from 2011 to 2021.
Design, Setting, And Participants: This retrospective cohort study used data from the California Department of Health Care Access and Information and the US Census Bureau to analyze ED facility characteristics from more than 400 general acute care hospitals with more than 320 EDs in California as well as patients who presented to those EDs between January 1, 2011, and December 31, 2021.