Objectives: Despite widespread efforts to reduce emergency department (ED) visits, patients newly diagnosed with cancer often use the ED for commonly anticipated acute care needs. Existing delivery innovations to reduce ED use are underused, and reasons for this are not understood. Patients who recently visited the ED may provide insights into these patterns of care.
View Article and Find Full Text PDFBackground: Placement stability is tied to well-being among children living in foster care, yet residential mobility remains largely unexplored for transition-age youth residing in extended foster care (EFC) between ages 18 and 21. During the time young adults in EFC can remain in foster homes, child welfare agencies offer living arrangements tailored to the transition into adulthood. In supervised independent living placements (SILPs), residents receive monthly stipends to cover their housing expenses and are responsible for covering food, utilities, and other basic needs-related costs.
View Article and Find Full Text PDFBackground: Sepsis is a life-threatening condition but predicting its development and progression remains a challenge.
Objective: This study aimed to assess the impact of infection site on sepsis development among emergency department (ED) patients.
Methods: Data were collected from a single-center ED between January 2016 and December 2019.
Background: Academic emergency medicine (EM) is foundational to the EM specialty through the development of new knowledge and clinical training of resident physicians. Despite recent increased attention to the future of the EM workforce, no evaluations have specifically characterized the U.S.
View Article and Find Full Text PDFIntroduction: The Balance Eyes Face Arms Speech Time stroke screening tool may have limitations for Spanish-speaking individuals. The purpose of this study is to identify potential screen failure events during evaluation for intervenable acute ischemic stroke events among Spanish-speaking patients.
Methods: This is a retrospective, observational, single-center study at an urban academic center during 2020.
Introduction: Emergency medicine (EM) has historically been among the most competitive specialties in the United States. However, in 2022 and 2023, 219 of 2921 and 554 of 3010 respective National Resident Matching Program positions were initially unfilled. Medical students' selection of a medical specialty is a complex process.
View Article and Find Full Text PDFBackground: In many countries including the USA, the UK and Canada, the impact of COVID-19 on people of colour has been disproportionately high but examination of disparities in patients presenting to ED has been limited. We assessed racial and ethnic differences in COVID-19 positivity and outcomes in patients presenting to EDs in the USA, and the effect of the phase of the pandemic on these outcomes.
Methods: This is a retrospective cohort study of adult patients tested for COVID-19 during, or 14 days prior to, the index ED visit in 2020.
Objectives: Adults with a new diagnosis of cancer frequently visit emergency departments (EDs) for disease- and treatment-related issues, although not exclusively. Many cancer care providers have 24/7 clinician phone triage available, but initial recorded phone messages tend to advise patients to go to the nearest ED if they are "experiencing a medical emergency." It is unclear how well patients triage themselves to the optimal site of care.
View Article and Find Full Text PDFStudy Objective: The SafeSDH Tool was derived to identify patients with isolated (no other type of intracranial hemorrhage) subdural hematoma who are at very low risk of neurologic deterioration, neurosurgical intervention, or death. Patients are low risk by the tool if they have none of the following: use of anticoagulant or nonaspirin antiplatelet agent, Glasgow Coma Score (GCS) <14, more than 1 discrete hematoma, hematoma thickness >5 mm, or midline shift. We attempted to externally validate the SafeSDH Tool.
View Article and Find Full Text PDFBackground: Emergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, we sought to investigate the age and number of years since residency graduation at which male and female emergency physicians (EPs) exhibited workforce attrition.
Methods: We performed a repeated cross-sectional analysis of EPs reimbursed by Medicare linked to date of birth and residency graduation date data from the American Board of Emergency Medicine for the years 2013-2020.
A small but growing body of research suggests that adolescents and young adults involved with the child welfare system and those transitioning out of foster care are at heightened risk of experiencing intimate partner violence (IPV). Understanding the factors that place youth at risk of IPV is central to prevention and treatment of this public health problem. However, questions remain about the prevalence and correlates of IPV among youth in foster care.
View Article and Find Full Text PDFChild Adolesc Social Work J
October 2022
Transitioning to adulthood is difficult for young people aging out of foster care. Research shows that this population faces substantial challenges in trying to avoid legal system involvement during this difficult period of life. Seeking to improve our understanding of the protective factors that mitigate the risks of legal system involvement among transition-age foster youth, this study focuses on social bonds as predictors.
View Article and Find Full Text PDFBackground: Increased body mass index (BMI) and metabolic syndrome (MetS) have been associated with adverse outcomes in viral syndromes. We sought to examine associations of increased BMI and MetS on several clinical outcomes in patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: The registry of suspected COVID-19 in emergency care (RECOVER) is an observational study of SARS-CoV-2-tested patients (n=27,051) across 155 United States emergency departments (EDs).
Study Objective: We sought to identify longitudinal trends in workforce entry and attrition among rural and urban emergency physicians, nonemergency physicians, and advanced practice providers.
Methods: We performed a repeated cross-sectional analysis, from 2013 to 2019, of emergency clinicians who received reimbursement for at least 50 Evaluation and Management services [99281-99285] from Medicare part B within any study year. We calculated the emergency workforce's entry and attrition rates annually.
Objective: Urgent care centers (UCs) commonly evaluate patients with respiratory infections, and patients increasingly prefer UCs to emergency departments (EDs) because of their customer-centric approach. The aim of this study is to describe antibiotic and opioid prescribing among UC and ED visits with respiratory diagnoses.
Methods: This is a cross-sectional study of visits to 7 EDs and 6 UCs in the greater Chicago area.
Introduction: Chronic kidney disease (CKD) is a global-health problem. A significant proportion of referrals to nephrologists for CKD management are early and guideline-discordant, which may lead to an excess number of referrals and increased wait-times. Various initiatives have been tested to increase the proportion of guideline-concordant referrals and decrease wait times.
View Article and Find Full Text PDFExtended foster care (EFC) is an important policy that supports human capital attainment for foster youth transitioning to adult independence. Previous studies have examined youth- and policy-level factors' influence on EFC participation and human capital outcomes (e.g.
View Article and Find Full Text PDFBackground: COVID-19 has been associated with increased risk of thromboembolism in critically ill patients.
Objective: We sought to examine the association of SARS-CoV-2 test positivity and subsequent acute vascular thrombosis, including venous thromboembolism (VTE) or arterial thrombosis (AT), in a large nationwide registry of emergency department (ED) patients tested with a nucleic acid test for suspected SARS-CoV-2.
Methods: The RECOVER (Registry of Potential COVID-19 in Emergency Care) registry includes 155 EDs across the United States.
Background: The challenging clinical dilemma of detecting pulmonary embolism (PE) in suspected patients is encountered in a variety of healthcare settings. We hypothesized that the optimal diagnostic approach to detect these patients in terms of safety and efficiency depends on underlying PE prevalence, case mix, and physician experience, overall reflected by the type of setting where patients are initially assessed. The objective of this study was to assess the capability of ruling out PE by available diagnostic strategies across all possible settings.
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