"I want to be taking my own last breath": patients' reflections on illness when presenting to the emergency department at the end of life.

Objective: To understand perceptions regarding their illness of patients who present to the Emergency Department at the end of life.

Methods: Semistructured one-on-one interviews were performed with a convenience sample of seriously ill, Emergency Department (ED) patients with advanced illness presenting to an urban, public hospital. A bilingual Latina health promoter used a predetermined discussion guide to conduct all interviews.

Evaluation of care management for the uninsured.

Background: In 2008, Kern Medical Center established a Care Management Program (CMP) for low-income adults identified as frequent users of hospital services. Frequent users are defined as having 4 or more emergency department (ED) visits or admissions, 3 or more admissions, or 2 or more admissions and 1 ED visit within 1 year. The CMP helps patients access primary care and medical and social resources.

Treatment preferences: impact of risk and benefit in decision-making.

Understanding treatment preferences of seriously ill patients is complex. Previous studies have shown a correlation between the burden and outcome of a treatment and the likelihood a patient will accept a given intervention. In this study the Willingness to Accept Life Sustaining Treatment (WALT) survey was used in a predominantly Latino population receiving care at a large urban safety net hospital.

Chronic kidney disease and US healthcare resource utilization in a nationally representative sample.

Background: Chronic kidney disease (CKD) is a prevalent condition; however, little is known about healthcare resource utilization (HRU) by CKD patients.

Methods: This analysis included NHANES participants aged > or =18 years, with serum creatinine, urine protein, and hemoglobin measurements. We assessed the association between CKD (stratified by stage) and HRU based on self-reported physician visits and hospitalizations in the year preceding the survey.

Burden and predictors of undetected eye disease in Mexican-Americans: the Los Angeles Latino Eye Study.

Background: Latinos have one of the highest rates of visual impairment associated with eye disease in the United States. Although little is known about the prevalence and risk of undetected eye disease (UED) in this population, it is known that Latinos encounter disproportionate barriers in accessing health care, which may influence the burden of UED.

Objective: To estimate the burden and to evaluate factors associated with UED among Latinos, a majority of whom were Mexican-American.

Predictors of on-call specialist response times in California emergency departments.

Objectives: To assess waiting times in emergency departments (EDs) for on-call specialist response and how these might vary by facility or neighborhood characteristics. Limited availability of on-call specialists is thought to contribute to ED overcrowding.

Methods: Direct observational data from a random sample of 1,798 patients visiting 30 California EDs during a six-month period provided specialist waiting times.

Effects of hospital closures and hospital characteristics on emergency department ambulance diversion, Los Angeles County, 1998 to 2004.

Study Objective: We assess the effects of nearby hospital closures and other hospital characteristics on emergency department (ED) ambulance diversion.

Methods: The study design was a retrospective, multiple interrupted time series with control group. We studied all ambulance-receiving hospitals with EDs in Los Angeles County from 1998 to 2004.

Health care expenditures of immigrants in the United States: a nationally representative analysis.

Objectives: We compared the health care expenditures of immigrants residing in the United States with health care expenditures of US-born persons.

Methods: We used the 1998 Medical Expenditure Panel Survey linked to the 1996-1997 National Health Interview Survey to analyze data on 18398 US-born persons and 2843 immigrants. Using a 2-part regression model, we estimated total health care expenditures, as well as expenditures for emergency department (ED) visits, office-based visits, hospital-based outpatient visits, inpatient visits, and prescription drugs.

Diabetes and cardiovascular disease among Asian Indians in the United States.

Context: Studies, mostly from outside the United States, have found high prevalence of diabetes, coronary heart disease (CHD), and hypertension among Asian Indians, despite low rates of associated risk factors.

Objective: To analyze the prevalence of obesity, diabetes, CHD, hypertension, and other associated risk factors among Asian Indians in the United States compared to non-Hispanic whites.

Design, Setting, And Subjects: Cross-sectional study using data from the National Health Interview Survey (NHIS) for 1997, 1998, 1999, and 2000.