Objective: EDs in Indonesia face an unprecedented increase in patient influx after the expansion of national health insurance system coverage. The present study aims to describe EDs' characteristics and capabilities utilisation in Jakarta.
Methods: An ED inventory was created from the Jakarta Provincial Health Office and the Indonesian Hospital Association registries. The EDs that were accessible to the general public 24/7 were surveyed about their characteristics during the calendar year 2017. For further ED analysis, we stratified the hospitals into four types (A, B, C and D) based on their size and capabilities, with type A being the largest.
Results: From the 118 (81%) out of 146 EDs that responded, there were 2 million ED visits or 202 per 1000 people. The median annual visit volume was 11 200 (interquartile range 4233-18 000). Further stratification highlights the annual visit difference among hospital types where type A hospitals reported the most with 32 000 (interquartile range 13 459-38 873). Almost half of the EDs (47%) answered that ≥60% of the inpatient census came from the ED. Less than half of the EDs (44%) can manage psychiatry, oral-maxillofacial and plastic surgery cases. Consultant coverage varied across hospitals and by hospital type (P < 0.05), except for general surgery and obstetrics and gynaecology consultants who were available in most hospitals (74%).
Conclusion: Physicians with limited experience and EDs with heterogeneous emergency care capabilities likely threatened the consistency of quality emergency care, particularly for time-sensitive conditions. Our study provides a benchmark for future improvements in emergency care.
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http://dx.doi.org/10.1111/1742-6723.13570 | DOI Listing |
Sci Diabetes Self Manag Care
January 2025
Department of Health Management, Economics, and Policy, School of Public Health, Augusta University, Augusta, Georgia.
Purpose: The purpose of the study was to examine the extent to which adults with diabetes engage in self-management practices to lower their blood glucose levels and determine factors associated with these engagements.
Methods: The study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). The sample included 1171 adults ages 20 and older with a laboratory A1C level of 6.
BMC Health Serv Res
January 2025
Indiana University School of Medicine, 410 W 10th St, Suite 2000A, Indianapolis, IN, 46202, USA.
Background: Individuals with Sickle Cell Disease (SCD) are a minoritized and marginalized community that have disparate health outcomes as a result of systemic racism and disease-related stigma. The purpose of this study was to determine the psychosocial risk factors for families caring for children with SCD at a pediatric SCD center through use of the Psychosocial Assessment Tool (PAT), a validated caregiver-report screener.
Methods: The PAT was administered annually during routine clinical visits and scored by the SCD Social Worker to provide tailored resources to families.
J Clin Rheumatol
November 2024
Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Background/objective: Systemic lupus erythematosus (SLE) is associated with increased dementia risk. Whether this association is present among older adults with SLE is unclear. Further, whether individuals with concomitant SLE and dementia are at increased risk of emergency department (ED) use has not been explored.
View Article and Find Full Text PDFAims: To evaluate the use of hybrid (telehealth and in-person) care on visitation and glycaemia in older adults with type 1 diabetes (T1D).
Methods: In this retrospective study, we examined clinical characteristics, number of visits (telehealth and in-person) and continuous glucose monitoring (CGM) metrics for older adults (≥65 years) with T1D from electronic health records during the pre-COVID-19 pandemic (March 1, 2019-March 1, 2020; in-person) and pandemic (September 1, 2020-August 31, 2021; hybrid) periods. Main outcomes were the number of visits and changes in glycaemic control (HbA1c), and in a sub-group of older adults using CGM, changes in CGM metrics between in-person and hybrid care.
Alzheimers Dement
January 2025
The USC Brain Health Observatory, University of Southern California, Los Angeles, California, USA.
Introduction: Medicare's Annual Wellness Visit (AWV) is a logical opportunity for early detection of cognitive impairment, but recent data for uptake and cognitive assessments during it are lacking.
Methods: We surveyed Medicare beneficiaries of a nationally representative panel about use of AWV and cognitive assessments and analyzed associations between uptake and beneficiaries' characteristics.
Results: Of 1871 participants, 80% had an AWV, among whom 31% underwent formal cognitive testing, 35% were asked about memory problems, including 15% having both.
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