Objective: To test the hypothesis that racial and ethnic minorities have increased emergency department visit rates, despite being established with a primary care provider.
Methods: In this retrospective cohort study, ED visits without hospital admission in a 12-month period among patients with a new primary care provider-issued diagnosis of depression were assessed. Electronic medical record (EMR) data was obtained from 47 family medicine clinics in a large Michigan-based healthcare system. General linear regression models with Poisson distribution were used to predict frequency of ED visits.
Results: A total of 4159 patients were included in the analyses. In multivariable analyses, Black / African American race was associated with an additional 0.90 (95% CI 0.64, 1.16) ED visits and American Indian or Alaska Native race was associated with an additional 1.39 (95% CI 0.92, 1.87) ED visits compared to White or Caucasians (null value 0). These risks were only exceeded by patients who received a prescription for a typical antipsychotic drug agent.
Conclusion: Despite being established patients at primary care providers and having follow-up encounters, Black / African American and American Indian or Alaska Native patients with depression were considerably more likely to seek ED treatment compared to White/Caucasian patients with depression.
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http://dx.doi.org/10.1016/j.genhosppsych.2023.10.018 | DOI Listing |
Obes Surg
January 2025
Division of Upper Gastrointestinal and General Surgery, Department of Surgery, Keck Medical Center of University of Southern California, Los Angeles, USA.
Background: Bariatric surgery is the most effective intervention for severe pediatric obesity, but a subset of youth experience suboptimal weight loss and/or recurrent weight gain. Early re-initiation of obesity pharmacotherapy postoperatively may improve outcomes, though this has not been evaluated in pediatric populations.
Methods: A retrospective cohort study at a tertiary care children's hospital evaluated the safety and efficacy of reintroducing obesity pharmacotherapy within six weeks after laparoscopic sleeve gastrectomy (LSG).
Clin Drug Investig
January 2025
Department of Medicine, Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
Purpose: The REDUCE-IT randomized trial demonstrated a cardiovascular benefit of icosapent ethyl (IPE) but also raised potential safety signals for atrial fibrillation (AF) and serious bleeding. We aimed to evaluate the real-world safety of IPE versus mixed omega-3 polyunsaturated fatty acid (OM-3) formulations.
Methods: This retrospective active comparator new-user cohort study compared rates of new-onset AF and major bleeding (MB) among adult new users of IPE versus OM-3 in 2020-2024 US Veterans Affairs data.
J Infect Dis
January 2025
College of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, NY.
Introduction: We sought to explore the variability of antibody responses to multiple vaccines during early life in individual children, assess the trajectory of each child longitudinally, determine the associations of demographic variables and antibiotic exposures with vaccine-induced immunity, and link vaccine responsiveness to infection proneness.
Methods: In 357 prospectively-recruited children, age six through 36 months, antibody levels to 13 routine vaccine antigens were measured in sera at multiple time points and normalized to their respective protective thresholds to categorize children into four groups: very low, low, normal, and high vaccine responder. Demographic variables and frequency of antibiotic exposure data were collected.
Introduction: Pediatric anxiety is rapidly increasing, and in 2022, the US Preventive Services Task Force recommended universal anxiety screening using a validated tool for children 8-18 years.
Method: This evidence-based practice quality improvement initiative integrated an educational process, a validated anxiety screening tool, and a Caregiver Satisfaction Survey into all primary care wellness visits for patients aged 8-18 years.
Results: Significant increases in screening and referrals for mental healthcare were observed postinitiative implementation, especially in ages 8-11 years.
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