The next step to reducing emergency department (ED) crowding: Engaging specialist physicians

Autor: Emily L. Aaronson, Jeffery B. Weilburg, Pamela Linov, Sandhya Rao, Brian J. Yun, Jarone Lee, Jungyeon Kim, Haytham M.A. Kaafarani
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Critical Care and Emergency Medicine
Medical Doctors
Health Care Providers
Cardiology
Specialty
lcsh:Medicine
Primary care
Pediatrics
03 medical and health sciences
0302 clinical medicine
Older patients
Diagnostic Medicine
Physicians
Mental Health and Psychiatry
Medicine and Health Sciences
medicine
Humans
Medical Personnel
030212 general & internal medicine
Medical diagnosis
lcsh:Science
Primary Care
Retrospective Studies
Ed crowding
Multidisciplinary
business.industry
lcsh:R
030208 emergency & critical care medicine
Overcrowding
Emergency department
Health Care
Professions
Crowding
Oncology
Pediatric Oncology
Family medicine
People and Places
Population Groupings
Female
lcsh:Q
Pediatric Infections
Emergency Service
Hospital
business
Research Article
Cohort study
Zdroj: PLoS ONE, Vol 13, Iss 8, p e0201393 (2018)
PLoS ONE
ISSN: 1932-6203
Popis: Background Much work on reducing ED utilization has focused on primary care practices, but few studies have examined ED visits from patients followed by specialists, especially when the ED visit is related to the specialist’s clinical practice. Objective To determine the proportion and characteristics of patients that utilized the ED for specialty-related diagnosis. Methods Retrospective, population-based, cohort study was conducted using information from electronic health records and billing database between January 2016 and December 2016. Patients who had seen a specialist during the last five years from the index ED visit date were included. The identification of ED visits attributable to specialists was based on the primary diagnosis of ED visits and the frequency of visit with specialists within a given timeframe. Results Approximately 28% of ED visits analyzed were attributable to specialists. ED visits attributed specialists were represented by older patients and occurred more during working hours and early days of week. The most common diagnoses related to ED visits attributed to specialists were Circulatory, Musculoskeletal, Skin, Breast and Mental. Multiple departments, subdivisions and specialists were involved with each ED visit. The number of specialists following the patients who visited the ED ranged from one to six and the number of departments/subdivisions ranged from one to four. Patients that used the ED often were more likely to belong to departments (OR = 1.53) and specialists (OR = 1.18) associated with high ED utilization patterns. Conclusion Patients coming to the ED with specialty-related complaints are unique and require full engagement of the specialist and the specialty group. This study offers a new view of connections patients have with their specialists and engaging specialists both at department level and individual specialist level may be an important factor to reduce ED overcrowding.
Databáze: OpenAIRE
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