Learn More
CONTEXT There is growing pressure to avoid hospitalizing emergency department patients who can be treated safely as outpatients, but this strategy depends on timely access to follow-up care. OBJECTIVE To determine the association between reported insurance status and access to follow-up appointments for serious conditions that are commonly identified(More)
Emergency department (ED) crowding has become a major barrier to receiving timely emergency care in the United States. Despite widespread recognition of the problem, the research and policy agendas needed to understand and address ED crowding are just beginning to unfold. We present a conceptual model of ED crowding to help researchers, administrators, and(More)
BACKGROUND An Institute of Medicine (IOM) report defines six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity. The effect of emergency department (ED) crowding on these domains of quality has not been comprehensively evaluated. OBJECTIVES The objective was to review the medical literature(More)
STUDY OBJECTIVE To assess outcome in patients with ventricular fibrillation (VF) treated by defibrillator-equipped police and emergency medical technician-paramedics in an advanced life support (ALS) emergency medical services (EMS) system. METHODS We carried out a retrospective observational outcome study of all consecutive adult patients with atraumatic(More)
STUDY OBJECTIVE To assess the prognostic value of initial end-tidal CO2 pressures (PETCO2) during CPR in patients with out-of-hospital cardiac arrest (OHCA). DESIGN A prospective observational study using a convenience sample. SETTING Primary service area of an advanced life support (ALS) ambulance service, including a city with a population of 70,745(More)
Frequent use of emergency department (ED) services is often perceived to be a potentially preventable misuse of resources. The underlying assumption is that similar and more appropriate care can be delivered outside of EDs at a lower cost. To reduce costs and incentivize more appropriate use of services, there have been efforts to design interventions to(More)
STUDY OBJECTIVE We identify measures of emergency department (ED) and hospital workflow that would be of value in understanding, monitoring, and managing crowding. METHODS A national group of 74 experts developed 113 potential measures using a conceptual model of ED crowding that segmented the measures into input, throughput, and output categories. Ten(More)
Despite the greatest economic expansion in history during the 1990s, the number of uninsured U.S. residents surpassed 44 million in 1998. Although this number declined for the first time in recent years in 1999, to 42.6 million, the current economic slow-down threatens once again to increase the ranks of the uninsured. Many uninsured patients use hospital(More)