Abstract:
:The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on the adoption of these plans and their effects on use and reimbursement. Compared to many specialties, the emergency department (ED) may be insulated from extensive shopping and price negotiation, because visits to the ED are often for urgent and time-sensitive conditions. However, ED utilization patterns may change if cost-conscious health savings account holders forgo other necessary medical care, or if they seek out substitutes to the ED for less urgent problems. In the long run, the ED may feel the impact of changes that stem from 2 areas: the ability of health savings accounts to control the increase in health care costs, and the potential of health savings accounts to replace or undermine more comprehensive health insurance plans. We note areas that emergency physicians should monitor as health savings accounts become more prominent.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
McConnell KJdoi
10.1016/j.annemergmed.2005.05.013subject
Has Abstractpub_date
2005-12-01 00:00:00pages
536-40issue
6eissn
0196-0644issn
1097-6760pii
S0196-0644(05)00618-9journal_volume
46pub_type
杂志文章abstract::Airway compromise is the most common cause of death and severe morbidity in acutely ill and injured children. Rapid-sequence intubation (RSI) is a technique for emergency airway control designed to maximize successful endotracheal intubation while minimizing the adverse physiologic effects of this procedure. RSI requi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(96)70140-3
更新日期:1996-07-01 00:00:00
abstract:STUDY OBJECTIVE:Anecdotal concerns suggest that health management organization (HMO) membership instructions may deter members from calling 911 or going to an emergency department for a perceived emergency. This study examines such instructions, specifically in regard to their definition of an emergency condition and a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70267-2
更新日期:1999-07-01 00:00:00
abstract::In order to assess more rationally the requirement for anticoagulation during intraoperative autotransfusion, the clotting competence of blood collected from the body cavities of 31 trauma victims entering our emergency department with indications for intraoperative transfusion was assessed. Blood was collected at tho...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80375-7
更新日期:1981-03-01 00:00:00
abstract::Situated in the heart of Europe, Switzerland's 7 million inhabitants, including 1 million foreigners, live in an area of 41,000 km2. German, French, Italian, and Rhaeto-Romanic are the official languages. The Swiss health service stands out because of the high quality and efficiency of its ambulatory and hospitalized ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70144-1
更新日期:1998-08-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)81652-x
更新日期:1991-04-01 00:00:00
abstract::A major earthquake devastated the Armenian Republic of the Soviet Union on December 7, 1988, resulting in thousands of deaths and injuries. In a postearthquake investigation of three towns seriously affected by the earthquake, we studied earthquake-related injury patterns, made observations on rescue and medical effor...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81563-x
更新日期:1990-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the concordance of emergency physicians' and cardiologists' interpretations of abnormal ECGs. DESIGN:Retrospective cohort study. SETTING:An urban teaching hospital emergency department. TYPE OF PARTICIPANTS:Patients with an abnormal ED ECG that was interpreted by both an emergency physic...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82521-1
更新日期:1992-05-01 00:00:00
abstract:STUDY OBJECTIVE:We compare the efficacy of intranasal fentanyl versus intravenous morphine in a pediatric population presenting to an emergency department (ED) with acute long-bone fractures. METHODS:We conducted a prospective, randomized, double-blind, placebo-controlled, clinical trial in a tertiary pediatric ED bet...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2006.06.016
更新日期:2007-03-01 00:00:00
abstract::Garter snake bites are generally innocuous to human beings. We report a case of human envenomation from the Wandering Garter snake (Thamnophis elegans vagrans). The patient, who was bitten on his right third fingertip, rapidly developed local edema, ecchymosis, and hemorrhagic vesicles. Systemic signs and symptoms did...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70113-x
更新日期:1994-05-01 00:00:00
abstract::The management of HIV disease has evolved into a complicated and sophisticated subspecialty in recent years. Fourteen drugs, in various combinations, are being used in increasingly complex treatment regimens. The side effects of some of these drugs, as well as certain drug-drug interactions may mimic signs and symptom...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(99)70341-0
更新日期:1999-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest. DESIGN:A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program. SE...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70009-5
更新日期:1994-01-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the diagnostic accuracy of a high-sensitivity cardiac troponin T (hs-cTnT) level less than 5 ng/L or less than or equal to 14 ng/L at emergency department (ED) presentation, combined with the emergency physician's assessment of history and ECG, for ruling out major adverse cardiac events wit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.06.008
更新日期:2016-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if hypertonic saline/dextran (HSD) is effective in treating hemorrhage in the presence of dehydration. DESIGN:After surgical preparation, swine were euhydrated or dehydrated for 24 or 48 hours. Animals were bled 25 mL/kg over 60 minutes and treated with HSD. SETTING:Laboratory. PARTICIPA...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80143-x
更新日期:1992-02-01 00:00:00
abstract:STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(97)70105-7
更新日期:1997-07-01 00:00:00
abstract::We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80462-7
更新日期:1989-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether reminder signs placed at the exits to parking decks increase the rate of safety belt use. METHODS:The subjects in this study were drivers of automobiles with permits to park in campus decks at a major university. Volunteer observers were positioned near the exits of 5 parking decks...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.111059
更新日期:2000-12-01 00:00:00
abstract::Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.10.015
更新日期:2011-07-01 00:00:00
abstract::A 57-year-old woman presented in severe respiratory distress 30 minutes after ingesting hydrochlorothiazide. Pulmonary edema was evident clinically and radiographically. A noncardiogenic etiology was suggested by the lack of jugular venous distention, S3 gallop, or pedal edema, and the presence of a normal cardiac sil...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80531-0
更新日期:1987-08-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to examine the outcome of a subgroup of patients with extreme carbon monoxide (CO) poisoning, specifically those discovered in cardiac arrest, resuscitated, and subsequently treated with hyperbaric oxygen (HBO(2)). Opinions of hyperbaric medicine physicians regarding the treatment of such pati...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.115532
更新日期:2001-07-01 00:00:00
abstract::The traditional use of the throat culture to guide treatment of potential streptococcal pharyngitis recently has been questioned because of the following facts: antibiotic therapy within the first 48 hours of illness reduces the severity and symptoms of streptococcal pharyngitis; more rapid treatment of streptococcal ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80573-x
更新日期:1986-03-01 00:00:00
abstract::This study was undertaken to determine the clinical circumstances of femoral fractures in children. The study was a retrospective investigation of 117 consecutive patients with femoral fractures admitted to The Children's Mercy Hospital, Kansas City, Missouri, from December 1975 to September 1979. Of the 117 patients....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80492-7
更新日期:1982-04-01 00:00:00
abstract::A 31-year-old white man with a core temperature of 60.8 F (16 C) and ventricular fibrillation was successfullly resuscitated using active core and external rewarming techniques. Rectal temperature at the time of reestablished electromechanical cardiac activity was 68 F (20 C), a temperature previously thought to be in...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80339-8
更新日期:1980-02-01 00:00:00
abstract::Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The present...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80019-8
更新日期:1989-07-01 00:00:00
abstract:STUDY OBJECTIVE:We derive a prediction rule to identify children at very low risk for intra-abdominal injuries undergoing acute intervention and for whom computed tomography (CT) could be obviated. METHODS:We prospectively enrolled children with blunt torso trauma in 20 emergency departments. We used binary recursive ...
journal_title:Annals of emergency medicine
pub_type: 临床试验,评论,杂志文章,多中心研究
doi:10.1016/j.annemergmed.2012.11.009
更新日期:2013-08-01 00:00:00
abstract:STUDY OBJECTIVE:Measurement of interval data is important in the accurate recording of events that occur in an emergency medical services system. Measurement of intervals should be a simple task. However, when two separate clocks are needed to record the beginning and end of an interval, accurate measurement may be dif...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70222-1
更新日期:1997-04-01 00:00:00
abstract:STUDY OBJECTIVE:Cancer immunotherapy is evolving rapidly and is transforming cancer care. During the last decade, immune checkpoint therapies have been developed to enhance the immune response; however, specific adverse effects related to autoimmunity are increasingly apparent. This study aims to fill the knowledge gap...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.04.019
更新日期:2019-01-01 00:00:00
abstract::A 27-year-old man was admitted to the emergency department with a fluphenazine decanoate-induced dystonia. He was treated with 125 mg diphenhydramine IV in four doses and 2 mg benztropine IM. A fluctuating response was observed before continued remission of the dystonia. Possible reasons for variable patient responses...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80077-x
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVE:In 2008, a pay-for-performance program was implemented in sequential waves in Ontario emergency departments (EDs), with the aim of reducing length of stay. We seek to evaluate its effects on ED length of stay and quality of care. METHODS:This was a retrospective observational study of ED visits in Onta...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.06.028
更新日期:2016-04-01 00:00:00
abstract::Transthoracic cardiac pacing historically has been relegated to the role of the technique of last resort in treating cardiac arrest. Recent studies have shown that this technique has a high rate of successful electrical capture, but often without mechanical activity. Survival rates have been shown to be dismal when th...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80450-3
更新日期:1984-09-01 00:00:00
abstract:STUDY OBJECTIVE:Patients who leave before being seen by a physician represent a significant problem for many emergency departments (EDs). We sought to determine the effect of a new ED rapid entry and accelerated care at triage (REACT) process on the frequency of patients who leave before being seen. METHODS:We conduct...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.06.013
更新日期:2005-12-01 00:00:00