Abstract：
STUDY OBJECTIVE:We identify factors that define frequent and highly frequent emergency department (ED) users. METHODS:Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most unique demographic, disease, and health care use features of these groups. RESULTS:Frequent users composed 9.9% of all ED visits, whereas highly frequent users composed 3.6% of visits. Compared with less frequent users, frequent users were defined most strongly by their substance abuse challenges and by their many visits to primary care and specialist physicians. Substance abuse also distinguished highly frequent from frequent ED users strongly; 67.3% versus 35.9% of these patient groups were substance abusers, respectively. Also, 70% of highly frequent versus only 17.8% of frequent users had a long history of frequent ED use. Last, highly frequent users did not use other health care services proportionally more than their frequent user counterparts, suggesting that these former patients use EDs as a main source of care. CONCLUSION:This research develops objective thresholds of frequent and highly frequent ED use. Although substance abuse is prominent in both groups, only highly frequent users seem to visit EDs in place of other health care services. Future analyses can investigate these patterns of health care use more closely, including how timely access to primary care affects ED use. Cluster analysis also has value for defining frequent user subgroups who may benefit from different yet equally effective treatment options.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Doupe MB,Palatnick W,Day S,Chateau D,Soodeen RA,Burchill C,Derksen Sdoi
10.1016/j.annemergmed.2011.11.036subject
Has Abstractpub_date
2012-07-01 00:00:00pages
24-32issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(11)01877-4journal_volume
60pub_type
杂志文章abstract：:Managed care organizations (MCOs) have proliferated throughout the United States. Interaction by patients, physicians, and emergency medical services systems with MCOs is evolving. Although MCOs have had some notable successes in reducing health care expenditures, the way in which MCO enrollees gain access to emergenc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70098-7
更新日期：1996-12-01 00:00:00
abstract：STUDY OBJECTIVE:Data on poisoning with MCPA (4-chloro-2-methyl-phenoxyacetic acid) are limited to 6 case reports. Our objective is to describe outcomes from intentional self-poisoning with MCPA in a prospective case series of 181 patients presenting to hospitals in Sri Lanka. METHODS:Patient information was collected ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.03.016
更新日期：2005-09-01 00:00:00
abstract：:In December 2002, the federal government began a program to immunize approximately 500000 civilian public health and health care workers with smallpox (vaccinia) vaccine as a part of our pre-event defense against bioterrorism. First responders will likely follow, and the general US population might be offered vaccinat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(03)00629-2
更新日期：2003-11-01 00:00:00
abstract：STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.014
更新日期：2013-09-01 00:00:00
abstract：:The 1982 US Festival, a three-day outdoor rock music festival, attracted close to 410,000 people. Through a private contractor, a group of physicians participated in the design, administration, and implementation of medical care for this event. Basic ambulatory care was provided by a multitiered approach, using emerge...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80986-6
更新日期：1986-05-01 00:00:00
abstract：:Acute ischemic stroke is the third leading cause of death in the United States and the leading cause of adult disability. The direct and indirect costs of stroke care exceed $51 billion annually. In 1996, the US Food and Drug Administration approved the first treatment for acute ischemic stroke, intravenous tissue pla...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1067/mem.2001.111573
更新日期：2001-02-01 00:00:00
abstract：:Admixture of erythrocytes (packed red blood cells) with heated saline solutions may provide a faster and safer method of bloodwarming and infusion than is currently available. We developed and tested such a system for ease and efficacy. One-day-old aliquots of erythrocytes (6 to 10 C) were combined with equal amounts ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80362-1
更新日期：1987-04-01 00:00:00
abstract：:Reported is a case of a 34-year-old man, previously in good health, who underwent chiropractic manipulation of the cervical spine for treatment of a recent whiplash injury. Immediately following manipulation, the patient became unresponsive and was found to have sustained a brain stem infarction resulting in the "Lock...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80217-0
更新日期：1983-10-01 00:00:00
abstract：:The use of electronic control devices has expanded worldwide during the last few years, the most widely used model being the Taser. However, the scientific knowledge about electronic control devices remains limited. We reviewed the medical literature to examine the potential implications of electronic devices in terms...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2011.01.023
更新日期：2011-08-01 00:00:00
abstract：STUDY OBJECTIVE:Serum markers of smooth muscle destruction have been shown to be elevated in ectopic pregnancy, but they remain of questionable clinical utility. Our goal was to determine the clinical utility of 3 markers of smooth muscle destruction: creatine phosphokinase (CPK), smooth muscle heavy-chain myosin (SMHC...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.119851
更新日期：2001-12-01 00:00:00
abstract：:The esophageal obturator airway (EOA) is in common use throughout the country. This report outlines an unexpected and serious complication: gastric rupture due to overinsufflation. A survey of the literature revealed that most of the known complications involve direct trauma to the esophagus or trachea. In our case, t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80240-5
更新日期：1981-07-01 00:00:00
abstract：:We present a framework for understanding calculations of continuous infusions of vasoactive substances. Several simplified methods for establishing initial concentrations and infusion rates of drug are derived, their applicability is discussed, and examples are given. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80418-1
更新日期：1983-11-01 00:00:00
abstract：STUDY OBJECTIVE:The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.10.007
更新日期：2017-04-01 00:00:00
abstract：:In a prospective investigation of isolated simple pneumothorax, the treatment of 35 patients with a total of 37 pneumothoraces was studied. A standardized sequential treatment approach was followed for evacuation of the pneumothorax and maintenance of lung reexpansion. The protocol involved catheter placement using a ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80676-0
更新日期：1988-09-01 00:00:00
abstract：STUDY OBJECTIVE:We determine the sensitivity, specificity, and clinical utility of the Gram's stain of peritoneal fluid in patients undergoing paracentesis. METHODS:We conducted a retrospective chart review of all peritoneal fluid analyses in a 3-year period in an urban 3-hospital system. Peritoneal dialysis and diagn...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2008.12.020
更新日期：2009-07-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether pediatric patients with acute, mild to moderate acetaminophen exposures, treated with home monitoring alone, develop systemic signs of hepatic injury. METHODS:A prospective, observational study of calls to a regional poison center over a 25-month period was performed. Patients were...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(00)70074-6
更新日期：2000-03-01 00:00:00
abstract：:This double-blind study compared the analgesic effects of morphine with those of butorphanol in patients who presented with pain because of sickle cell crisis. Patients were placed at bed rest, administered IV hydration, and randomly assigned on each visit to receive either 2 mg IM butorphanol or 6 mg IM morphine ever...
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(88)80554-7
更新日期：1988-08-01 00:00:00
abstract：STUDY OBJECTIVE:The literature suggests that the d -dimer is useful in patients suspected of having pulmonary embolism and who have a low pretest probability of disease. A previously defined clinical decision rule, the Wells Criteria, may provide a reliable and reproducible means of determining this pretest probability...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.04.002
更新日期：2004-11-01 00:00:00
abstract：STUDY OBJECTIVE:In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events. METHODS:The multicenter, prospectively collected Internet Tracking Regist...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.03.021
更新日期：2004-12-01 00:00:00
abstract：STUDY OBJECTIVE:Apnea is a known complication of pediatric seizures, but patient factors that predispose children are unclear. We seek to quantify the risk of apnea attributable to midazolam and identify additional risk factors for apnea in children transported by paramedics for out-of-hospital seizure. METHODS:This i...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.09.015
更新日期：2014-03-01 00:00:00
abstract：STUDY OBJECTIVE:Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.11.019
更新日期：2008-04-01 00:00:00
abstract：:This report describes a case of near-fatal intoxication following accidental exposure to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used in industrial and domestic preparations. Exposure to high levels ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80011-x
更新日期：1981-10-01 00:00:00
abstract：STUDY OBJECTIVE:Postoverdose interventions that deploy peer recovery support specialists to emergency departments (EDs) are a promising response to opioid overdoses among patients presenting in EDs. The objective of this study was to elicit patients' perspectives regarding the feasibility and acceptability of such an i...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2020.06.003
更新日期：2020-12-01 00:00:00
abstract：:A prospective study was conducted to determine the usefulness of clinical findings and 25-degree pronation and supination radiologic views to diagnose carpal navicular fractures. All patients presenting to the emergency department during a two-year period who fell on their outstretched hand and had pain and/or swellin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82039-6
更新日期：1990-03-01 00:00:00
abstract：STUDY OBJECTIVE:We assess the prognostic role of initial glucose levels in patients with a first acute myocardial infarction in the emergency department (ED). METHODS:We conducted a 3-year retrospective cohort study. Patients with a first acute myocardial infarction were recruited from the ED of a tertiary hospital fr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.10.023
更新日期：2007-05-01 00:00:00
abstract：:The hypotension and myocardial depression that result from calcium channel blocker ingestion often are refractory to standard therapeutic modalities. Anecdotal reports on the use of glucagon have failed to show significant hemodynamic improvement. We report the first case of calcium channel blocker overdose that respo...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80997-7
更新日期：1993-07-01 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：:Twenty cases of shaken baby syndrome are reviewed to determine important signs, symptoms, physical findings, laboratory parameters, and prognosis. The signs and symptoms of this form of head trauma are nonspecific. The findings may mimic infection, intoxication, or metabolic abnormalities. Diagnosis depends on a high ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80571-5
更新日期：1984-02-01 00:00:00
abstract：STUDY OBJECTIVES:To determine the incidence of needlestick injury among paramedics working in Florida during 1987, to describe the circumstances surrounding such injuries, and to assess the hepatitis B vaccination status of this group. DESIGN:Survey of a systematic random sample of paramedics using a self-administered...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81072-8
更新日期：1991-12-01 00:00:00
abstract：STUDY OBJECTIVE:We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED). METHODS:This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomize...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2019.01.021
更新日期：2019-08-01 00:00:00
