(Press-News.org) The rate of emergency department visits in California for non-injuries has risen while the rate of visits for injuries has dropped, according to a new study led by UC San Francisco that documents the increasing amount of care provided in emergency departments for complex, chronic conditions.
The research shows the growing importance of non-trauma cases in the emergency department (ED), the authors said, and it provides an opportunity to better understand the health of people as well as shifting patterns of care, especially among vulnerable populations.
The findings will be published in the April edition of Health Affairs.
The study, which looks at all visits to California emergency departments from 2005-2011, shows that the emergency department "visit rate" decreased by 0.7 percent during the study's timeframe, while the rate of ED visits for non-injury diagnoses rose 13.4 percent. Among non-injury diagnoses, gastrointestinal system diseases, nervous system disorders, and symptoms of abdominal pain were among the diagnoses with the highest growth in the rate of ED visits, the study found.
"While many people think of the ED as simply a place to go when you have a car accident or some type of major trauma, it is increasingly the case that the emergency department is caring for complex medical patients," said lead author Renee Y. Hsia, MD, professor of emergency medicine at UCSF and director of health policy studies in the UCSF Department of Emergency Medicine. She is also an attending physician in the emergency department at San Francisco General Hospital and Trauma Center.
"At the same time, as our population ages, we are seeing a significant rise in older patients with falls or other trauma," Hsia said. "The emergency department therefore plays a critical role in our health care system's ability to care for the acutely injured as well as complex disease."
While the rate of ED visits for injuries rose more slowly than non-injury diagnoses among Medicaid beneficiaries and the privately insured, the rate decreased among the uninsured, the authors found. Medicare beneficiaries, on the other hand, had a similar percent growth for injury and non-injury diagnoses. Younger patients 5-44 years old experienced more non-injury related diagnoses, compared to the older population (45 and older) who had more injury-related diagnoses.
Finally, the authors found that the rate of growth in mental health conditions as a primary diagnosis was significant among the uninsured, Medicare beneficiaries, and the privately insured, showing the emergency department is also serving as a place of care for patients with mental illness.
The research shows the complexity of emergency care, Hsia said, and it may help policy makers and emergency care physicians to reshape the structure, staffing and funding of emergency departments.
INFORMATION:
Co-authors are Julia B. Nath, a medical student at the University of Chicago Pritzker School of Medicine; and Laurence C. Baker, PhD, a professor in health research and policy at Stanford University, and a research associate at the National Bureau of Economic Research in Massachusetts.
The study was primarily funded by a grant from the California HealthCare Foundation. Additional support was provided by the National Center for Advancing Translational Sciences, National Institutes of Health, through the UCSF Clinical & Translational Science Institute (Grant No. KL2TR000143); and the Robert Wood Johnson Foundation Physician Faculty Scholars Program.
UCSF is the nation's leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and top-tier hospitals, UCSF Medical Center and UCSF Benioff Children's Hospitals. Please visit http://www.ucsf.edu.
Despite concerns about the increasing costs of treating illnesses like breast cancer, higher treatment costs are linked to better survival rates, according to a study by Yale School of Medicine researchers in the Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center at Yale School of Medicine and Yale Cancer Center.
The study appears in the April issue of Health Affairs.
"Our findings indicate that in some instances, newer and costlier approaches may be leading to improved outcomes in breast cancer patients," said senior author Cary P. Gross, M.D., ...
Separating circulating cancer cells from blood cells for diagnostic, prognostic and treatment purposes may become much easier using an acoustic separation method and an inexpensive, disposable chip, according to a team of engineers.
"Looking for circulating tumor cells in a blood sample is like looking for a needle in a haystack," said Tony Jun Huang, professor of engineering science and mechanics. "Typically, the CTCs are about one in every one billion blood cells in the sample."
Existing methods of separation use tumor-specific antibodies to bind with the cancer ...
06.04.2015: Rocks do not loose their memory during Earth history but their true ages might be distorted: even under ultra high-temperature metamorphic conditions exceeding 1200°C zircon maintains its lead content accumulated during radioactive decay of uranium and thorium.
Giga year old zircon crystals still contain lead in form of nanometre size spheres of pure lead. However, the inhomogeneous spatial distribution of the lead spheres might falsify ages determined from high-resolution Pb isotope measurement with ion probe.
Zircon is an ideal mineral for age determination ...
Insects form swarms, fish school, birds flock together. Likewise, one species of bacteria forms dynamic, living crystals, says new research from Rockefeller University. Biophysicists have revealed that fast-swimming, sulfur-eating microbes known as Thiovulum majus can organize themselves into a two-dimensional lattice composed of rotating cells, the first known example of bacteria spontaneously forming such a pattern.
"The regular, repeated arrangement of the microbial cells shares the geometry of atoms within a mineral crystal, but the dynamics are fundamentally different; ...
Scientists at The University of Manchester have discovered that a previously known gene also helps cells divide normally and that its absence can cause tumours.
The glucocorticoid receptor (GR) has previously been shown to have a role in cell development, immune response and metabolism. It is found in almost every cell in the body. Many widely used drugs, including prednisolone, act through this protein.
The research from Manchester, to be published in the journal Proceedings of the National Academy of Sciences (PNAS), showed a new role for GR after the scientists ...
The stigma associated with particular neighborhoods has a direct impact on economic transactions, a team of New York University sociologists has found.
Their study, which appears in the journal Proceedings of the National Academy of Sciences, shows that when sellers are seen as being from an economically disadvantaged neighborhood, they receive fewer responses to advertisements placed in online marketplaces.
"Advertisements identifying the seller as a resident of a lower-income neighborhood received significantly fewer responses than advertisements identifying the ...
PROVIDENCE, R.I. [Brown University] -- Life may seem precarious for the sea sponge known as Venus' flower basket. Tiny, hair-like appendages made essentially of glass are all that hold the creatures to their seafloor homes. But fear not for these creatures of the deep. Those tiny lifelines, called basalia spicules, are fine-tuned for strength, according to new research led by Brown University engineers.
In a paper published in the Proceedings of the National Academy of Sciences, the researchers show that the secret to spicules' strength lies in their remarkable internal ...
ANN ARBOR, Mich. - What happens in the moments just before death is widely believed to be a slowdown of the body's systems as the heart stops beating and blood flow ends.
But a new laboratory study by the University of Michigan Medical School reveals a storm of brain activity that erupts as the heart deteriorates and plays a surprising destabilizing role in heart function.
This near-death brain signaling may be targeted to help cardiac arrest patients survive. Most of the more than 400,000 Americans who experience cardiac arrest at home, at work or in public die without ...
Researchers sketching out a wiring diagram for rat brains -- a field known as "connectomics" -- have discovered that its structure is organized like the Internet.
For years, scientists looking for clues to brain function through its structure focused on what could be seen -- the brain's lobes, grooves and folds. Now, with a more comprehensive picture of how neurons connect to one another, they've discovered local networks of neurons nested into one another like shells.
"The cerebral cortex is like a mini-Internet," said Larry Swanson, professor at the USC Dornsife College ...
Scientists funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have identified a cellular receptor for rhinovirus C, a cold-causing virus that is strongly associated with severe asthma attacks. A variant in the gene for this receptor previously had been linked to asthma in genetic studies, but the potential role of the receptor, called CDHR3, in asthma was unknown. The new findings help clarify the function of CDHR3 and point to a novel target for the development of prevention and treatment strategies against ...
