PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Uninsured trauma patients are more likely to use the ED for follow-up care

Many resort to emergency department for minor medical needs that could have been cared for in outpatient clinic

2011-08-27
(Press-News.org) Providing access to an outpatient clinic isn't enough to keep some trauma patients who have been discharged from the hospital from returning to the emergency department (ED) for follow-up care, even for such minor needs as pain medication refills and dressing changes, according to new Johns Hopkins research.

Reporting in the Annals of Emergency Medicine, the researchers say that patients with Medicaid, Medicare and those with no insurance were 60 percent more likely to seek such care in the ED. Those living in poor neighborhoods were 70 percent more likely than patients with insurance to head to the ED instead of going to a doctor's office or clinic.

The findings suggest that, for reasons that are not well understood, many patients who could receive less expensive outpatient care won't or can't seek it, the Hopkins team says. These patients, the researchers say, end up receiving far more costly care in the ED, where they have longer waits and add to the notorious crowding that burdens many emergency rooms.

"Just providing patients access to doctors outside of the ER clearly isn't working, especially for those without insurance," says study leader Adil H. Haider, M.D., M.P.H., an assistant professor of surgery at the Johns Hopkins University School of Medicine. "We need better ways to help patients discharged from the hospital receive appropriate follow-up care."

Haider and his colleagues analyzed the records of 6,675 trauma patients admitted to The Johns Hopkins Hospital between 1997 and 2007. Roughly 13 percent of these patients returned to the ED within a month of discharge, yet nearly 90 percent of them were not readmitted into the hospital, suggesting that their ER visit was avoidable and that they could have been treated in an outpatient clinic, Haider says. Among the small number of return patients who were readmitted, the main cause was complications from their original injury and hospitalization.

Along with being uninsured or government insured and living in low-income neighborhoods, black patients and those with more serious injuries were more likely to return to the ED for follow-up care. Patients who were discharged to a rehabilitation, nursing or acute-care facility were significantly less likely to return to the ER than those who were discharged home. The nature of the injury made no difference, the researchers found. Those with penetrating injury, like stabbing or gunshot wounds, were no more and no less likely to seek repeat care in the ER than those with blunt trauma injuries, like those sustained in car crashes.

All trauma patients discharged from Johns Hopkins receive a free follow-up appointment, regardless of insurance. Therefore, access to care shouldn't be an issue even for those who have no insurance and are too poor to afford private care, the investigators say.

"Clearly, there are more factors at play than just having an appointment or access to care," says Haider, who is also co-director of Johns Hopkins' Center for Surgery Trials and Outcomes Research.

To mitigate this problem, the Hopkins staff now makes the initial follow-up appointment for the patient before discharge. Yet, even so, the researchers say, some of the poorest patients may find it hard to believe there is no up-front cost, and they may know they won't have to pay before being seen at the ED. Another possible factor, the researchers add, might be that clinic appointment times are inconvenient for those who cannot take time off work or who have no transportation.

"It may be that going to the ER, typically considered the provider of last resort, is the easiest option," Haider says.

"Regardless of the underlying cause, further research is needed to investigate how the system can be more efficient in taking care of these vulnerable populations," Haider adds. "Improving follow-up care for these vulnerable patients will not only improve the quality of their care, but will also ease the burden on already strained emergency departments and reduce overall healthcare costs."

INFORMATION:

Other Johns Hopkins researchers who participated in the study include Karim S. Ladha, M.D.; J. Hunter Young, M.D., M.H.S.; Derek K. Ng, Sc.M.; and David T. Efron, M.D., M.P.H.

For more information: http://www.hopkinsmedicine.org/surgery/faculty/Haider

END



ELSE PRESS RELEASES FROM THIS DATE:

The Carlsbad Department of Development Attends NCSL to Promote WIPP and Nuclear Industry

The Carlsbad Department of Development Attends NCSL to Promote WIPP and Nuclear Industry
2011-08-27
The Carlsbad Department of Development (CDOD) recently attended the National Conference of State Legislators (NCSL) in San Antonio, Texas. Over 4,800 legislators from all over the United States attended the annual conference. The CDOD made positive connections related primarily to the nuclear efforts in Carlsbad and throughout Eddy County. The CDOD, which exists to develop the City of Carlsbad and Eddy County, New Mexico, works to promote and recruit existing and new industry to the area. CDOD representatives were on hand at the NCSL to promote the success of the Waste ...

What determines a company's performance? The shape of the CEO's face!

2011-08-27
Believe it or not, one thing that predicts how well a CEO's company performs is the width of his face. CEOs with wider faces, like Herb Kelleher, the former CEO of Southwest Airlines, have better-performing companies than CEOs like Dick Fuld, the long-faced final CEO of Lehman Brothers. That's the conclusion of a new study which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science. Elaine M. Wong at the University of Wisconsin-Milwaukee and her colleagues study how top management teams work. But they have ...

Single vaccines to protect against both rabies and Ebola

Single vaccines to protect against both rabies and Ebola
2011-08-27
PHILADELPHIA—Researchers from Thomas Jefferson University, among other institutions, including the National Institute of Allergy and Infectious Diseases, have developed single vaccines to protect against both rabies and the Ebola virus. Successfully tested in mice, these bivalent vaccines have several advantages over other Ebola candidates that could help speed up development for use in humans and primates. It's built on the same platform as the already approved and financially viable rabies vaccine, and it protects at-risk populations against two viruses, not just one, ...

New Department Store Codes and Offers Announced by DiscountVouchers.co.uk

2011-08-27
Popular money-saving offers site DiscountVouchers.co.uk this week introduces new deals which can allow consumers and shoppers make the most of their budgets at top name department stores. The website, which is home to discount deals for over 800 stores and suppliers, is this week offering deals redeemable at House of Fraser and Debenhams. Savings on garden furniture, bed linen and free delivery are all on show on the DiscountVouchers.co.uk website this week with deals redeemable at House of Fraser. Consumers who want to get themselves great value homeware can log on ...

Chickens eject sperm from males they don't fancy

Chickens eject sperm from males they dont fancy
2011-08-27
Chickens eject sperm from males they don't fancy New research finds that even though hens aren't terribly picky about their mates, they are picky about whose sperm makes it to the egg. Female domestic chickens generally mate with multiple males and are known to sometimes eject sperm following mating encounters. It was unclear, however, whether the sperm ejection was a consequence of receiving a large amount of ejaculate, or because hens are actively trying to rid themselves of undesirable sperm. A team led by Oxford researcher Rebecca Dean investigated the phenomenon ...

Online Retailer of Bathroom Vanities, Home Design Outlet Center Chicago, Joins Skokie Chamber of Commerce to Support and Serve the Community

2011-08-27
Online retailer of bathroom vanities, Home Design Outlet Center Chicago, is joining Skokie Chamber of Commerce to support and serve the community. About Home Design Outlet Center Home Design Outlet Center is a fast growing online retailer of bathroom vanities. Homeowners will be pleasantly surprised by the wide variety of vanities available on the Company's official website. Besides offering the more commonly seen contemporary designs, Home Design Outlet Center also stock up on antique vanities. This is to ensure that homeowners can easily find the design that is ...

Wrapping Up Those Summer Projects with Thin Brick Installation

Wrapping Up Those Summer Projects with Thin Brick Installation
2011-08-27
Thin brick installations hit an all-time high this summer, as builders and contractors continue to look for building solutions that are both environmentally sound and affordable. American Brick Company (Ambrico) reports that the popularity of thin brick has been growing steadily in the last ten years, as more attention is being paid to finding economical solutions to building renovations and new construction projects. According to the experts at Ambrico, thin brick, also known as "faux brick", can be used in just about any type of construction project, from ...

New depiction of light could boost telecommunications channels

2011-08-27
Physicists with the Institute of Ultrafast Spectroscopy and Lasers (IUSL) at The City College of New York have presented a new way to map spiraling light that could help harness untapped data channels in optical fibers. Increased bandwidth would ease the burden on fiber-optic telecommunications networks taxed by an ever-growing demand for audio, video and digital media. The new model, developed by graduate student Giovanni Milione, Professor Robert Alfano and colleagues, could even spur enhancements in quantum computing and other applications. "People now can detect ...

Notre Dame astrophysicists identify missing fuel for galactic star formation

2011-08-27
The Milky Way will have the fuel to continue forming stars, thanks to massive clouds of ionized gas raining down from its halo and intergalactic space. This is the conclusion of a new study by Nicolas Lehner and Christopher Howk, faculty in the Department of Physics at the University of Notre Dame. Their report, "A Reservoir of Ionized Gas in the Galactic Halo to Sustain Star Formation in the Milky Way," will be published in Science tomorrow (Aug. 26). Using the Cosmic Origins Spectrograph, one of the newest instruments on the NASA/ESA Hubble Space Telescope, these researchers ...

Research shows heat in chili peppers can ease sinus problems

2011-08-27
CINCINNATI—Hot chili peppers are known to make people "tear up," but a new study led by University of Cincinnati allergy researcher Jonathan Bernstein, MD, found that a nasal spray containing an ingredient derived from hot chili peppers (Capsicum annum) may help people "clear up" certain types of sinus inflammation. The study, which appears in the August 2011 edition of Annals of Allergy, Asthma & Immunology, compares the use of the Capsicum annum nasal spray to a placebo nasal spray in 44 subjects with a significant component of nonallergic rhinitis (i.e., nasal congestion, ...

LAST 30 PRESS RELEASES:

Exercise as an anti-ageing intervention to avoid detrimental impact of mental fatigue

UMass Amherst Nursing Professor Emerita honored as ‘Living Legend’

New guidelines aim to improve cystic fibrosis screening

Picky eaters by day, buffet by night: Butterfly, moth diets sync to plant aromas

Pennington Biomedical’s Dr. Leanne Redman honored with the E. V. McCollum Award from the American Society for Nutrition

CCNY physicists uncover electronic interactions mediated via spin waves

Researchers’ 3D-printing formula may transform future of foam

Nurture more important than nature for robotic hand

Drug-delivering aptamers target leukemia stem cells for one-two knockout punch

New study finds that over 95% of sponsored influencer posts on Twitter were not disclosed

New sea grant report helps great lakes fish farmers navigate aquaculture regulations

Strain “trick” improves perovskite solar cells’ efficiency

How GPS helps older drivers stay on the roads

Estrogen and progesterone stimulate the body to make opioids

Dancing with the cells – how acoustically levitating a diamond led to a breakthrough in biotech automation

Machine learning helps construct an evolutionary timeline of bacteria

Cellular regulator of mRNA vaccine revealed... offering new therapeutic options

Animal behavioral diversity at risk in the face of declining biodiversity

Finding their way: GPS ignites independence in older adult drivers

Antibiotic resistance among key bacterial species plateaus over time

‘Some insects are declining but what’s happening to the other 99%?’

Powerful new software platform could reshape biomedical research by making data analysis more accessible

Revealing capillaries and cells in living organs with ultrasound

American College of Physicians awards $260,000 in grants to address equity challenges in obesity care

Researchers from MARE ULisboa discover that the European catfish, an invasive species in Portugal, has a prolonged breeding season, enhancing its invasive potential

Rakesh K. Jain, PhD, FAACR, honored with the 2025 AACR Award for Lifetime Achievement in Cancer Research

Solar cells made of moon dust could power future space exploration

Deporting immigrants may further shrink the health care workforce

Border region emergency medical services in migrant emergency care

Resident physician intentions regarding unionization

[Press-News.org] Uninsured trauma patients are more likely to use the ED for follow-up care
Many resort to emergency department for minor medical needs that could have been cared for in outpatient clinic