CJEM
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Caring for patients with low-acuity conditions in Emergency Departments (ED) is often thought to cost more than treating those patients in other ambulatory settings. Understanding the relative cost of care between settings has critical implications for healthcare policy and system design. ⋯ No studies since 2001 assess the comparative costs of ED versus non-ED care for low-acuity ambulatory conditions. Physician and facility charges for ED care are higher than in other ambulatory settings for low-acuity conditions. Empirical evidence is lacking to support that ED care is more costly than similar care in other ambulatory settings.
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Wide variations in emergency department (ED) syncope management exist. The Canadian Syncope Risk Score (CSRS) was developed to predict the probability of 30-day serious outcomes after ED disposition. Study objectives were to evaluate the acceptability of proposed CSRS practice recommendations among providers and patients, and identify barriers and facilitators for CSRS use to guide disposition decisions. ⋯ Our recommendations based on the study results were: discharge of low-risk patients with physician follow-up as needed; discharge of medium-risk patients with 15-day cardiac monitoring and brief hospitalization of high-risk patients with 15-day cardiac monitoring if discharged. Patients preferred less resource intensive options, in line with CSRS recommended care. Implementation should leverage identified facilitators (e.g., patient education) and address the barriers (e.g., monitor access) to improve ED syncope care.
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Disaster medicine teaching is an important, and understudied, component of EM residency training programs. Little is known about disaster medicine training in Canadian EM programs, particularly within the 1-year EM enhanced skills programs. The purpose of this study is to (1) understand which disaster medicine topics are currently taught in EM enhanced skills programs and (2) establish a list of the highest priority disaster medicine teaching topics for those programs. ⋯ This study identified disaster medicine topics currently taught at Canadian EM enhanced skills programs, along with recommending a list of priority teaching topics. These findings can inform future disaster medicine content in EM training program curricula.