Annals of emergency medicine
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Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. ⋯ Penetrating injury due to blast from lightning strike is extremely rare. These "shrapnel" injuries should however be ruled out in all patients struck by lightning.
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We study how reimbursements to emergency departments (EDs) for outpatient visits may be affected by the insurance coverage expansion of the Patient Protection and Affordable Care Act as previously uninsured patients gain coverage either through the Medicaid expansion or through health insurance exchanges. ⋯ Assuming historical reimbursement patterns remain after Patient Protection and Affordable Care Act implementation, outpatient ED encounters could reimburse considerably more for both the previously uninsured patients who will obtain Medicaid insurance and for those who move into private insurance products through health insurance exchanges. Although our study does provide insight into the future, multiple factors will ultimately influence reimbursements after implementation of the act.
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Hospital standardized mortality ratios are used for hospital performance assessment. As a first step to develop a ratio variant sensitive to the outcome of patients admitted from the emergency department (ED), we identified International Classification of Diseases, 10th Revision, Canada diagnosis groups in which high-quality ED care would be expected to reduce inhospital mortality (emergency-sensitive conditions). ⋯ We identified 37 diagnosis groups representing emergency-sensitive conditions that will enable the calculation of a hospital standardized mortality ratio relevant to emergency care.