The American journal of emergency medicine
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Observational Study
Variability in opioid prescribing in veterans affairs emergency departments and urgent cares.
The Veterans Health Administration (VHA) is the largest integrated health care system in the U.S., serving approximately 2.5 million Veterans in the Emergency Department/Urgent Care Centers (ED/UCC) each year. Variation in opioid prescribing by ED/UCC providers in the VHA is described. ⋯ ED/UCC providers in the VHA system nationally vary considerably in rates of opioid prescribing. A focused initiative tailored for ED/UCC providers is needed to decrease opioid prescribing variability.
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To determine whether ambulance arrival to the emergency department has remained an unidentified signal of perceived medical acuity. Informed by economic signaling theory, does arrival via ambulance affect resource utilization given varying levels of patient acuity? ⋯ The results are consistent with the notion that emergency department medical providers readily accept ambulance transport as a valid signal of patient acuity, regardless of true acuity level. Consequently, patients transported to the hospital via ambulance may be receiving a disproportionate amount of medical resources in an increasingly cost-conscious environment.