Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The current crisis in the emergency care system is characterized by worsening emergency department (ED) overcrowding. Lack of health insurance is widely perceived to be a major contributing factor to ED overcrowding in the United States. This study aimed to compare ED visit rates in the United States and Ontario, Canada, according to demographic and clinical characteristics. ⋯ ED visit rates and patterns are similar in the United States and Ontario, Canada. Differences in health insurance coverage may not have a substantial impact on the overall utilization of emergency care.
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To determine if respondents differed by their demography (age group, race or ethnicity, and insurance status) in their tendency to correctly answer knowledge-based questions when they were in an agree-disagree instead of a multiple-choice format. ⋯ This study demonstrated that survey responses are influenced by the format of the questions, particularly in certain demographic groups. Policy makers and researchers might draw false conclusions about the baseline knowledge and need for education of patients, especially in these populations. The use of agree-disagree format questions in preventive health knowledge surveys should be avoided whenever possible.
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The percentage of adult patients admitted with pneumonia who receive antibiotics within four hours of hospital arrival is publicly reported as a quality and pay-for-performance measure by the Department of Health and Human Services and is called PN-5b. ⋯ All EDs in this study have addressed early antibiotic administration with multiple operational changes despite mixed sentiment that these changes will improve care. Future research is needed to measure the impact of pay-for-performance initiatives.
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To examine unexpected events (UEs) that occur during the intrahospital transport of critically ill emergency department patients. ⋯ Unexpected events during the intrahospital transport of critically ill patients from the emergency department are common and can be potentially life threatening. Transporting physician experience is associated with UE rate. Strict adherence to and review of existing transport guidelines is recommended.