Articles: hospital-emergency-service.
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The WHO recognises patient safety as a serious public health problem. The COVID-19 pandemic affected adult EDs (AEDs) and paediatric EDs (PEDs) differently. We compared the culture of safety in the adult AED and PED before and after the COVID-19 pandemic. ⋯ The baseline perception of the culture of safety was higher in the PED but improved in both services during the COVID-19 pandemic. Adverse situations can provide an opportunity to improve patient safety culture.
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Despite pronounced increases in homelessness and mental health problems in the USA over the past decade, further exacerbated during the pandemic, and the higher prevalence of mental health conditions among individuals experiencing homelessness, no study has examined trends in self-injury-related ED visits by individuals experiencing homelessness using up-to-date nationwide data. To address this gap, we aimed to investigate the association of self-injury-related ED visits with homelessness and to examine trends in these ED visits by individuals experiencing homelessness. ⋯ Among adults aged 25-64 years, experiencing homelessness was significantly associated with self-injury-related ED visits, and an increase in the rate of such visits among individuals experiencing homelessness was observed during 2020 and 2021. Future studies should assess longer-term trends in these visits and explore interventions to address the societal, health and mental healthcare needs in order to improve the health outcomes of these marginalised individuals.
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Observational Study
Characteristics of patients leaving the emergency department without being seen by a doctor: The first report from Türkiye.
The presence of patients who leave without being seen (LWBS) by a physician in the emergency department (ED) is an essential indicator of the accessibility and quality of healthcare delivery. A high LWBS rate implies low patient satisfaction. This study aims to analyze the prevalence and characteristics of LWBS patients in Türkiye and their ED readmission rate within 3 days. ⋯ LWBS patients are both a result and a consequence of ED crowding. A zero LWBS rate is crucial for older adults' health as they may fall victim to an invisible accident while avoiding ED traffic. Prioritizing older adults and reorganizing waiting areas can reduce ED crowding and cost burden due to delayed treatments.
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Most post-9/11 Veterans have completed at least 1 combat deployment-a known factor associated with adverse health outcomes. Such Veterans are known to have unmet health care needs, and the emergency department (ED) may serve as a safety net, yet little is known about whether combat status is associated with more frequent ED use. We sought to evaluate the relationship between combat status and frequency of ED use among post-9/11 Veterans and assess the most common reasons for ED visits. ⋯ Those who deployed to a combat zone had a significantly higher rate of ED use compared to those who did not. Further, mental health-related ED diagnoses appeared to be more prevalent in combat Veterans. These findings highlight the unique health care needs faced by combat Veterans and emphasize the importance of tailored interventions and support services for this specific population.
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Randomized Controlled Trial
Effect of Cash Benefits on Health Care Utilization and Health: A Randomized Study.
Poverty is associated with greater barriers to health care and worse health outcomes, but it remains unclear whether income support can improve health. ⋯ In this randomized study, individuals who received a cash benefit had significantly fewer emergency department visits, including those related to behavioral health and substance use, fewer admissions to the hospital from the emergency department, and increased use of outpatient subspecialty care. Study results suggest that policies that seek to alleviate poverty by providing income support may have important benefits for health and access to care.