Articles: hospital-emergency-service.
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Many asthmatics in the Auckland area use hospital accident and emergency (A & E) departments as the primary source of treatment during acute asthmatic attacks. A review of A & E records has revealed important variations in the standard of care they receive, and highlights the need for further education of A & E officers.
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It is commonly believed that emergency department (ED) use is affected by extreme weather. To test this hypothesis, data concerning use of a pediatric ED during three seasonally diverse months was analyzed in the light of Weather Bureau information concerning daily conditions during the study months. ⋯ The data indicate 1) season has a major affect on ED use because it affects prevalence of disease and injury; 2) extremely cold and stormy conditions significant reductions in ED use of approximately 5-20%; 3) 80-95% of expected visits are made on days with very bad weather. The data indicate that weather is a minor factor in determining ED use.
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A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. ⋯ They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.
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A method is proposed for allocating doctors to weekly shifts in an accident and emergency department of a hospital. Two models, solved by dynamic programming, are used. The first finds the optimal solution to the problem of allocating doctors per hour of the week proportionally to the corresponding patient arrival-rate; and the second uses this solution to smooth out the hourly discrepancies in the number of doctors within a shift. The solution is then assessed by computer simulation.