Articles: emergency-medicine.
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Review Meta Analysis
Clinical frailty scale as a predictor of short-term mortality: A systematic review and meta-analysis of studies on diagnostic test accuracy.
The Clinical Frailty Scale (CFS) is a representative frailty assessment tool in medicine. This systematic review and meta-analysis aimed to examine whether frailty defined based on the CFS could adequately predict short-term mortality in emergency department (ED) patients. ⋯ Evidence that is published to date suggests that the CFS is an accurate and reliable tool for predicting short-term mortality in emergency patients.
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Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases and expanding knowledge of this has prompted a need for a focused review for practicing clinicians. ⋯ An understanding of the presentation, evaluation, and management of monkeypox is essential for emergency clinicians to ensure appropriate diagnosis and treatment of this emerging disease.
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'Surprise billing', or the phenomenon of unexpected coverage gaps in which patients receiving out-of-network medical bills after what they thought was in-network care, has been a major focus of policymakers and advocacy groups recently, particularly in the Emergency Department (ED) setting, where patients' ability to choose a provider is exceedingly limited. The No Surprises Act is the legislative culmination to address "surprise bills," with the aim of promoting price transparency as a solution for billing irregularities. However, the knowledge and perceptions of patients regarding emergency care price transparency, particularly the degree to which ED patients are cost conscious is unknown. Accordingly, we sought to quantify that perception by measuring patients' direct predictions for the cost of their care. ⋯ This study is the first to our knowledge that sought to quantify how patients perceive the cost of acute, unscheduled care in the ED. We found that ED patients generally do not consider the price before going to the ED, and subsequently overestimate the negotiated total costs of acute, unscheduled emergency care as well as their out-of-pocket responsibility for care. Certain demographics are less predictive of this association. Notably, patients with Medicare/Medicaid and those with high school education or below were of the furthest off in predicting the actual cost of care. This lends credence to the established trend of patients' limited knowledge of the total cost of healthcare; moreover, that they overestimate the cost of their care could serve as a barrier to accessing that care particularly in more vulnerable groups. We hope that this finding adds useful information to policymakers in sculpting future legislation around surprise billing.
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Observational Study
Cost variation and revisit rate for adult patients with asthma presenting to the emergency department.
Asthma is common, resulting in 53 million emergency department (ED) visits annually. Little is known about variation in cost and quality of ED asthma care. ⋯ Hospital costs associated with ED asthma visits vary but are not associated with odds of ED revisit.