Articles: emergency-services.
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Clinical Trial
Compliance with emergency department referral: the effect of computerized discharge instructions.
To examine the effect of computerized discharge instructions on emergency department patient referral recommendations. ⋯ Computerized discharge instructions were associated with improved compliance with ED referral recommendations, based on historic and contemporary controls.
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To evaluate an emergency department's "treat and transfer" policy during a two-month period of reduced inpatient capacity by determining the number and characteristics of transferred patients not admitted as planned to the receiving hospital. ⋯ Patients transferred from the public hospital ED resulted in admission to the receiving hospital in 92% of transfers. A history of IV drug use was the only characteristic found to be associated with discharge without admission to the accepting hospital.
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Editorial Comparative Study
Clinton's health reform and emergency department volumes: a return visit.
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To estimate (1) the prevalence of human immunodeficiency virus (HIV) infection in emergency department (ED) patients, (2) the frequency of blood contact (BC) in ED workers (EDWs), (3) the efficacy of gloves in preventing BC, and (4) the risk of HIV infection in EDWs due to BC. ⋯ In both inner-city and suburban EDs, patient HIV seroprevalence varies with patient demographics and clinical presentation; the infection status of most HIV-positive patients is unknown to ED staff. The risk to an EDW of occupationally acquiring HIV infection varies by ED location and the nature and frequency of BC; this risk can be reduced by adherence to universal precautions.
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In the final analysis, implementing the ED funding model will not generate additional dollars for hospitals; rather the funding model will function as a tool for reallocating existing health care dollars. This function is particularly important as government funding for health care is subjected to increasing financial restraint. As such, the ED funding model will serve to further the Acute Care Funding Plan principles of fairness and equity, a recognition of the unique funding requirements for ambulatory care, and the need to develop cost-effective service delivery. Adherence to these principles is integral to maintaining the affordable, publicly administered national health care system Canadians have come to expect and cherish.