Articles: emergency-services.
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J Public Health Med · Feb 1990
Frequency of emergency department attendances as a predictor of mortality: nine-year follow-up of a population-based cohort.
Heavy users of the services of emergency departments (EDs) have in previous studies been found to have psychological, social, economic and other difficulties besides their more or less acute medical problems. In order to establish whether mortality is associated with high ED use, a nine-year follow-up study was conducted of a 10 per cent population sample (n = 17,000), selected from the catchment area of Huddinge Hospital, Sweden. ED visits were found to predict nine-year mortality in the cohort. ⋯ The three predominant causes of death in the cohort were diseases in the circulatory system, tumours and violent death. Heavy ED users had elevated mortality in all diagnoses, the most important excess mortality being from violent death, comprising suicide, probable suicide and alcohol/drug abuse, with an SMR of 6.3 (95 per cent CI = 6.0-6.7). The excess mortality from these causes of the heavy ED users accounted for more than one-third of their total excess mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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This study developed a patient classification system for hospital emergency departments. Conducted at three Los Angeles area community hospitals, data collection included coding and abstracting medical records information, patient billing information detailing each patient's utilization of hospital services, and patient-specific provider time measuring each provider's time spent in direct patient care activities. ⋯ Patient visits were classified into 216 homogeneous groups, or patient clusters, using four types of variables: diagnoses, disposition, age, and physician procedures. The Emergency Department Groups (EDGs) appear to represent a clinically coherent system for classifying emergency department visits; moreover, the groups were found to explain 63% of the overall variance in resource use (total direct cost) suggesting that the EDGs may offer a useful tool for hospital cost control and reimbursement reform.