Articles: emergency-services.
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An analysis of the first seven years of performance of our hospital-based emergency medical services (EMS) helicopter was conducted to evaluate the possible need for a second aircraft. A survey of seven hospitals currently operating two or more helicopters resulted in a consensus that one helicopter can effectively perform only 70 to 90 flights per month. The number of requests for our helicopter service has increased 148% from 610 to 1,512 in seven years while the number of completed missions has increased only 92% from 486 (40.5/month) to 935 (78/month). ⋯ Our data and industry survey suggests this will occur at 75 captured flights per month. Affordability and continued overall growth of trauma and other critical care referrals to the base hospital(s) is mandatory. This study provides a model for hospital-based EMS helicopter operators to apply to the decision whether to add a second aircraft.
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Medicare's prospective pricing system has fostered much cost-consciousness in hospitals regarding inpatient activities. But hospital managers must also examine other activities in search of opportunities to decrease expenses. Managers can minimize the large loss potential in emergency departments by developing detailed protocols and ensuring their consistent application through well-trained employees. This is particularly true for emergency departments having especially acute loss potential because of the volume of care provided to indigents.
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To determine the short-term functional and medical outcomes and predictors of outcome following discharge from an acute hospital emergency department, 100 elderly (greater than or equal to 65 yr) and 100 nonelderly (less than 65 yr) patients were studied prospectively. Patients were interviewed at three days and again at three weeks following emergency department discharge. The number of new prescriptions given to both groups in the emergency department was similar (elderly 41%; nonelderly, 31%). ⋯ None of the nonelderly required hospitalization or had died. Functional impairments were more common in the elderly both at baseline (elderly, 26%; nonelderly, 6%; P less than .01) and at three weeks (elderly, 27%; nonelderly, 5%; P less than .001). Independent predictors of poor medical outcome included age greater than or equal to 65 (P less than .009) and functional impairment at baseline (P less than .022).(ABSTRACT TRUNCATED AT 250 WORDS)