Nonurgent Emergency Research Articles

Nonurgent Emergency Department Visits

Americans will visit hospital emergency departments (EDs) more than 90 million times this year.²Growth in ED visits has been particularly pronounced among Medicaid and Medicare recipients and uninsured patients.³Although many patients seek emergency care for problems that threaten life or limb, most have less serious conditions. Use of the ED for nonurgent care has become so widespread that it is commonly cited as a major contributor to increasing health care costs.^4,5 Federal reports estimate that between 40% and 55% of all ED visits involve nonurgent problems.^3,6Because care of minor illness or injuries in the ED generates greater charges, on average, than comparable care in a physician's office or outpatient clinic, various administrative and financial strategies have been proposed to divert patients from the ED. It is also assumed that demand for nonurgent care in the ED will decline when everyone is covered by

Nonurgent emergency department visits. Meeting an unmet need

Nonurgent emergency department visits. Meeting an unmet need

Preliminary tissue-characterization studies of rat prostate in vivo

To explore the decision to seek care and decision-making regarding location of care among parents with low and adequate health literacy.Parents of children 8 years old or younger who presented for ‘sick child’ visits at a clinic or a nonurgent emergency department (ED) visit (triage level 5) were interviewed. The Newest Vital Sign was used to categorize parental health literacy. Interviewers followed a semistructured interview guide to understand: 1) care-seeking for current illness, and 2) choice of clinic or ED. Themes emerged using a grounded theory process, facilitated by NVivo version 10.0 software (QSR International, Melbourne, Australia). Themes included the experiences of low and adequate health literacy in the clinic as well as in the ED.Fifty semistructured interviews were completed with parents who brought their child to the ED for a nonurgent visit (n = 30) and clinic parents (n = 20) with 56% possessing low health literacy. Parents with low health literacy were more inclined to overestimate severity of illness and seek care sooner to gain answers about the illness and treatment options, and visit the clinic only when an appointment was available within hours. Parents with adequate health literacy sought reassurance for their ongoing illness management and valued close relationships with their physician, and were willing to wait longer for an appointment. Fever, vomiting, and young child age prompted some parents to seek expedient care regardless of health literacy.Caregiving skills (eg, assessing and treating illness, understanding illness severity, and navigating the health care system) in addition to physician-parent relationships and perception of care seem to influence the behavior of parents managing their child's mild acute illness. These factors might be amenable to a future health literacy intervention.

Nurse Practitioner and Physician Care Compared for Nonurgent Emergency Room Patients

This experimental field study compared knowledge, satisfaction and compliance in 62 nonurgent emergency room (ER) patients based on whether they were cared for by a nurse practitioner (experimental group) or a physician (control). Data were collected via structured interviews in the ER, two weeks later by phone and three months later by phone, mail and chart review. No significant differences were found between groups in overall short- and long-term compliance scores, appointment-keeping scores for the three-month study period, number of health recommendations recalled, resolution of health problem or satisfaction ratings of ER care. It was also found that: referrals were the recommendation least complied with; 60 percent of appointments were kept; frequent reasons for noncompliance were inconvenience and lack of perceived need; experimental subjects showed greater comprehension of diagnostic recommendations and therapeutic applications, while controls had better knowledge of medications; 77 percent of experimentals were completely satisfied with NP care, as compared to only 48 percent of the controls with MD care; and reasons for satisfaction centered on the quality of care, while reasons for dissatisfaction focused on unresolved problems and slow care.