scholarly journals Emergency Department Use by Primary Care Patients at a Safety-Net Hospital

2012 ◽  
Vol 172 (3) ◽  
pp. 278 ◽  
Author(s):  
Karen E. Lasser
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Safety Net ◽  
Emergency Department Use ◽  
Safety Net Hospital ◽  
Primary Care Patients

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

Understanding Frequent Emergency Department Use Among Primary Care Patients

2018 ◽  
Vol 21 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Morgan Hardy ◽  
Alex Cho ◽  
Alissa Stavig ◽  
Marigny Bratcher ◽  
Janice Dillard ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Department Use ◽  
Primary Care Patients

scholarly journals Effect of Patient Navigation and Financial Incentives on Smoking Cessation Among Primary Care Patients at an Urban Safety-Net Hospital

2017 ◽  
Vol 177 (12) ◽  
pp. 1798 ◽  
Author(s):  
Karen E. Lasser ◽  
Lisa M. Quintiliani ◽  
Ve Truong ◽  
Ziming Xuan ◽  
Jennifer Murillo ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Financial Incentives ◽  
Patient Navigation ◽  
Safety Net ◽  
Safety Net Hospital ◽  
Urban Safety ◽  
Primary Care Patients

Prior Frequent Emergency Department Use as a Predictor of Emergency Department Visits After a New Cancer Diagnosis

2021 ◽  
pp. OP.20.00889
Author(s):  
Arthur S. Hong ◽  
Danh Q. Nguyen ◽  
Simon Craddock Lee ◽  
D. Mark Courtney ◽  
John W. Sweetenham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cancer Diagnosis ◽  
Negative Binomial ◽  
Academic Medical Center ◽  
Safety Net ◽  
Emergency Department Visits ◽  
Patients With Cancer ◽  
Safety Net Hospital ◽  
Ed Visits ◽  
After Cancer

PURPOSE: To determine whether emergency department (ED) visit history prior to cancer diagnosis is associated with ED visit volume after cancer diagnosis. METHODS: This was a retrospective cohort study of adults (≥ 18 years) with an incident cancer diagnosis (excluding nonmelanoma skin cancers or leukemia) at an academic medical center between 2008 and 2018 and a safety-net hospital between 2012 and 2016. Our primary outcome was the number of ED visits in the first 6 months after cancer diagnosis, modeled using a multivariable negative binomial regression accounting for ED visit history in the 6-12 months preceding cancer diagnosis, electronic health record proxy social determinants of health, and clinical cancer-related characteristics. RESULTS: Among 35,090 patients with cancer (49% female and 50% non-White), 57% had ≥ 1 ED visit in the 6 months immediately following cancer diagnosis and 20% had ≥ 1 ED visit in the 6-12 months prior to cancer diagnosis. The strongest predictor of postdiagnosis ED visits was frequent (≥ 4) prediagnosis ED visits (adjusted incidence rate ratio [aIRR]: 3.68; 95% CI, 3.36 to 4.02). Other covariates associated with greater postdiagnosis ED use included having 1-3 prediagnosis ED visits (aIRR: 1.32; 95% CI, 1.28 to 1.36), Hispanic (aIRR: 1.12; 95% CI, 1.07 to 1.17) and Black (aIRR: 1.21; 95% CI, 1.17 to 1.25) race, homelessness (aIRR: 1.95; 95% CI, 1.73 to 2.20), advanced-stage cancer (aIRR: 1.30; 95% CI, 1.26 to 1.35), and treatment regimens including chemotherapy (aIRR: 1.44; 95% CI, 1.40 to 1.48). CONCLUSION: The strongest independent predictor for ED use after a new cancer diagnosis was frequent ED visits before cancer diagnosis. Efforts to reduce potentially avoidable ED visits among patients with cancer should consider educational initiatives that target heavy prior ED users and offer them alternative ways to seek urgent medical care.

scholarly journals Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: a Pilot Randomized Controlled Trial

Mindfulness ◽  
2019 ◽  
Vol 10 (9) ◽  
pp. 1744-1759 ◽  
Author(s):  
Richa Gawande ◽  
Elizabeth Pine ◽  
Todd Griswold ◽  
Timothy Creedon ◽  
Zayda Vallejo ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Safety Net ◽  
Randomized Controlled ◽  
Primary Care Patients ◽  
Pilot Randomized Controlled Trial
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