scholarly journals 4256 Association Between Injury Intent and Emergency Department and Hospital Charges for Pediatric Firearm Injuries in the United States

2020 ◽  
Vol 4 (s1) ◽  
pp. 124-124
Author(s):  
Diana Marie Bongiorno ◽  
Gia M. Badolato ◽  
Meleah D. Boyle ◽  
Jon S. Vernick ◽  
Joseph F. Levy ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
The United States ◽  
Hospital Charges ◽  
Unintentional Injuries ◽  
Severe Injuries ◽  
Cross Sectional ◽  
Emergency Department Care ◽  
Sample Mean ◽  
Firearm Injury

OBJECTIVES/GOALS: In 2016, more than 3,100 children died, and an estimated 17,000 children had non-fatal injuries, from firearms in the United States. In this study, we used hospital charges as a proxy for medical resource utilization, and compared differences in charges by intent of firearm injury among children. METHODS/STUDY POPULATION: In this cross-sectional study of the 2016 Nationwide Emergency Department Sample, we identified firearm injury cases among children aged 19 years or younger using ICD-10-CM external cause of morbidity codes. Injury intent was characterized as unintentional, assault, self-inflicted, undetermined, or due to legal intervention. We included patients treated and released from the emergency department (ED) or admitted alive to the hospital, and excluded those who were transferred or died in the ED. We used linear regressions with survey weighting to compare differences in mean healthcare charges by firearm injury intent, with and without adjustment for ED disposition. RESULTS/ANTICIPATED RESULTS: Among 12,469 cases in the weighted sample, mean age was 16.5 years, a majority were male (88.2%) and Medicaid-insured (57.8%), and 64% were discharged from the ED and 36% admitted. Injuries were 49.0% unintentional, 45.1% assault-related, and 1.8% self-inflicted. Compared to children with self-inflicted injuries (charges $115,224), children with assault-related injuries (charges $55,052; p<0.007) and unintentional injuries (charges $38,643; p<0.001) had lower mean charges per visit. Differences in charges were no longer significant after adjusting for ED disposition, as 85.8% of self-inflicted injuries were admitted, compared to 46.5% of assault-related and 24.3% of unintentional injuries. DISCUSSION/SIGNIFICANCE OF IMPACT: Although the majority of pediatric firearm-related injuries resulting in emergency department care are unintentional or assault-related, self-inflicted injuries result in greater per visit hospital charges, attributable to higher hospitalization rates, and likely due to more severe injuries.

scholarly journals Incidence, Distribution, and Cost of Lawn-Mower Injuries in the United States, 2006-2013

2018 ◽  
Vol 133 (5) ◽  
pp. 570-577
Author(s):  
Daniel G. Hottinger ◽  
Isam Nasr ◽  
Joseph K. Canner ◽  
Deepa Kattail ◽  
Rahul Koka ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Injury Severity ◽  
Age Groups ◽  
The United States ◽  
Hospital Charges ◽  
Weighted Estimate ◽  
Wound Irrigation ◽  
Cross Sectional ◽  
Lawn Mower

Objectives: Characterization of the epidemiology and cost of lawn-mower injuries is potentially useful to inform injury prevention and health policy efforts. We examined the incidence, distribution, types and severity, and emergency department (ED) and hospitalization charges of lawn-mower injuries among all age groups across the United States. Methods: This retrospective, cross-sectional study used nationally representative, population-based (all-payer) data from the US Nationwide Emergency Department Sample for lawn-mower–related ED visits and hospitalizations from January 1, 2006, through December 31, 2013. Lawn-mower injuries were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification code E920 (accidents caused by a powered lawn mower). We analyzed data on demographic characteristics, age, geographic distribution, type of injury, injury severity, and hospital charges. Results: We calculated a weighted estimate of 51 151 lawn-mower injuries during the 8-year study period. The most common types of injuries were lacerations (n = 23 907, 46.7%), fractures (n = 11 433, 22.4%), and amputations (n = 11 013, 21.5%). The most common injury locations were wrist or hand (n = 33 477, 65.4%) and foot or toe (n = 10 122, 19.8%). Mean ED charges were $2482 per patient, and mean inpatient charges were $36 987 per patient. The most common procedures performed were wound irrigation or debridement (n = 1436, 29.9%) and amputation (n = 1230, 25.6%). Conclusions: Lawn-mower injuries occurred at a constant rate during the study period. Changes to nationwide industry safety standards are needed to reduce the frequency and severity of these preventable injuries.

scholarly journals Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Valerie E. Whiteman ◽  
Jason L. Salemi ◽  
Mulubrhan F. Mogos ◽  
Mary Ashley Cain ◽  
Muktar H. Aliyu ◽  
...  
Keyword(s):  
United States ◽  
Healthcare Costs ◽  
Perinatal Outcomes ◽  
The United States ◽  
Hospital Charges ◽  
Perinatal Morbidity ◽  
Opioid Use ◽  
Linear Modeling ◽  
Cross Sectional ◽  
Hospitalization Costs

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers.Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status.Results. Women who used opioids during pregnancy experienced higher rates of depression, anxiety, and chronic medical conditions. After adjusting for confounders, opioid use was associated with increased odds of threatened preterm labor, early onset delivery, poor fetal growth, and stillbirth. Users were four times as likely to have a prolonged hospital stay and were almost four times more likely to die before discharge. The mean per-hospitalization cost of a woman who used opioids during pregnancy was $5,616 (95% CI: $5,166–$6,067), compared to $4,084 (95% CI: $4,002–$4,166) for nonusers.Conclusion. Opioid use during pregnancy is associated with adverse perinatal outcomes and increased healthcare costs.

A Cross-sectional Study of Emergency Department Boarding Practices in the United States

2014 ◽  
Vol 21 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Stephen R. Pitts ◽  
Frances L. Vaughns ◽  
Marc A. Gautreau ◽  
Matthew W. Cogdell ◽  
Zachary Meisel
Keyword(s):  
United States ◽  
Emergency Department ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Trends in Emergency Department Visits and Charges for Gout in the United States between 2006 and 2012

2016 ◽  
Vol 43 (8) ◽  
pp. 1589-1592 ◽  
Author(s):  
Sadao Jinno ◽  
Kohei Hasegawa ◽  
Tuhina Neogi ◽  
Tadahiro Goto ◽  
Maureen Dubreuil
Keyword(s):  
United States ◽  
Emergency Department ◽  
Temporal Trends ◽  
The United States ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Ed Visits ◽  
Sectional Analysis

Objective.To examine temporal trends in the rate of gout emergency department (ED) visits and charges in the United States between 2006 and 2012.Methods.A serial cross-sectional analysis of the Nationwide Emergency Department Sample.Results.The rate of ED visits for gout in adults overall increased from 75.0 to 85.4 per 100,000 persons over the study period (14% increase, p < 0.001), and increased 29% for those aged 45–54 years. Nationwide ED charges increased from $156 million to $281 million (80% increase, p < 0.001).Conclusion.Between 2006 and 2012, the rate of gout ED visits increased among US adults, most notably in those aged 45–54 years.

Emergency Department Visits for Firearm-Related Injuries among Youth in the United States, 2006–2015

2020 ◽  
Vol 48 (S4) ◽  
pp. 67-73
Author(s):  
Victor Lee ◽  
Catherine Camp ◽  
Vikram Jairam ◽  
Henry S. Park ◽  
James B. Yu
Keyword(s):  
United States ◽  
Emergency Department ◽  
Descriptive Analysis ◽  
Public Health Problem ◽  
The United States ◽  
Emergency Department Visits ◽  
Reliable Estimate ◽  
Current Debate ◽  
Firearm Injury ◽  
Injury Data

Firearm injuries are a significant public health problem. Prior studies have analyzed firearm death data or adult firearm injury data, but few studies have analyzed firearm injury data specifically among youth. To inform the current debate surrounding gun policy in the United States, this study aims to provide an estimate of the immense burden of youth firearm injury and its associated risk factors. Therefore, we performed a descriptive analysis of the Nationwide Emergency Department Sample (NEDS), the largest all-payer emergency department database in the United States, from January 2006 to September 2015. All patients age < 21 who presented with any diagnosis of firearm-related injuries were included. There were an estimated 198,839 incidents of firearm-related emergency department visits for patients age < 21 from 2006 through 2015. After presenting to the ED, an estimated 11,909 cases resulted in death. The population adjusted rate of firearm-related emergency department visits was highest in the South and Midwest. This study demonstrates the significant burden of firearm injury among youth. Having a reliable estimate of the number of children harmed by firearms each year is a critical tool for policymakers — and may make common-sense gun safety measures more politically possible.

Emergency department utilization by patients with gynecologic cancer in the United States

2020 ◽  
pp. ijgc-2020-001520
Author(s):  
Benjamin B Albright ◽  
Mucio K Delgado ◽  
Nawar A Latif ◽  
Robert L Giuntoli ◽  
Emily M Ko ◽  
...  
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Emergency Department ◽  
Gynecologic Cancer ◽  
The United States ◽  
Emergency Department Visits ◽  
Emergency Department Utilization ◽  
Gynecologic Cancers ◽  
Emergency Department Care ◽  
Co Morbidity

IntroductionPayment reform will give oncologists increasing responsibility for how patients with cancer meet unexpected care needs.ObjectiveTo differentiate how patients with gynecologic cancers use emergency care, and to assess the characteristics associated with potentially avoidable treat-and-release visits.MethodsWe performed a retrospective cohort study using the Nationwide Emergency Department Sample, a stratified sample of visits in United States hospital-based emergency departments, from 2010 to 2014. Visits by patients with a diagnosis of gynecologic cancer were selected. Sample weights were applied to calculate national estimates of care patterns and trends. Associations with treat-and-release disposition were assessed with weighted logistic regression.ResultsIn the study period, patients with gynecologic cancer made an estimated 370 104 annual emergency department visits (95% CI 351 997 to 388 211). A total of 50.2% of patients were treated and released, 48% were admitted, 1.6% were transferred, and 0.1% died. These visits corresponded to over US$1.27 billion in annual charges, with an average charge of US$3428 per visit (95% CI 3348 to 3509). Driven by growing treat-and-release utilization, annual visits increased, while admission rates fell over time. Patients with cervical cancer represented the plurality (36%) of visits; they were relatively younger, of lower socioeconomic status, and had fewer co-morbidities. Models for treat-and-release disposition did not vary significantly across different cancer populations. In the all-cancer model, increased odds of treat-and-release disposition was associated with cervical cancer diagnosis, younger age, lesser Elixhauser co-morbidity, Medicare coverage (OR=1.19; p<0.001), Medicaid coverage (OR=1.25; p<0.001), uninsured status (OR=1.70; p<0.001), and weekend visits. Visits in the northeast, at urban hospitals, and in winter months showed decreased odds of treat-and-release disposition.DiscussionPatients with gynecologic cancers have been using the emergency department at increasing rates, primarily driven by treat-and-release visits that did not result in admission or death. Patients with cervical cancer have higher rates of treat-and-release utilization and may over-use emergency department care.

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