scholarly journals Associations of Patient Experience in Primary Care With Hospitalizations and Emergency Department Visits on Isolated Islands: A Prospective Cohort Study

2018 ◽  
Vol 35 (4) ◽  
pp. 498-505
Author(s):  
Makoto Kaneko ◽  
Takuya Aoki ◽  
Hideki Mori ◽  
Ryuichi Ohta ◽  
Hiroki Matsuzawa ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Cohort Study ◽  
Patient Experience ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Emergency Department Visits

scholarly journals P143: A prospective cohort study characterizing 30-day recurrent emergency department visits for hyperglycemia

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S116
Author(s):  
J. Yan ◽  
D. Azzam ◽  
M. Columbus ◽  
K. Van Aarsen
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Diabetes Management ◽  
Care Delivery ◽  
Tertiary Care ◽  
Emergency Department Visits ◽  
Local Health

Introduction: Hyperglycemic emergencies, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), often recur in patients who have poorly controlled diabetes. Identification of those at risk for recurrent hyperglycemia visits may improve health care delivery and reduce ED utilization for these patients. The objective of this study was to prospectively characterize patients re-presenting to the emergency department (ED) for hyperglycemia within 30 days of an initial ED visit. Methods: This is a prospective cohort study of patients ≥18 years presenting to two tertiary care EDs (combined annual census 150,000 visits) with a discharge diagnosis of hyperglycemia, DKA or HHS from Jul 2016-Nov 2018. Trained research personnel collected data from medical records, telephoned patients at 10-14 days after the ED visit for follow-up, and completed an electronic review to determine if patients had a recurrent hyperglycemia visit to any of 11 EDs within our local health integration network within 30 days of the initial visit. Descriptive statistics were used where appropriate to summarize the data. Results: 240 patients were enrolled with a mean (SD) age of 53.9 (18.6) years and 126 (52.5%) were male. 77 (32.1%) patients were admitted from their initial ED visit. Of the 237 patients (98.8%) with 30-day data available, 55 (23.2%) had a recurrent ED visit for hyperglycemia within this time period. 21 (8.9%) were admitted on this subsequent visit, with one admission to intensive care and one death within 30 days. For all patients who had a recurrent 30-day hyperglycemia visit, 22/55 (40.0%) reported having outpatient follow-up with a physician for diabetes management within 10-14 days of their index ED visit. 7/21 (33.3%) patients who were admitted on the subsequent visit had received follow-up within the same 10-14 day period. Conclusion: This prospective study builds on our previous retrospective work and describes patients who present recurrently for hyperglycemia within 30 days of an index ED visit. Further research will attempt to determine if access to prompt follow-up after discharge can reduce recurrent hyperglycemia visits in patients presenting to the ED.

scholarly journals Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030101 ◽  
Author(s):  
Makoto Kaneko ◽  
Takuya Aoki ◽  
Masafumi Funato ◽  
Keita Yamashiro ◽  
Kaku Kuroda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Cohort Study ◽  
Ambulatory Care ◽  
Patient Experience ◽  
Prospective Cohort Study ◽  
Rural Areas ◽  
Prospective Cohort ◽  
Ambulatory Care Sensitive Conditions ◽  
Ambulatory Care Sensitive

ObjectivesThe rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is an association between admissions for ACSCs and PX in rural areas has not been examined. This study aimed to document admissions for ACSCs on Japanese rural islands, and assess whether there was an association between the rate of admissions for ACSCs and PX.DesignMulticentred, prospective, cohort studySettingThis study was conducted on five rural islands in Okinawa, Japan.ParticipantsThe study participants were all island inhabitants aged 65 years or older.Primary outcome measuresThis study examined the association between ACSCs and PX assessed by a questionnaire, the Japanese Version of Primary Care Assessment Tool. ACSCs were classified using the International Classification of Diseases, Tenth Revision, and the rate of admissions for ACSCs in 1 year.ResultsOf 1258 residents, 740 completed the questionnaire. This study documented 38 admissions for ACSCs (29 patients, males/females: 15/14, median age 81.9) that included congestive heart failure (11), pneumonia (7) and influenza (5). After adjusting for covariates and geographical clustering, admissions for ACSCs had a significant positive association with each patient’s PX scores (OR per 1 SD increase=1.62, 95% CI 1.02–2.61).ConclusionsPhysicians serving rural areas need to stress the importance of preventive interventions for heart failure, pneumonia and influenza to reduce the number of admissions for ACSCs. Contrary to previous studies, our findings might be explained by close patient–doctor relationships on the rural islands.

scholarly journals Thirty-day hospital readmission and emergency department visits after vascular surgery: a Canadian prospective cohort study

2018 ◽  
Vol 61 (4) ◽  
pp. 257-263 ◽  
Author(s):  
Muzammil H. Syed ◽  
Mohamad A. Hussain ◽  
Zeyad Khoshhal ◽  
Konrad Salata ◽  
Beidaa Altuwaijri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Emergency Department Visits ◽  
Day Hospital

scholarly journals Hospital Readmission and Emergency Department Visits After Vascular Surgery: A Prospective Cohort Study

2017 ◽  
Vol 66 (3) ◽  
pp. e80
Author(s):  
Mohamad A. Hussain ◽  
Zeyad Khoshhal ◽  
Konrad Salata ◽  
Baidaa Altuwaijri ◽  
Norah Alsaif ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Emergency Department Visits
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