Search

Emergency departments (ED) have proposed utilizing a Web-based format to distribute patient satisfaction surveys, but the potential for bias in this distribution method has not been assessed.The aim of this study was to evaluate the characteristics of ED patients who have access to the Internet to better understand potential bias in Web-based patient satisfaction surveys.We distributed a 20-question survey to consenting, English-speaking adult patients presenting to the ED from December 2010 to March 2012. Patients reported demographic information and answered questions related to their access and use of the Internet.Seven hundred four patients participated in the study; 90% of Whites reported Internet access, vs. 82% of Hispanics (p = 0.034). Ninety-two percent of patients with at least some college education had Internet access, compared to 79% of those with a high school education level or lower (p ≤ 0.001). Of households reporting an income of$22,000/year, 95% had Internet access, compared to 77% of those reporting a household income$22,000/year (p ≤ 0.001). Ninety-four percent of participants40 years of age had Internet access, compared to 83% between the ages of 40 and 56 years, and 77% for those over 56 years of age (p0.001).A Web-based distribution of ED patient satisfaction surveys may underrepresent minorities, patients without college education, those with lower income, and patients older than 40 years. This information may provide guidance in interpreting results of Web-based patient satisfaction surveys and may suggest the need for multiple sampling methods.

Scurvy, caused by a lack of Vitamin C in the diet, is thought to occur only sporadically in developed countries. The signs and symptoms are diverse but generally follow a predictable progression most striking for their hemorrhagic component, particularly of the skin, gums, and joints. We report a case of scurvy in an elderly, alcoholic woman. The diagnosis was contemplated based on dermatologic findings and a dietary history. All symptoms resolved within 10 days of oral ascorbic acid supplementation. Patients most at risk for developing scurvy include food faddists, the isolated elderly, and the mentally ill.