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1 | INTRODUCTION Access to hospital-based emergency care is an important population health metric, (1) but it is not equitable. Emergency department (ED) capability and capacity vary geographically, (2-4) with [...], Objective: To examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences. Data Sources and Study Setting: ED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010-2019); American Hospital Association Annual Survey (2009-2018). Study Design: Logistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patients. The base model was controlled for patient and hospital characteristics and year fixed effects. Models II and III added urbanicity and hospital referral region (HRR), respectively. Model IV used hospital fixed effects, which compares patients within the same hospital. Models V and VI stratified Model IV by payer and condition, respectively. Conditions were classified as emergency care sensitive conditions (ECSCs), where transfer is protocolized, and non-ECSCs. We reported marginal effects at the means. Data Collection/Extraction Methods: We examined 1,265,588 adult ED patients transferred from 187 hospitals. Principal Findings: Black patients were more likely to be transferred to public hospitals compared with White patients in all models except ECSC patients within the same initial hospital (except trauma). Black patients were 0.5-1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients in the same hospital with the same payer. In the base model, Hispanic patients were more likely to be transferred to public hospitals compared with White patients, but this difference reversed after controlling for HRR. Hispanic patients were - 0.6 pp to -1.2 pp less likely to be transferred to public hospitals than White patients in the same hospital with the same payer. Conclusions: Large population-level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that they may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors. KEYWORDS disparities, emergency departments, public hospital, race and ethnicity, transfers

Earlier this year, a young practitioner posed a question about emergency compensation on the AAEP New Practitioners listserv. This led to a short survey being posted on this community's listserv, [...]

INTRODUCTION Emergency medicine (EM) is a quixotic profession: emergency physicians (EPs) deliver one-time, episodic care to random patients during unpredictable health crises at all hours of the day; and then, [...], Objective: Emergency physicians (EPs) rarely find out what happens to patients after the patients leave their care, a process we call 'outcome feedback.' Some suggest this hinders the practice of emergency medicine (EM); however, evidence is lacking. We sought to evaluate EPs' perception of the current and potential role of outcome feedback in EM. Methods: We surveyed practising French- and English-speaking EPs from emergency departments within 100 km of Ottawa, Ont., in the provinces of Ontario and Quebec. The main outcomes included the prevalence, role and effect of outcome feedback. Results: Of the 297 physicians surveyed, 231 (77.8%) respond ed. The sample contained good representation of language groups, practice settings, sexes and age groups. All participants indicated that knowing outcomes is 'essential' (62.6%) or 'beneficial' (37.4%) to gaining experience in EM. Participants reported currently receiving passive outcome feedback in 10.0% of all cases, and seeking out (active) outcome feedback in 7.5% of all cases. The great majority of participants (97.3%) stated that they would like to receive more outcome feedback and believed that this would improve diagnostic accuracy (97.3%), clinical efficiency (85.5%), treatment outcomes (95.6%) and job satisfaction (95.1%). When asked to indicate 'any possible negative effects that might arise from increased outcome feedback,' 62.1% indicated none. However, 17.9% hypothesized negative emotional effects and 11.5% suggested increased time requirements. Conclusion: The overwhelming majority of EPs receive very little outcome feedback. Most would like more outcome feedback and believe it would improve the practice of EM. Keywords: treatment outcome, quality of health care, emergency medicine, decision support techniques, outcome feedback Objectif : Les medecins d'urgence savent rarement ce qu'il advient de leurs patients apres leur passage a l'urgence. Il y a ce qu'on appelle un manque <>. Certains suggerent que cela entrave la pratique de la medecine d'urgence. Il n'y a toutefois pas suffisamment de preuves a l'appui de cette hypothese. Nous avons cherche a evaluer la perception des medecins d'urgence quant au role actuel et potentiel de l'information sur les resultats en medecine d'urgence. Methodes : Nous avons interroge des medecins d'urgence francophones et anglophones travaillant dans les services d'urgence, en Ontario et au Quebec, dans un perimetre de 100 kilometres autour d'Ottawa (Ont.). Les principaux criteres d'evaluation etaient la prevalence, le role et l'effet de l'information sur les resultats. Resultats : Des 297 medecins interroges, 231 (77,8 %) ont repondu. L'echantillon offrait une bonne representation des groupes linguistiques, des milieux de pratique, des sexes et des groupes d'age. Tous les participants ont indique qu'il etait <> (62,6 %) ou << benefique >> (37,4 %) de recevoir de l'information sur le devenir de leurs patients pour acquerir des competences en medecine d'urgence. Les repondants ont signifie qu'ils recevaient actuellement de l'information passive sur leurs patients dans 10,0 % des cas, et qu'ils faisaient activement des demarches pour obtenir de l'information sur leurs patients dans 7,5 % des cas. La grande majorite (97,3 %) des repondants ont dit vouloir recevoir davantage d'information sur les resultats et pense que cela ameliorerait la precision du diagnostic (97,3 %), l'efficacite clinique (85,5 %), les resultats therapeutiques (95,6 %) et la satisfaction professionnelle (95,1 %). Lorsqu'on a demande aux repondants de reperer les << effets negatifs eventuels que pourrait entrainer une augmentation de la communication d'information sur les resultats >>, 62,1 % n'ont rien indique. Toutefois, 17,9 % ont suppose que cela pourrait engendrer des effets emotionnels negatifs et 11,5 % ont suggere comme effet eventuel la hausse d'exigences en matiere de temps. Conclusion : La grande majorite des medecins d'urgence recoivent tres peu d'information sur les resultats. La plupart aimeraient en recevoir davantage et estiment que cela ameliorerait la qualite de la pratique de medecine d'urgence.

Objective: Consultation is a common and important aspect of emergency department (ED) care. We prospectively examined the consultation rates, the admission rates of consulted patients, the emergency physician (EP) disposition [...]

Introduction: US emergency personnel cared for 106% more patients in 1990 than they did in 1980,1 and national emergency department census data show that 60%-80% of those patients presented with [...]

Objective: The objective of this study was to identify the facilitators and barriers associated with integrating nurse practitioners (NPs) into Canadian emergency departments (EDs) from the perspectives of NPs and [...]

Background Patients frequently present to emergency departments (EDs) with abdominal pain. The use of analgesia for this complaint has been debated for many years. (1-3) The fear of analgesics originated [...]

Hockey is enjoyed by millions of people around the world and is a sport in which aggression is encouraged and injuries are common. Although body-checking is the most common cause [...]

Objective: To evaluate whether the addition of intravenous (IV) dexamethasone to standard emergency department (ED) benign headache therapy would reduce the incidence of headache recurrence at 48-72 hours. Methods: This [...]

PUBLISHED IN PEDIATRIC EMERGENCY CARE 'Yes' is the answer to this question, according to results of a survey targeting pediatric emergency medicine (EM) and general EM attending physicians. However, fewer [...]

Objective: To determine whether doctors working in emergency departments are aware which of the common conditions seen have driving restrictions associated with them and whether they routinely advise patients of [...]

Posted on cmajnews.com on June 27, 2018. Doctors, nurses and other health professionals often volunteer to assist during medical emergencies on airplanes, at amateur sporting events, or in other public [...]

You may walk out of an emergency room bandaged, splinted, or medicated, but whatever you do, don't leave confused. Most patients exit the ER without understanding their next steps, according [...]

The success of TV emergency room dramas notwithstanding, real ERs are still facing lots of troubles. And one of them seems to be the confidence of their administrators, according to [...]