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KCE reports vol. 19B Urgences 107
AUTHOR, YEAR
COUNTRY
SUCOV, A., 1999
USA
WALLS CA, 2002
USA
WEST TD ET AL, 1997
USA
WOOLFENDEN S ET AL,
2000
AUSTRALIA
YOUNG TL ET AL, 2001
USA
STUDY DESIGN
SAMPLE
SETTING
retrospective 1995-1996
urban university trauma centre
RESULT / CONCLUSION
11 discharge diagnoses (DX11) identified as being Âinappropriate by a third party payer (i.e. chronic
nasopharyngitis; chronic sinusitis; chronic pharyngitis; rhinitis; constipation; head cold;
haemorrhoids; toothache; flu; headache; and tension headache), corresponding to 82 different chief
complaints.
Patients' presenting complaints are incapable of predicting diagnosis or disposition.
Retrospective denial of payment by discharge diagnosis is inappropriate
Cross--sectional 1998 National Health Interview Survey Poverty, lack of insurance, younger age, male gender, and minority race or ethnicity predicted
identifying the ED as the usual source of care.
Review on archival data
3671 ED patients
university hospital
Qualitative 25 in-depth interviews of parents of children
with non-urgent illness
Difference among emergent, urgent and routine care assessments by triage staff, nurses and
physicians exist.
(less predictive of nursing acuity then physicians resource-based relative value scale codes)
reducing process variation in patient acuity assessments, improves quality of care while managing
cost
The parental choice to attend a PED is a dynamic, complex and unique process and the parental
views that underpin this process often diverge from those of health professionals about the most
'appropriate' use of a PED
Evaluation study Implementation of an elementary SBHC (School-based health centers) resulted in a significant
decrease in non-urgent emergency department visits.