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  1. AU="Margaret Greenwood-Ericksen"
  2. AU=Chang Yuan
  3. AU="Cervantes, Paige E"
  4. AU="Tankova, T"
  5. AU="Callegari, Rachel A"
  6. AU=Wang Yan AU=Wang Yan
  7. AU=Hassan Md Imtaiyaz
  8. AU="Galgani, Alessandro"
  9. AU="Yoshimura, Katsuhiro"
  10. AU=Periyasamy Petrick AU=Periyasamy Petrick
  11. AU="Lockey, David"
  12. AU="Gibson, G G"
  13. AU="K. Danzmann"

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  1. Artikel ; Online: National Trends in Vital Sign Abnormalities at Arrival to the Emergency Department

    Rama A. Salhi / Margaret Greenwood-Ericksen / Keith E. Kocher

    Western Journal of Emergency Medicine, Vol 24, Iss

    2023  Band 3

    Abstract: Introduction: Recent reports suggest rising intensity of emergency department (ED) billing practices, sparking concerns that this may represent up-coding. However, it may reflect increasing severity and complexity of care in the ED population. We ... ...

    Abstract Introduction: Recent reports suggest rising intensity of emergency department (ED) billing practices, sparking concerns that this may represent up-coding. However, it may reflect increasing severity and complexity of care in the ED population. We hypothesize that this in part may be reflected in more severe manifestations of illness as indicated by vital sign abnormalities. Methods: Using 18 years of data from the National Hospital Ambulatory Medical Care Survey, we conducted a retrospective secondary analysis of adults (>18 years). We assessed standard vital signs using weighted descriptive statistics (heart rate, oxygen saturation, temperature, and systolic blood pressure [SBP]), as well as hypotension and tachycardia. Finally, we evaluated for differing effects stratifying by subpopulations of interest, including age (<65 vs ≥65), payer type, arrival by ambulance, and high-risk diagnoses. Results: In total there were 418,849 observations representing 1,745,368,303 ED visits. We found only minimal variations in vital signs over the study period: heart rate (median 85, interquartile range [IQR] 74–97); oxygen saturation (median 98, IQR 97–99); temperature (median 98.1, IQR 97.6–98.6); and SBP (median 134, IQR 120–149). Similar results were found among the subpopulations tested. The proportion of visits with hypotension decreased (first/last year difference 0.5% [95% CI 0.2%–0.7%]) while there was no difference in the proportion of patients with tachycardia. Conclusions: Arrival vital signs in the ED have largely remained unchanged or improved over the most recent 18 years of nationally representative data, even for key subpopulations. Greater intensity in ED billing practices is not explained by changes in arrival vital signs.
    Schlagwörter Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Sprache Englisch
    Erscheinungsdatum 2023-05-01T00:00:00Z
    Verlag eScholarship Publishing, University of California
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Conceptualizing lifer versus destination patients for optimized care delivery

    Jacob Lambrecht / Mahshid Abir / Kristian Seiler / Neil Kamdar / Tim Peterson / Paul Lin / Wilson Nham / Margaret Greenwood-Ericksen

    BMC Health Services Research, Vol 23, Iss 1, Pp 1-

    2023  Band 10

    Abstract: Abstract Background Patients presenting to academic medical centers (AMC) typically receive primary care, specialty care, or both. Resources needed for each type of care vary, requiring different levels of care coordination. We propose a novel method to ... ...

    Abstract Abstract Background Patients presenting to academic medical centers (AMC) typically receive primary care, specialty care, or both. Resources needed for each type of care vary, requiring different levels of care coordination. We propose a novel method to determine whether a patient primarily receives primary or specialty care to allow for optimization of care coordination. Objectives We aimed to define the concepts of a Lifer Patient and Destination Patient and analyze the current state of care utilization in those groups to inform opportunities for improving care coordination. Methods Using AMC data for a 36-month study period (FY17-19), we evaluated the number of unique patients by residence zip code. Patients with at least one primary care visit and patients without a primary care visit were classified as Lifer and Destination patients, respectively. Cohen’s effect sizes were used to evaluate differences in mean utilization of different care delivery settings. Results The AMC saw 35,909 Lifer patients and 744,037 Destination patients during the study period. Most patients were white, non-Hispanic females; however, the average age of a Lifer was seventy-two years whereas that of a Destination patient was thirty-eight. On average, a Lifer had three times more ambulatory care visits than a Destination patient. The proportion of Inpatient encounters is similar between the groups. Mean Inpatient length of stay (LOS) is similar between the groups, but Destination patients have more variance in LOS. The rate of admission from the emergency department (ED) for Destination patients is nearly double Lifers’. Conclusion There were differences in ED, ambulatory care, and inpatient utilization between the Lifer and Destination patients. Furthermore, there were incongruities between rate of hospital admissions and LOS between two groups. The Lifer and Destination patient definitions allow for identification of opportunities to tailor care coordination to these unique groups and to allocate resources more efficiently.
    Schlagwörter Care coordination ; Primary care ; Specialty care ; Healthcare delivery ; Healthcare utilization ; Ambulatory care ; Public aspects of medicine ; RA1-1270
    Sprache Englisch
    Erscheinungsdatum 2023-11-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Association between Chlamydia and routine place for healthcare in the United States

    Cornelius D Jamison / Margaret Greenwood-Ericksen / Caroline R Richardson / Hwajung Choi / Tammy Chang

    PLoS ONE, Vol 16, Iss 5, p e

    NHANES 1999-2016.

    2021  Band 0251113

    Abstract: Background The United States is experiencing a surge in Chlamydia trachomatis (CT) infections representing a critical need to improve sexually transmitted infection (STI) screening and treatment programs. To understand where patients with STIs seek ... ...

    Abstract Background The United States is experiencing a surge in Chlamydia trachomatis (CT) infections representing a critical need to improve sexually transmitted infection (STI) screening and treatment programs. To understand where patients with STIs seek healthcare, we evaluated the relationship between CT infections and the place where individuals report usually receiving healthcare. Methods Our study used a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. The study population is adult patients, aged 18 to 39 years in whom a urine CT screen was obtained. Logistic regression models were used to determine if location of usual healthcare was predictive of a positive urine CT screen result. Models were adjusted for known confounders including age, gender, race/ethnicity, education, and insurance status. Results In this nationally representative sample (n = 19,275; weighted n = 85.8 million), 1.9% of individuals had a positive urine CT result. Participants reported usually going to the doctor's office (70.3%), "no place" (24.8%), Emergency Department (ED) (3.3%), or "other" place (1.7%) for healthcare. In adjusted models, the predicted probability of having a positive urine CT result is higher (4.9% vs 3.2%, p = 0.022; OR = 1.58) among those that reported the ED as their usual place for healthcare compared to those that reported going to a doctor's office or clinic. Conclusions Individuals having a positive urine CT screen are associated with using the ED as a usual source for healthcare. Understanding this association has the potential to improve STI clinical and policy interventions as the ED may be a critical site in combatting the record high rates of STIs.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 360
    Sprache Englisch
    Erscheinungsdatum 2021-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: First Responder Resiliency ECHO

    Joanna G. Katzman / Laura E. Tomedi / George Everly / Margaret Greenwood-Ericksen / Elizabeth Romero / Nils Rosenbaum / Jessica Medrano / Paige Menking / Gaelyn R.D. Archer / Chamron Martin / Karina A. Dow / Shannon McCoy-Hayes / Jeffrey W. Katzman

    International Journal of Environmental Research and Public Health, Vol 18, Iss 4900, p

    Innovative Telementoring during the COVID-19 Pandemic

    2021  Band 4900

    Abstract: The First Responder ECHO (Extension for Community Outcomes) program was established in 2019 to provide education for first responders on self-care techniques and resiliency while establishing a community of practice to alleviate the enormous stress due ... ...

    Abstract The First Responder ECHO (Extension for Community Outcomes) program was established in 2019 to provide education for first responders on self-care techniques and resiliency while establishing a community of practice to alleviate the enormous stress due to trauma and substance misuse in the community. When the SARS-CoV-2 (COVID-19) pandemic hit the United States (US) in March 2020, a tremendous strain was placed on first responders and healthcare workers, resulting in a program expansion to include stress mitigation strategies. From 31 March 2020, through 31 December 2020, 1530 unique first responders and frontline clinicians participated in the newly expanded First Responder Resiliency (FRR) ECHO. The robust curriculum included: psychological first aid, critical incident debriefing, moral distress, crisis management strategies, and self-care skills. Survey and focus group results demonstrated that, while overall stress levels did not decline, participants felt more confident using psychological first aid, managing and recognizing colleagues who needed mental health assistance, and taking time for self-care. Although first responders still face a higher level of stress as a result of their occupation, this FRR ECHO program improves stress management skills while providing weekly learning-listening sessions, social support, and a community of practice for all first responders.
    Schlagwörter first responder ; resiliency ; self-care ; COVID-19 ; healthcare worker ; stress ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2021-05-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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