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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
DHHS Publication PHS 2001-1721. Vital and Health Statistics. Series 13, Data from the National Health Care Survey, No. 150. Describes trends in hospital emergency department visits in the United States. Presents statistics for overall utiliation, case mix of patients, services provided, and outcome measures.
Children represent a special challenge for emergency care providers, because they have unique medical needs in comparison to adults. For decades, policy makers and providers have recognized the special needs of children, but the system has been slow to develop an adequate response to their needs. This is in part due to inadequacies within the broader emergency care system. Emergency Care for Children examines the challenges associated with the provision of emergency services to children and families and evaluates progress since the publication of the Institute of Medicine report Emergency Medical Services for Children (1993), the first comprehensive look at pediatric emergency care in the United States. This new book offers an analysis of: • The role of pediatric emergency services as an integrated component of the overall health system. • System-wide pediatric emergency care planning, preparedness, coordination, and funding. • Pediatric training in professional education. • Research in pediatric emergency care. Emergency Care for Children is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency health care providers, professional organizations, and policy makers looking to address the pediatric deficiencies within their emergency care systems.
This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults.
Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
KEY FINDINGS: Data from the National Nursing Home Survey, 2004. In 2004, 8 percent of U.S. nursing home residents had an emergency department (ED) visit in the past 90 days. Among nursing home residents with an ED visit in the past 90 days, 40 percent had a potentially preventable ED visit. Injuries from falls were the most common conditions accounting for potentially preventable ED visits by nursing home residents. Nursing home residents who had a potentially preventable ED visit in the past 90 days had shorter lengths of stay and more medications In 2004, 8 percent of U.S. nursing home residents had an emergency department (ED) visit in the past 90 days. Among nursing home residents with an ED visit in the past 90 days, 40 percent had a potentially preventable ED visit. Injuries from falls were the most common conditions accounting for potentially preventable ED visits by nursing home residents. Nursing home residents who had a potentially preventable ED visit in the past 90 days had shorter lengths of stay and more medications.
The Manchester Triage System (MTS) is the most widely used triagesystem in the UK, Europe and Australia, with tens of millions ofpatients being processed through hospital emergencydepartments. Emergency Triage is the core text for the MTS which utilises arisk averse system of prioritisation for patients in allunscheduled care settings, and as such it is an essential text forall emergency department staff using the MTS, in particular triagenurses themselves. The second edition has been revised throughout and takes in thechanges in practice introduced into MTS since the book was firstpublished. These include: Redesigned and expanded flow charts Additional charts for allergy and palpitations New practices - such as the possibility of revascularisation forpatients with stroke New discriminators, for example acute neurological deficit andsignificant respiratory history Redefinition of existing discriminators Also new to this edition is the incorporation of sections on theuse of the risk averse system in telephone triage, in settingswhere ‘streaming’ takes place and as an early warningscore for patients in all unscheduled care settings. The tone ofthis edition reflects the more up to date, modified approach totriage while retaining the principles of clinical prioritisation,which in the authors’ words “remains a central plank ofclinical risk management in emergency care”. Emergency Triage is an essential handbook for all cliniciansinvolved in unscheduled care settings such as emergency care, walkin centres, minor injury units, primary care out of hoursservices.
Social Emergency Medicine incorporates consideration of patients’ social needs and larger structural context into the practice of emergency care and related research. In doing so, the field explores the interplay of social forces and the emergency care system as they influence the well-being of individual patients and the broader community. Social Emergency Medicine recognizes that in many cases typical fixes such as prescriptions and follow-up visits are not enough; the need for housing, a safe neighborhood in which to exercise or socialize, or access to healthy food must be identified and addressed before patients’ health can be restored. While interest in the subject is growing rapidly, the field of Social Emergency Medicine to date has lacked a foundational text – a gap this book seeks to fill. This book includes foundational chapters on the salience of racism, gender and gender identity, immigration, language and literacy, and neighborhood to emergency care. It provides readers with knowledge and resources to assess and assist emergency department patients with social needs including but not limited to housing, food, economic opportunity, and transportation. Core emergency medicine content areas including violence and substance use are covered uniquely through the lens of Social Emergency Medicine. Each chapter provides background and research, implications and recommendations for practice from the bedside to the hospital/healthcare system and beyond, and case studies for teaching. Social Emergency Medicine: Principles and Practice is an essential resource for physicians and physician assistants, residents, medical students, nurses and nurse practitioners, social workers, hospital administrators, and other professionals who recognize that high-quality emergency care extends beyond the ambulance bay.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.