OBJECTIVES To assess the effects of a home-based telehealth intervention on the use of secondary healthcare and mortality. DESIGN Observational study of a mainstream telehealth service, using person-level administrative data. Time to event analysis (Cox regression) was performed comparing telehealth patients with controls who were matched using a machine-learning algorithm. SETTING A predom...

OBJECTIVE To determine whether patients who are not admitted to hospital after attending an emergency department during shifts with long waiting times are at risk for adverse events. DESIGN Population based retrospective cohort study using health administrative databases. Setting High volume emergency departments in Ontario, Canada, fiscal years 2003-7. PARTICIPANTS All emergency department...

OBJECTIVE To examine national patterns in the emergency department assessment and treatment during visits by young people, aged 7 to 24 years, who are seen following an episode of deliberate self-harm. METHOD An analysis was conducted of a nationally representative sample of hospital emergency department visits from the 1997-2002 National Hospital Ambulatory Medical Care Survey focusing on vi...

Direct Admission toHospitals Among Children in theUnited States While a decade of research and policy interventions has begun to transform hospital discharge processes, research focused on hospital admissions is lacking. Emergency departments (EDs) are increasingly serving as portals of hospital admission, contributing to national concerns about ED volumes,wait times, anddiscontinuityof care.1D...

BACKGROUND Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical presentation, management and mortality to describe adult non-trauma patients that upon ED arrival eli...

BACKGROUND After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. OBJECTIVE To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. METHODS A total of 241 consecutive admissions to intensive care...

BACKGROUND We sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost. METHODS We conducted a retrospective analysis of 13,460 adult (>or= 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery o...

Emergency department access block is an urgent problem faced by many public hospitals today. When access block occurs, patients in need of acute care cannot access inpatient wards within an optimal time frame. A widely held belief is that access block is the end product of a long causal chain, which involves poor discharge planning, insufficient bed capacity, and inadequate admission intensity ...