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Assessment of ambulance response performance using a geographic information system.

https://arctichealth.org/en/permalink/ahliterature200637
Source
Soc Sci Med. 1999 Dec;49(11):1551-66
Publication Type
Article
Date
Dec-1999
Author
J. Peters
G B Hall
Author Affiliation
MapInfo Corporation, Troy, New York, USA. jeremy_peters@mapinfo.com
Source
Soc Sci Med. 1999 Dec;49(11):1551-66
Date
Dec-1999
Language
English
Publication Type
Article
Keywords
Ambulances - utilization
Catchment Area (Health)
Decision Support Systems, Management
Emergency Medical Services - organization & administration - utilization
Geography
Health Services Accessibility
Humans
Information Systems
Models, Theoretical
Ontario
Organizational Case Studies
Process Assessment (Health Care)
Time Factors
Abstract
The accessibility, distribution and utilisation of emergency medical services are important components of health care delivery. The impact of these services on well-being is heightened by the fact that ambulance resources must respond in a reliable and timely manner to emergency calls from demand areas. However, many factors, such as the unavailability of an ambulance at a center closest to a call, can adversely influence response time. This paper discusses the design and implementation of a framework developed in a Geographic Information System for assessing ambulance response performance. A case study of ambulance response in three communities in Southern Ontario, Canada is presented that allows easy and rapid identification of anomalous calls that may adversely affect overall operating performance evaluation. Extensions of the framework into a fully fledged service deployment and planning decision support system are discussed.
PubMed ID
10515636 View in PubMed
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Day medicine: an urgent internal medicine clinic and medical procedures suite.

https://arctichealth.org/en/permalink/ahliterature184150
Source
Healthc Manage Forum. 2003;16(1):17-23
Publication Type
Article
Date
2003
Author
H Jay Biem
David Cotton
Shirley McNeil
Alice Boechler
Debra Gudmundson
Author Affiliation
Department of Medicine, University of Saskatchewan, Saskatoon.
Source
Healthc Manage Forum. 2003;16(1):17-23
Date
2003
Language
English
Publication Type
Article
Keywords
Day Care - organization & administration - utilization
Diagnosis-Related Groups - statistics & numerical data
Diagnostic Services - utilization
Emergency Medical Services - organization & administration - utilization
Hospital Planning
Hospitals, University
Humans
Internal Medicine - organization & administration
Outpatient Clinics, Hospital - organization & administration - utilization
Saskatchewan
Utilization Review
Abstract
During Saskatchewan's healthcare reform of the 1990s, the number of acute hospital beds in Saskatoon District Health was cut in half. The emergency room and outpatient facilities were not able to accommodate an increasing number of patients needing urgent assessments and medical procedures. In this article, we describe the development, implementation and utilization of a day medicine program. This description may be useful to others planning healthcare delivery to medical patients, especially in a setting of resource constraint.
PubMed ID
12908162 View in PubMed
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[Dispensary-diagnostic department in the system of emergency surgical care].

https://arctichealth.org/en/permalink/ahliterature191193
Source
Khirurgiia (Mosk). 2002;(1):49-51
Publication Type
Article
Date
2002
Author
T V Avdeeva
A M Kosyrev
I M Varshavskii
Source
Khirurgiia (Mosk). 2002;(1):49-51
Date
2002
Language
Russian
Publication Type
Article
Keywords
Bed Occupancy
Emergency Medical Services - organization & administration - utilization
Humans
Patient Discharge
Patient transfer
Russia
Surgical Procedures, Operative - methods
Abstract
3-year experience of dispensary-diagnostic department (DDD) working at the Center of emergency surgical care is analyzed. DDD activity consists of 2 types: dispensary-diagnostic and curative-prophylactic. Department has 5 beds where patients with indeterminate diagnosis are hospitalized (2737 patients over 3 years). Diagnostic beds permit to make diagnosis and select patients with parallel therapeutic procedures. 503 patients were discharged from DDD over 3 years. 534 patients were transferred to surgery department, 97 patients--in internal medicine department. 2% patients required 1-3 hours for final diagnosis, 17%--3-6 hours, 29%--12-24 hours, and only 4%--over twenty-four hours. In 1998--30% patients didn't require hospital treatment, in 1999--38.5%, in 2000--48.5%. A significant cost-effect was achieved.
PubMed ID
11875951 View in PubMed
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Emergency hospitalisation in six municipalities in the Sunnmøre district.

https://arctichealth.org/en/permalink/ahliterature271720
Source
Tidsskr Nor Laegeforen. 2015 Sep 22;135(17):1553-7
Publication Type
Article
Date
Sep-22-2015
Author
Torstein Hole
Johan Barstad
Solfrid Teigen
Marit Kvangarsnes
Source
Tidsskr Nor Laegeforen. 2015 Sep 22;135(17):1553-7
Date
Sep-22-2015
Language
English
Norwegian
Publication Type
Article
Keywords
Bed Occupancy
Emergency Medical Services - organization & administration - utilization
Focus Groups
Health Personnel
Health Services Accessibility
Hospitalization
Humans
Interprofessional Relations
Norway
Nursing Homes
Patient Participation
Patient-Centered Care
Abstract
Providing better and more cost-efficient health services is a goal for health policy. It is seen as desirable to provide health services close to the patient's home. From 2016, all municipalities must provide emergency hospitalisation (EH). The objective of this study was to develop experience-based knowledge from medium-sized municipalities that operate such services without any inter-municipal collaboration.
Focus-group interviews with 25 health workers who are responsible for this service in six small and medium-sized municipalities in Western Norway were conducted in the autumn of 2013 and the spring of 2014. Additional information on bed utilisation was also collected.
The informants reported that their municipalities had chosen emergency hospitalisation as a measure to reinforce the professional communities in the nursing homes. They described this as a patient-centred and flexible treatment option. In their opinion, the programme would help ensure competence enhancement in the municipalities. Bed utilisation increased from the introduction of EH until 31 August 2014.
The health workers reported that emergency hospitalisation in the municipality fulfilled key intentions of the Interaction Reform, in terms of providing treatment to patients locally and close to their homes.
Notes
Comment In: Tidsskr Nor Laegeforen. 2015 Oct 20;135(19):171326486660
Comment In: Tidsskr Nor Laegeforen. 2015 Sep 22;135(17):152826394562
Comment In: Tidsskr Nor Laegeforen. 2015 Oct 20;135(19):1713-426486661
PubMed ID
26394586 View in PubMed
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Hospital admissions via the emergency department: implications for planning and patient flow.

https://arctichealth.org/en/permalink/ahliterature158388
Source
Healthc Q. 2008;11(1):20-2
Publication Type
Article
Date
2008
Author
Heather Dawson
Jaya Weerasooriya
Greg Webster
Author Affiliation
CIHI, Toronto.
Source
Healthc Q. 2008;11(1):20-2
Date
2008
Language
English
Publication Type
Article
Keywords
Canada
Emergency Medical Services - organization & administration - utilization
Humans
Patient Admission - statistics & numerical data
Patient Care Planning - organization & administration
Abstract
In summary, there are important differences among patients admitted via the ED versus those admitted via other means in terms of both utilization and patient characteristics. When compared with patients admitted via other means, patients admitted via the ED are more likely to fall into the medical patient group, to be older and to have more complex and more diseases or health conditions. Medical patients admitted via the ED are more likely to become ALC patients than are other types of patients. As hospitals, health regions and policy makers focus on improving patient flow through Canada's EDs, it is important to consider the volume and characteristics of the patient population admitted via the ED.
PubMed ID
18326375 View in PubMed
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[Influence of the list patient system on the increase of emergency ward attendance].

https://arctichealth.org/en/permalink/ahliterature184958
Source
Tidsskr Nor Laegeforen. 2003 May 15;123(10):1327-9
Publication Type
Article
Date
May-15-2003

Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users?

https://arctichealth.org/en/permalink/ahliterature93781
Source
Eur J Emerg Med. 2008 Feb;15(1):34-9
Publication Type
Article
Date
Feb-2008
Author
Hansagi Helen
Olsson Mariann
Hussain Aliasgher
Ohlén Gunnar
Author Affiliation
Department of aClinical Neuroscience, Karolinska University Hospital, Huddinge, Sweden. helen.hansagi@sll.se
Source
Eur J Emerg Med. 2008 Feb;15(1):34-9
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Emergency Medical Services - organization & administration - utilization
Emergency Service, Hospital - organization & administration - utilization
Female
Hospitals, University
Humans
Male
Medical Records Systems, Computerized - statistics & numerical data
Middle Aged
Physicians, Family
Primary Health Care
Remote Consultation
Sweden
Abstract
OBJECTIVES: To assess whether easy access to medical information of the emergency department's (ED) frequent users would be useful to patient care in the ED and at primary healthcare centres (PHCs), and if resource utilization in the following year would be affected. METHODS: During a 6-month period, frequent users presenting to the ED of Karolinska University Hospital Huddinge, Sweden, were randomized by the electronic database system into an intervention (n=834) or control group (n=965), the definition being three or more visits in 12 months before the index visit. Printout case notes, from the intervention patients' last three visits, were made accessible to the ED physicians and optionally forwarded to the patient's PHC physician. Usefulness of this enhanced information was measured by questionnaires, whereas healthcare utilization was compiled from the electronic database. RESULTS: The case notes of 59 (7.1%) intervention patients were forwarded to the respective PHCs. Of these, access to the enhanced patient information was deemed useful in 82% cases in the ED, versus 76% in PHCs. The mean number of ED visits in the following year did not differ significantly in the total intervention group as compared with the controls: 4.0 and 3.9, respectively (P=0.49). Nor were there any differences in utilization of other care resources. CONCLUSION: Although only a small subgroup's information was shared, yielding no decrease in overall healthcare utilization, the study indicated benefits of the enhanced information at the respective care level and also had important clinical and organizational implications.
PubMed ID
18180664 View in PubMed
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Medical support during the European Union Summit in Gothenburg, Sweden, June 2001.

https://arctichealth.org/en/permalink/ahliterature166806
Source
Prehosp Disaster Med. 2006 Jul-Aug;21(4):282-5
Publication Type
Article
Author
Kristina M C Johnsson
Per A Ortenwall
Anne-Lii H Kivi
Annika H E Hedelin
Author Affiliation
Centre for Prehospital and Disaster Medicine, University of Gothenburg, Gothenburg, Sweden. Kristina.m.johnsson@astrazeneca.com
Source
Prehosp Disaster Med. 2006 Jul-Aug;21(4):282-5
Language
English
Publication Type
Article
Keywords
Congresses as topic
Emergency Medical Services - organization & administration - utilization
European Union
Humans
Medical Audit
Sweden
Violence
Abstract
Several factors are important for the number and severity of medical emergencies during mass-gatherings. The risk of violence, the size and mobility of the crowd, the type of event, weather, and duration of the event all influence the outcome. During the European Union (EU) Summit, from 15-16 June 2001 in Gothenburg, Sweden, approximately 50,000 people participated in 43 protest marches, some which included 15,000 participants. Clashes between police and the protesters occurred.
The objective of this study was to analyze the amount and character of injuries as well as the medical complaints in relation to the EU Summit. In addition, the aim of this study was to describe the organization and function of the healthcare services provided during the meeting.
This study is based on the medical records of patients presenting with injuries and other types of medical emergencies at the healthcare stations during the Summit.
In total, 143 patients sought medical care. Fifty-three (37.1%) were police officers. Most patients had minor complaints, but a few were seriously injured. The Patient Presentation Rate (PPR) was 2.7. Nine victims were hospitalized as high priority.
The PPR for the EU Summit was 2.7, which is in the same range as previously reported from other mass-gatherings.
PubMed ID
17076431 View in PubMed
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A paramedic-staffed medical rehydration unit at a mass gathering.

https://arctichealth.org/en/permalink/ahliterature176793
Source
Prehosp Emerg Care. 2004 Oct-Dec;8(4):411-6
Publication Type
Article
Author
Jane L Lukins
Michael J Feldman
James A Summers
P Richard Verbeek
Author Affiliation
Division of Prehospital Care, Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario, Canada.
Source
Prehosp Emerg Care. 2004 Oct-Dec;8(4):411-6
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Emergency Medical Services - organization & administration - utilization
Emergency Medical Technicians
Female
Fluid Therapy
Heat Stress Disorders - therapy
Humans
Length of Stay
Male
Middle Aged
Ontario
Personnel Staffing and Scheduling
Prospective Studies
Abstract
Heat-related illness is reported to be a significant cause of morbidity at outdoor mass gatherings during warm weather. Paramedics are traditionally present at mass gatherings to provide prehospital care for people in need.
To describe a paramedic-staffed medical rehydration unit and a new role for paramedics at a mass gathering attended by more than 450,000 people.
A 48-bed medical rehydration unit was deployed adjacent to the main field hospital. Paramedics admitted patients to the unit if they met predetermined criteria for mild to moderate heat-related illness. Each paramedic was responsible for four beds. Paramedics initiated oral and intravenous rehydration therapy by following medical directives. Emergency medical services (EMS) physicians reviewed patients before discharge.
The medical rehydration unit managed 143 patients (3/10,000 attendees). The mean number of patients admitted per hour was nine. The average age was 24 years; 103 (72%) were female. The main presenting complaint was syncope, presyncope, or dizziness in 43 (30%). Forty-four (31%) patients received parenteral and oral fluids; the remainder received oral fluids alone. The average length of stay was 94 minutes (95% CI 82-106). One hundred seven (75%) patients were discharged, 17 (12%) were transferred to the main field hospital, four (3%) left against medical advice, and two (1%) required transfer to a hospital off site. In 13 (9%) cases, records of patient disposition were incomplete.
This article defines a new role for paramedics and describes the operation of a medical rehydration unit at a large, single-day mass gathering in summer.
PubMed ID
15626003 View in PubMed
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Prehospital emergency care and medical preparedness for the 2005 World Championship Games in Athletics in Helsinki.

https://arctichealth.org/en/permalink/ahliterature160293
Source
Prehosp Disaster Med. 2007 Jul-Aug;22(4):304-11
Publication Type
Article
Author
Tuomas Hiltunen
Markku Kuisma
Teuvo Määttä
Arto Tennilä
Tuomo Hari
Riitta Bäckman
Taneli Väyrynen
Author Affiliation
Helsinki Emergency Medical Services, Helsinki University Central Hospital, Helsinki, Finland. tuomas.hiltunen@hus.fi
Source
Prehosp Disaster Med. 2007 Jul-Aug;22(4):304-11
Language
English
Publication Type
Article
Keywords
Ambulances - utilization
Anniversaries and Special Events
Disaster Planning - organization & administration
Emergency Medical Services - organization & administration - utilization
Finland
First Aid - utilization
Humans
Observation
Program Evaluation
Prospective Studies
Sports
Time Factors
Transportation of Patients - utilization
Abstract
International mass gatherings can cause great challenges to local healthcare system and emergency medical services (EMS). Traditionally, planning has been based on retrospective reports of previous events, but there still is a need for prospective studies in order to make the process more evidence-based. The aim of this study was to analyze the success of medical preparedness, ambulance patient characteristics, emergency care, and the use of pre-hospital resources during the 2005 World Championship Games in Athletics in Helsinki, Finland.
The study was a prospective, observational study conducted within the Helsinki EMS. Data from all emergency calls at the sport venues and Games village between 05 and 14 August 2005 were collected. Data from the organizations responsible for the health care and first aid of spectators and accredited persons (e.g., athletes, coaches, the press, very important persons and personnel working in the Games area) also were collected. The Institutional Review Board of Helsinki University Central Hospital approved the study plan.
A total of 479,000 persons visited the Games. The ambulance call incidence at the Olympic Stadium was 0.50 per 10,000 people and 0.7 per 10,000 when the Games Village was included. The overall need for ambulance transportation to the emergency department was 0.52 per 10,000. No patients needed cardiopulmonary resuscitation or other immediate, life-saving procedures on-site. First aid was provided to 554 spectators (0.17 per 10,000 people). The three medical organizations cared for 1,586 patients of which 25 (1.6%) were transported to a hospital by an ambulance. The number of patients needing transportation and the overall patient load for the healthcare system was well-anticipated. Accredited persons sought health care a total of 1,009 times. The number of patients treated was associated closely with the number of spectators (p = 0.05). The number of ambulance calls in the city increased 5.9 % as compared to the corresponding time period in the five previous years.
The medical preparedness and resources for the Games proved to be sufficient. The EMS personnel were able to provide quality emergency care. This prospective study provided new, detailed data for the medical aspects of mass gatherings and confirmed many previous observations.
PubMed ID
18019097 View in PubMed
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11 records – page 1 of 2.