Age, insurance status and history of emergency department visits determines whether a patient will leave the ED without being seen by a physician, according to a study in the December issue of Annals of Emergency Medicine.
The Department of Emergency Medicine at Johns Hopkins University School of Medicine conducted the study, which selected 1,476 case-controlled pairs of patients who entered an ED in a university hospital from July 2004 through December 2004.
The study found that the following patient characteristics significantly increased the risk of an uncompleted visit:
- Being uninsured or covered by Medicaid;
- Being under age 55; and
- Having a history of at least one uncompleted visit within the last year.
Researchers said the insurance factor is "disturbing" because the uninsured and Medicaid-insured population has limited options for seeking medical treatment elsewhere.
The study concludes that patients who leave EDs without being seen by a physician are potentially hazardous to themselves and the hospital (Ding et al., Annals of Emergency Medicine, December 2006).
Hospitals across the nation followed only about three-quarters of recommended processes for care for three conditions, a study in the Archives of Internal Medicine found.
For the study, researchers used 2004 data from the Joint Commission on Accreditation of Healthcare Organizations and CMS to measure quality of care for patients with acute myocardial infarction, congestive heart failure and pneumonia at more than 4,000 hospitals in the U.S.
The study found that not-for-profit hospitals and hospitals with higher ratios of registered nurses to patients and more technology scored better in quality measurements than for-profit hospitals and hospitals that provide for large numbers of Medicaid beneficiaries.
The researchers concluded that quality of care should be determined by core factors -- such as prevention, counseling and diagnosis -- instead of treatment of particular diseases and that these core factors should be the targets for improvement (Landon et al., Archives of Internal Medicine, 12/11). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.