adults with disabilities account for a disproportionately high amount of annual
emergency department visits, reports a comparison study from National Institutes of Health (NIH) researchers.
The NIH study analyzed pooled data from the Medical Expenditure
Panel Survey. Researchers found access to regular medical care, health
profile complexity, and disability status contributed to people with
disabilities' use of the emergency department.
Despite representing 17% of the working age US population, the study found
that adults with disabilities accounted for 39.2% of total emergency department
visits. Those with a severely limiting disability visited an urgent care
department more often than their peers and were more likely to visit the emergency
department more than 4 times per year.
Emergency visits also were associated with poor access to primary medical
care, which was more prevalent among adults with disabilities.
"We want to understand what takes people to the emergency department to
learn if their care could be better managed in other ways," said Elizabeth
Rasch, PhD, chief of the Epidemiology and Biostatistics Section in the NIH
Clinical Center's Rehabilitation Medicine Department. "While many of those
visits may be necessary, it is likely that some could be avoided through better
information sharing among all of the health care providers who see a particular
The authors make recommendations for providers and policymakers to offset
some of the need for emergency care by individuals with disabilities.
Prevention and chronic condition management programs tailored for the
functional limitations and service needs of people with disabilities may help
avoid a crisis situation that would call for an urgent care visit, the report
noted. The authors also endorsed wider adoption of coordinated care systems for
people with disabilities that provide case management, integration of
psychosocial care, and 24/7 access to medical assistance, among other services.
Free full text of the study is available online in Health Services Research.
therapists (PTs) are increasingly being asked to provide evaluation and
management of patients in the emergency department. As part of the emergency
department team, PTs have the opportunity to collaborate in the care of patients
with a wide range of acute and chronic problems coming from the
neuromusculoskeletal, cardiovascular/pulmonary and integumentary systems. PTs
in this setting also serve a critical role in screening for appropriateness of
care, consultation with other practitioners, and in the direct care of
patients. For more information about this expanding area of practice, visit
APTA's Physical Therapist Practice in the Emergency Department webpage, which includes a toolkit
designed to help PTs initiate the development of a PT practice in an
A new infographic roadmap
from the Robert Wood Johnson Foundation (RWJF) illustrates a 6-step framework
that integrates reducing disparities into all health care quality improvement
efforts. The framework is designed to be flexible: organizations can get on the
road where appropriate. Its goal is to support a thoughtful and comprehensive
approach to achieving equity, even though the causes of disparities may vary
across regions or patient populations.
roadmap draws upon lessons learned from RWJF's Finding Answers' 33
grantee projects and 11 systematic reviews of the disparities-reduction
and pasting old, potentially out-of-date information into patients' electronic
health records (EHR) is common among physicians in the intensive care unit
(ICU), according to a Reuters Health article based
on a study that examined
2,068 electronic patient progress reports created by 62 residents and 11
attending physicians in a Cleveland hospital ICU.
Using plagiarism-detection software,
the researchers analyzed 5 months' worth of progress notes for 135 patients. They
found that 82% of residents' notes and 74% of attending physicians' notes
included 20% or more copied and pasted material from the patients' records.
In their report, published in Critical Care Medicine, the authors
did not examine what motivated physicians and residents to copy and paste, or
whether the shortcut affected patient care, says Reuters.
Nothing about a patient—length of stay, sex, age, race or ethnicity, what
brought them into the ICU or how severely ill they were—affected how often a
physician copied information into the medical record.
Although residents' notes more often included copied material, attending
physicians tended to copy more material between notes. They also tended to copy
more of their own assessments from other notes.
Experts suggested that copying information signifies a shift in how
physicians use notes—away from being a means of communication among fellow
health care providers and toward being a barrage of data to document billing,
the article says.
Supreme Court will not hear a challenge to President Obama's policy of
expanding government-funded research using embryonic stem cells that scientists
say may offer hope for new treatments for spinal injuries and Parkinson
disease, reports the Los
The court's action brings an end to a lawsuit that threatened to end all
funding for such research.
A federal judge in Washington in 2010 ordered the National Institutes of
Health (NIH) to halt funding of the research, citing a long-standing
congressional ban on spending for research in which "human embryos are
But an appeals court overturned that order and ruled last year that the ban
applied only to research that destroyed human embryos so as to obtain stem
President George W. Bush in 2001 had allowed limited research on
several stem cell lines that were already in existence. Upon taking office in
2009, President Obama went further and said NIH could conduct
"scientifically worthy human stem cell research to the extent permitted by
law." Under guidelines issued by NIH, researchers can used stem line
cells derived from donated frozen embryos that are no longer needed for
fertility treatments, says the article.
Two researchers who work with adult stem lines brought the lawsuit to the high
court. They were represented by several groups, including the Law of Life
Project, whose general counsel called human stem cell research "an ethical
tragedy as well as a waste of the taxpayer's money," the Times says.