BACKGROUND Clinicians cannot provide all recommended preventive services in a single office visit and must learn to prioritize. This skill is not overtly addressed in medical school. METHODS We designed a workshop to teach third-year medical students to prioritize preventive services during an office visit. In a prospective controlled trial, we compared performance on a standardized patient c...

Abstract Introduction Lumbar spinal stenosis (LSS) affects 11-39% of adults and contributes to significant pain disability. Decompressive laminectomy (DL) is a common surgical intervention for LSS but many with medical psychosocial comorbidities may not improve. Insomnia unhealthy alcohol use, example, are among people living chronic affect key outcomes, such as healthcare utilization rates. We...

BACKGROUND Visits to the emergency room (ER) for atrial fibrillation/flutter (AF) are common, but follow-up care is rarely systematically organized and is often delayed. PURPOSE We conducted a pilot program to develop a systematic, protocol-based system of care for patients presenting to the ER with a primary diagnosis of AF. METHODS Consecutive patients presenting to the ER with ECG-docume...

OBJECTIVE To examine in a longitudinal investigation perceptions of disease severity among children and adolescents with sickle cell disease (SCD) and their caregivers and to determine whether perceptions of disease severity and self-reported adjustment would account for a greater percentage of the variance in emergency room (ER) use than objective measures of disease severity. METHODS Partic...

BACKGROUND Medicaid-insured asthmatic children frequently use emergency rooms (ERs). The reasons are unclear and have predominantly been studied in inner-city populations. METHODS We used billing data and focus groups to clarify reasons for frequent ER use by Medicaid-insured children with asthma living in rural areas and 23 towns in Kansas. RESULTS High ER utilization was concentrated in a...

Major depressive disorder (MDD) is a disabling mental health condition with significant economic burden. This study evaluated direct and indirect healthcare costs for patients MDD cost differences across severity levels. Adults (≥18 years) self-reported physician diagnosis of depression on the 2019 National Health Wellness Survey were stratified by disease using Patient Questionnaire (PHQ-9) sc...

The American Academy of Pediatrics policy statement "Options Counseling for the Pregnant Adolescent Patient" recommends the basic content of the pediatrician's counseling for an adolescent facing a new diagnosis of pregnancy. However, options counseling is just one aspect of what may be one of the more challenging scenarios in the pediatric office. Pediatricians must remain alert to the possibi...

PURPOSE This study compared the expenditure by the state Medicaid program for episodic, nondefinitive care provided through the emergency room (ER) of a children's hospital with the cost to Medicaid of covering that same child with the recommended preventive service calculated on the fee schedule of the state dental Medicaid program. METHODS Records of patients discharged from the ER during 1...

BACKGROUND It is sometimes difficult to decide on a safe discharge of an acute asthmatic patient from the emergency room (ER). OBJECTIVE To develop a predictive score for safe discharge of an acute asthmatic patient from the ER. MATERIAL AND METHOD All adult asthmatic patients who visited the ER at Ramathibodi Hospital from January 2004 to August 2005 were recruited Vital signs, oxygen satu...