Low Income, Poor Insurance Tied to Leaving ED Without Being Seen

From ACEP:

Low-income and poorly insured patients are at a disproportionately increased risk of leaving emergency departments without being seen, according to an analysis of 262 California hospitals.

The proportion of patients who leave emergency departments (EDs) without being seen has increased significantly over the last 15 years, as strains on the emergency care system have mounted. And, although it’s logical to assume that vulnerable populations and the hospitals that serve them are at greatest risk, there are few multicenter studies to show it, said Dr. Renee Y. Hsia of the University of California, San Francisco, and her associates (Ann. Emerg. Med. 2011 Feb. 21 [doi:10.1016/j.annemergmed.2011.01.009]).

“Patients who leave without being seen from an ED are a glaring measure of impaired health care access. Their observed behavior represents individual attempts to enter the health care system without success. Our study provides descriptive data about [patients who] left without being seen from a large statewide cohort of hospital EDs. … The increasing phenomenon of left without being seen patients differentially affects those at hospitals that tend to serve the most vulnerable. Real action and resources should be applied to address the disparities on a systems level,” the investigators said.

Required EM Rural Rotations Influence Job Choice

From ACEP:

Increasing the number of residency programs that require rotations in rural areas would help address the shortage of emergency physicians who choose to work in rural U.S. emergency departments, according to a survey of 2,380 graduates of 111 residency training programs.

Based on the findings of their nationwide July-December 2009 survey, “exposure to rural emergency department (ED) rotations may positively enhance rural recruitment after graduation,” wrote Dr. Brad E. Talley of the department of emergency medicine at Denver Health Medical Center, and his coauthors.

The investigators surveyed the program directors of all 126 emergency medicine residency training programs recognized by the Accreditation Council for Graduate Medical Education, with the exception of military programs and those started after 2006. Of the 111 programs that provided complete responses, only 6 (5%) required residents to have a rotation in a rural area. Of the remainder, 16 (14%) offered residents rural rotations at predesignated sites as an elective, 76 (69%) offered rural rotations as an elective but students were required to find their own site, and 13 (12%) offered no opportunity for a rural rotation.

Programs that required rural rotations had a significantly greater percentage of residents who later chose to start their careers in rural areas (22%) than did programs with electives at predesignated sites (7%), programs with electives at student-selected sites (6%), and programs with no rural rotations (7%), Dr. Talley and his coinvestigators reported.

Playing Operation with the da Vinci Surgical Robot

From Neatorama:

Ever played the game Operation? Sure you have – but have you ever played it with a surgical robot?

Johns Hopkins graduate student Carol Reiley has access to the da Vinci surgical robot, and put it to good use