Emergency room symptoms may not predict health care needs

From Reuters:

The symptoms people come to the emergency room with may not predict the actual diagnosis they’re given when they’re released from the hospital, according to a new study.

Researchers found about 6 percent of 35,000 patients who visited ERs in 2009 did not need immediate care, but that could not be predicted when they first got to the emergency department.

The findings may not be just academic. Some state Medicaid programs – government-run health insurance plans for the poor – have proposed discouraging unnecessary ER care by withholding hospital and doctor payments for problems that family doctors can manage.

See also MedPage Today and Medical XPress

Medical homes for the homeless can curb ED use

From Fierce Healthcare:

In Delaware, for example, Wilmington’s St. Francis Healthcare sends a medical van into underserved communities to offer free primary care services, reports theNews Journal. For Christiana Care Health System, the solution is its Medical Home Without Walls, which visits uninsured patients in homeless shelters or on the streets, among other locations, and can even accompany patients on provider visits.

The medical home targets “super users” who account for more than 20 percent of hospital visits, program medical director Diane Bohner, M.D., told the News Journal. The hospital’s electronic record system flags uninsured patients admitted twice in six months, and uninsured patients who visited the ED four times in six months. A team including a social worker and a nurse practitioner help coordinate care for patients, the newspaper reported.

Research Suggests Time for Change in Prehospital Spinal Immobilization

From JEMS:

Many experts question the current practice of prehospital spinal immobilization.There are now some guidelines, textbooks and an increasing number of EMS agencies that support a progressive, evidence-based approach in an effort to lessen unnecessary spinal immobilizations in the field.

Ambulance stolen after paramedics rush dying woman into emergency room

From BND:

An ambulance crew tried in vain early Monday to save the life of a woman critically injured in a Fairmont City car crash — only to have their emergency vehicle stolen outside the hospital as they rushed her into the emergency room.

The ambulance, owned by Sparta-based MedStar Ambulance, was idling outside the hospital shortly before 3 a.m. when it was taken. It later was recovered in East St. Louis.

Maine-based Ambulance Service to Provide Free, In-home Fall Assessments by Community Paramedics

From JEMS:

This service is part of United’s Home Visit Program, a new program that is slated to be released later this year. With this program, a patient is referred to United by their primary care practitioner for a free, in-home fall assessment by one of United’s community paramedics. The visit takes place within the patient’s home and consists of a fall assessment, which is complete with reviewing simple interventions that may assist the patient toward decreasing the likelihood of falls within their home or while out in the community.

This information is then shared with the patient’s PCP so that they are aware of any challenges associated with patient mobility within the home. The PCP can utilize this information to have a better understanding of how a patient’s mobility is affecting their activities of daily living.