Educational Interventions to Alter Pediatric Emergency Department Utilization Patterns

From JAMA:

Objective:  To test the hypothesis that educating parents about use of their primary care provider and providing information about common pediatric illnesses will reduce visits to the pediatric emergency department (PED).

Design:  Prospective, randomized, controlled trial conducted from September 1, 1993, to October 31, 1994.

Setting:  Pediatric emergency department of an urban university hospital.

Participants:  Parents of 130 patients seen in the PED for minor illness.

Interventions:  Subjects were randomized to intervention or control groups. Parents in both groups were interviewed about their child’s health and use of health care services. The intervention group received education on pediatric health care issues; the control group received usual PED discharge instructions. Use of the PED by all subjects was tracked for 6 months by telephone follow-up and medical record review.

Main Outcome Measures:  Differences between the two groups in total number of return visits to the PED and return visits to the PED for minor illness.

Results:  Sixty-seven (97%) of the 69 patients in the intervention group and 56 (92%) of the 61 patients in the control group identified a primary care provider. At 6-month follow-up, 21 patients (30%) from the intervention group and 16 (26%) from the control group had returned to the PED (P=.68, X2). Seventeen (81%) of intervention group returnees to the PED had minor illness, as did 11 (69%) of control group returnees.

Conclusions:  A one-time educational intervention in the PED does not alter long-term emergency department utilization habits. More extensive education and greater availability of primary care providers may be needed to decrease use of the PED for minor illness.(Arch Pediatr Adolesc Med. 1996;150:525-528)

The Apple Watch Can Accurately Detect Hypertension and Sleep Apnea

From Gizmodo:

The data that fitness trackers collect about your body goes far beyond just how many steps you’ve taken, and researchers are just beginning to understand how to harness all that valuable data-collecting power.

 A new study from the health startup Cardiogram and UCSF suggests that off-the-shelf wearables like the Apple Watch and Fitbit could be used to accurately detect common conditions like hypertension and sleep apnea. It’s only the latest example in a string of recent studies in which researchers have tapped into the biosensors of wearables to turn them into devices that can detect and monitor serious health conditions.

Is your own MD best in the hospital? Study eyes hospitalists

From the News-Democrat:

Medicare patients with common conditions including pneumonia, heart failure and urinary infections who were treated by their own primary care doctors were slightly more likely to survive after being sent home than those cared for instead by hospitalists — internists who provide care only in hospitals.

While hospitalist care can shorten stays and reduce costs, the new results suggest that, for at least some patients, getting taken care of in the hospital by a doctor who knows them can have important advantages.

The researchers don’t advocate replacing hospitalists, but Stevens said the study “opens the door” to limiting their use with certain hospital patients, particularly the elderly. Patients in the study were aged 80 on average.