13% of Americans live in county with shortage of primary care physicians

From Becker’s:

Forty-four million people, or 13 percent of Americans, live in a county with a primary care physician shortage, defined as less than one primary care physician per 2,000 people, according to a report from UnitedHealth Group.

UnitedHealth Group, one of the largest U.S. insurers, analyzed gaps in primary care access, primary care demand and the value of advanced practice clinicians, including nurse practitioners and physician assistants.

The Emergency Department as an Opportunity for Naloxone Distribution: A Systematic Review

From eScholarship:

Introduction: Substance use disorders, including opioid use disorders, are a major public health concern in the United States. Between 2005 and 2014, the rate of opioid-related emergency department (ED) visits nearly doubled, from 89.1 per 100,000 persons in 2005 to 177.7 per 100,000 persons in 2014. Thus, the ED presents a distinctive opportunity for harm-reduction strategies such as distribution of naloxone to patients who are at risk for an opioid overdose.

Methods: We conducted a systematic review of all existing literature related to naloxone distribution from the ED. We included only those articles published in peer-reviewed journals that described results relating to naloxone distribution from the ED.

Results: Of the 2,286 articles we identified from the search, five met the inclusion criteria and had direct relevance to naloxone distribution from the ED setting. Across the studies, we found variation in the methods of implementation and evaluation of take-home naloxone programs in the ED. In the three studies that attempted patient follow-up, success was low, limiting the evidence for the programs’ effectiveness. Overall, in the included studies there is evidence that distributing take-home naloxone from the ED has the potential for harm reduction; however, the uptake of the practice remained low. Barriers to implementation included time allocated for training hospital staff and the burden on workflow.

Conclusion: This systematic review of the best evidence available supports the ED as a potential setting for naloxone distribution for overdose reversal in the community. The variability of the implementation methods across the studies highlights the need for future research to determine the most effective practices.

Push to reduce ED visits leads patients to urgent care, retail clinics — not telehealth

From Becker’s (hat tip: Dr. Menadue):

As payers increasingly turn to alternate modes of care delivery as a way to keep patients with low-acuity conditions out of expensive emergency departments, recent evidence suggests that urgent care centers and retail clinics — not telehealth — appear to be patients’ go-to options, a JAMA Internal Medicine investigation has found.

A team of researchers led by Sabrina Poon, MD, a physician in the department of emergency medicine at Brigham and Women’s Hospital in Boston, reviewed a set of deidentified claims data from Aetna between Jan. 1, 2008, and Dec. 31, 2015. The cohort included about 20 million insured members per study year.