Spat Spatiotemporal Epidemiol - The influence of rurality on the volume of non-urgent emergency department visits.

Tópicos

{ patient(1821) servic(1111) care(1106) }
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{ treatment(1704) effect(941) patient(846) }
{ studi(1119) effect(1106) posit(819) }
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{ high(1669) rate(1365) level(1280) }
{ patient(2315) diseas(1263) diabet(1191) }
{ data(3008) multipl(1320) sourc(1022) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ health(3367) inform(1360) care(1135) }
{ state(1844) use(1261) util(961) }
{ patient(2837) hospit(1953) medic(668) }
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{ record(1888) medic(1808) patient(1693) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ research(1218) medic(880) student(794) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
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{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

At least one-third of emergency department (ED) visits in the United States are non-urgent, for conditions that can be treated more efficiently in primary care settings. Research suggests rural areas may have higher non-urgent ED visit rates. Such research rarely accounts for spatial factors that may bias results, and is often limited to dichotomous rurality measures, either "rural" or "urban". We examined the association between multiple levels of rurality and ED visits in South Carolina. Controlling for spatial effects, the distance of Community Health Centers from the cores of populated areas (centroids), and the percentage of the population in poverty, increasing levels of rurality predicted higher rates of uninsured ED visits, non-urgent ED visits, non-urgent privately insured ED visits, and non-urgent uninsured ED visits. Results also demonstrated that estimates of effects of rurality on ED use that do not account for spatial random effects would be biased.

Resumo Limpo

least onethird emerg depart ed visit unit state nonurg condit can treat effici primari care set research suggest rural area may higher nonurg ed visit rate research rare account spatial factor may bias result often limit dichotom rural measur either rural urban examin associ multipl level rural ed visit south carolina control spatial effect distanc communiti health center core popul area centroid percentag popul poverti increas level rural predict higher rate uninsur ed visit nonurg ed visit nonurg privat insur ed visit nonurg uninsur ed visit result also demonstr estim effect rural ed use account spatial random effect bias

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