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The article focuses on a study regarding the use of emergency department and acute care services among the readmitted patients and who are recently discharged from the hospital in the U.S. It states that hospital readmission within 30 days of recharge signifies the poor hospital quality and return to the ED after hospital discharge reflects the poor quality of care provided to patients. The study reveals that ED visits after discharge from hospitals within 30 days are common among adults and account for 39.8 percent of post discharge hospital-based acute care visits. It also presents several tables and graphs regarding the readmission of patients.

Objective: To evaluate whether mortality and clinical outcomes vary for injured patients in a mature trauma system on weeknights and weekends compared with weekdays. Design: Retrospective cohort study. Setting: Pennsylvania trauma system. Patients: A total of 90 461 patients over 5 years. Intervention: Treatment at a level I, II, or III trauma center. Main Outcome Measures: In-hospital mortality, time to procedures, and length of stay. Results: In adjusted analyses, patients presenting on weeknights were no more likely to die than patients presenting during weekdays, and patients presenting on weekends were less likely to die than patients presenting on weekdays (odds ratio=0.89; 95% confidence interval, 0.81-0.97). Presenting on weeknights was associated with longer intensive care unit stay (incidence rate ratio=1.06; 95% confidence interval, 1.02-1.10) and longer hospital stay (incidence rate ratio=1.02; 95% confidence interval, 1.00-1.04). Presenting on weekends was associated with longer intensive care unit stay (incidence rate ratio=1.04; 95% confidence interval, 1.02- 1.10) but not longer hospital stay. Delays to laparotomy or craniotomy were not seen in either group. Conclusions: We demonstrate comparable mortality among injured patients presenting on weeknights vs weekdays and lower mortality among injured patients on weekends vs weekdays. Systems-based solutions of the trauma model are protective against the weekend effect and inform care for other emergency care-sensitive conditions. [ABSTRACT FROM AUTHOR]

Objectives: Our primary objective was to determine the proportion of the population able to achieve acute cerebrovascular care in emergency stroke systems (ACCESS) in the United States. In addition, we examined how policy changes, including allowing ground ambulances to cross state lines and allowing air ambulances to transport patients from the prehospital setting to primary stroke centers (PSCs), would affect population access to stroke care. Design: Data were obtained via the US Census Bureau, The Joint Commission, and the Atlas and Database of Air Medical Services. Driving distances, ambulance driving speeds, and prehospital times were estimated using validated models and adjusted for population density. Access was determined by summing the population that could reach a PSC within the specified time intervals. Setting/Participants: US population. Main Outcome Measures: Thirty-, 45-, and 60-minute access by ground and air ambulance to PSCs. Results: Fewer than 1 in 4 Americans (22.3%) have access to a PSC within 30 minutes, less than half (43.2%) have access within 45 minutes, and just over half (55.4%) have access within 60 minutes. The use of air ambulances to deliver patients to PSCs would increase access from 22.3% to 26.0% for 30 minutes, 43.2% to 65.5% for 45 minutes, and from 55.4% to 79.3% for 60 minutes. The combination of prehospital regionalization and air ambulance transport of patients with acute stroke would reduce the 135.7 million Americans without 60-minute access to a PSC by half, to 62.9 million. Conclusions: About half of the US population has timely access to a PSC. The use of air ambulances to triage patients with ischemic stroke to a PSC would increase the percentage of the US population with prompt access to stroke care. These data have implications for the ongoing design of the US stroke system. [ABSTRACT FROM AUTHOR]

A letter is presented which discloses information on a study which evaluated U.S. population-level critical care bed supply and its implications for pandemic and disaster planning. Data analyzed by the researchers were from the 2007 Centers for Medicare & Medicaid Services Healthcare Cost Report Information System (HCRIS), and regional boundaries were defined using Dartmouth Atlas hospital referral regions (HRR). Presented in details are the study findings. Also noted are the limitations of the study.