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Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?

Background: Traumatic hand injuries represent approximately 20% of emergency department visits; yet, access to emergency care remains inadequate. Recent surveys from several states report a wider availability of hand specialists providing elective care than emergency care. The authors aim to examine...

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Autores principales: Chung, Stella Y., Sood, Aditya, Granick, Mark S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Open Science Company, LLC 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021704/
https://www.ncbi.nlm.nih.gov/pubmed/27651852
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author Chung, Stella Y.
Sood, Aditya
Granick, Mark S.
author_facet Chung, Stella Y.
Sood, Aditya
Granick, Mark S.
author_sort Chung, Stella Y.
collection PubMed
description Background: Traumatic hand injuries represent approximately 20% of emergency department visits; yet, access to emergency care remains inadequate. Recent surveys from several states report a wider availability of hand specialists providing elective care than emergency care. The authors aim to examine this phenomenon in the state of New Jersey and whether there is a national trend toward disproportionate availability between emergency and elective hand coverage. Methods: A survey was conducted of all New Jersey hospitals, excepting university hospitals, in August 2014. To assess the availability of hand surgery coverage, the following questions were asked: (1) Does your hospital provide elective hand surgery? and (2) Is there a hand specialist/surgeon on call always, sometimes, or never? Results: A total of 58 hospitals were called, with a 67.2% response rate (n = 39). The majority (87.2%) of hospitals offered elective hand surgery, whereas only 64.1% provided immediate 24/7 hand coverage. Only 38.5% of hospitals located in the same county as a level I trauma center provided 24/7 emergency hand care, whereas 76.9% of hospitals in counties without any level I trauma center did (P < .05). Cities with a higher poverty level were less likely to provide emergency coverage than cities with a lower poverty level (47.4% vs 80.0%; P < .05). Conclusions: There is a discrepancy between emergency and elective hand care in New Jersey. Similar findings across the nation suggest a concerning trend of limited access to emergency hand health care. Alternative systems that can appropriately triage and treat patients are warranted.
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spelling pubmed-50217042016-09-20 Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend? Chung, Stella Y. Sood, Aditya Granick, Mark S. Eplasty Journal Article Background: Traumatic hand injuries represent approximately 20% of emergency department visits; yet, access to emergency care remains inadequate. Recent surveys from several states report a wider availability of hand specialists providing elective care than emergency care. The authors aim to examine this phenomenon in the state of New Jersey and whether there is a national trend toward disproportionate availability between emergency and elective hand coverage. Methods: A survey was conducted of all New Jersey hospitals, excepting university hospitals, in August 2014. To assess the availability of hand surgery coverage, the following questions were asked: (1) Does your hospital provide elective hand surgery? and (2) Is there a hand specialist/surgeon on call always, sometimes, or never? Results: A total of 58 hospitals were called, with a 67.2% response rate (n = 39). The majority (87.2%) of hospitals offered elective hand surgery, whereas only 64.1% provided immediate 24/7 hand coverage. Only 38.5% of hospitals located in the same county as a level I trauma center provided 24/7 emergency hand care, whereas 76.9% of hospitals in counties without any level I trauma center did (P < .05). Cities with a higher poverty level were less likely to provide emergency coverage than cities with a lower poverty level (47.4% vs 80.0%; P < .05). Conclusions: There is a discrepancy between emergency and elective hand care in New Jersey. Similar findings across the nation suggest a concerning trend of limited access to emergency hand health care. Alternative systems that can appropriately triage and treat patients are warranted. Open Science Company, LLC 2016-09-09 /pmc/articles/PMC5021704/ /pubmed/27651852 Text en Copyright © 2016 The Author(s) http://creativecommons.org/licenses/by/2.0/ This is an open-access article whereby the authors retain copyright of the work. The article is distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Journal Article
Chung, Stella Y.
Sood, Aditya
Granick, Mark S.
Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title_full Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title_fullStr Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title_full_unstemmed Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title_short Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
title_sort disproportionate availability between emergency and elective hand coverage: a national trend?
topic Journal Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021704/
https://www.ncbi.nlm.nih.gov/pubmed/27651852
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