Journal articles: 'Emergency department visits'

1

Schrager, Craig. "Emergency department visits." Journal of the American Dental Association 147, no. 6 (June 2016): 390. http://dx.doi.org/10.1016/j.adaj.2016.04.007.

Full text

APA, Harvard, Vancouver, ISO, and other styles

2

Buesching, Don P., Alexander Jablonowski, Ernest Vesta, William Dilts, Charles Runge, Johanna Lund, and Robert Porter. "Inappropriate emergency department visits." Annals of Emergency Medicine 14, no. 7 (July 1985): 672–76. http://dx.doi.org/10.1016/s0196-0644(85)80886-6.

Full text

APA, Harvard, Vancouver, ISO, and other styles

3

Resar, Roger K., and Frances A. Griffin. "Rethinking Emergency Department Visits." Journal of Ambulatory Care Management 33, no. 4 (2010): 290–95. http://dx.doi.org/10.1097/jac.0b013e3181f53424.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Petersen, Laura A., Helen R. Burstin, Anne C. O'Neil, E. John Orav, and Troyen A. Brennan. "Nonurgent Emergency Department Visits." Medical Care 36, no. 8 (August 1998): 1249–55. http://dx.doi.org/10.1097/00005650-199808000-00012.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Kellermann, Arthur L. "Nonurgent Emergency Department Visits." JAMA 271, no. 24 (June 22, 1994): 1953. http://dx.doi.org/10.1001/jama.1994.03510480077038.

Full text

APA, Harvard, Vancouver, ISO, and other styles

6

Shao, Qiujun, Karen L. Rascati, Kenneth A. Lawson, and James P. Wilson. "Patterns and predictors of opioid use among migraine patients at emergency departments: A retrospective database analysis." Cephalalgia 40, no. 13 (August 11, 2020): 1489–501. http://dx.doi.org/10.1177/0333102420946710.

Full text

Abstract:

Objectives To compare medication use and health resource utilization between migraineurs with evidence of opioid use at emergency department visit versus no opioid use at emergency department visit, and to examine predictors of opioid use among migraineurs at emergency department visits. Methods This was a retrospective study using REACHnet electronic health records (December 2013 to April 2017) from Baylor Scott & White Health Plan. The index date was defined as the first migraine-related emergency department visit after ≥6 months of enrollment. Adult patients with a migraine diagnosis and ≥6 months of continuous enrollment before and after their index dates were included. Descriptive statistics and bivariate analyses were used to compare medication use and health resource utilization between opioid users and non-opioid users. Multivariable logistic regression was used to examine predictors of opioid use at emergency department visits. Results A total of 788 migraineurs met eligibility criteria. Over one-third (n = 283, 35.9%) received ≥1 opioid medication during their index date emergency department visit. Morphine (n = 103, 13.1%) and hydromorphone (n = 85, 10.8%) were the most frequently used opioids. Opioid users had more hospitalizations and emergency department visits during their pre-index period (both p < 0.05). Significant ( p < 0.05) predictors of opioid use at emergency department visits included past migraine-related opioid use (2–4 prescriptions, Odds Ratio = 1.66; 5–9 prescriptions, Odds Ratio = 2.12; ≥10 prescriptions, Odds Ratio = 4.43), past non-migraine-related opioid use (≥10 prescriptions, Odds Ratio = 1.93), past emergency department visits (1–3 visits, Odds Ratio = 1.84), age (45–64 years, Odds Ratio = 1.45), and sleep disorder (Odds Ratio = 1.43), controlling for covariates. Conclusion Opioids were commonly given to migraineurs at emergency departments. Previous opioid use, health resource utilization, age, and specific comorbidities might be used to identify migraineurs with a high risk of opioid use.

APA, Harvard, Vancouver, ISO, and other styles

7

Simon, Alan E., and Kenneth C. Schoendorf. "Emergency Department Visits for Mental Health Conditions Among US Children, 2001-2011." Clinical Pediatrics 53, no. 14 (July 7, 2014): 1359–66. http://dx.doi.org/10.1177/0009922814541806.

Full text

Abstract:

We examined mental health–related visits to emergency departments (EDs) among children from 2001 to 2011. We used the National Hospital Ambulatory Medical Care Survey—Emergency Department, 2001-2011 to identify visits of children 6 to 20 years old with a reason-for-visit code or ICD-9-CM diagnosis code reflecting mental health issues. National percentages of total visits, visit counts, and population rates were calculated, overall and by race, age, and sex. Emergency department visits for mental health issues increased from 4.4% of all visits in 2001 to 7.2% in 2011. Counts increased 55 000 visits per year and rates increased from 13.6 visits/1000 population in 2001 to 25.3 visits/1000 in 2011 ( P < .01 for all trends). Black children (all ages) had higher visit rates than white children and 13- to 20-year-olds had higher visit rates than children 6 to 12 years old ( P < .01 for all comparisons). Differences between groups did not decline over time.

APA, Harvard, Vancouver, ISO, and other styles

8

Mariani, Peter J. "Auditing emergency department return visits." Annals of Emergency Medicine 19, no. 8 (August 1990): 952. http://dx.doi.org/10.1016/s0196-0644(05)81593-8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

While, Alison. "Emergency department visits and hospitalisation." British Journal of Community Nursing 24, no. 7 (July 2, 2019): 354. http://dx.doi.org/10.12968/bjcn.2019.24.7.354.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Hunt, Summer. "Alcohol-Related Emergency Department Visits." Nursing for Women's Health 22, no. 2 (April 2018): 113. http://dx.doi.org/10.1016/s1751-4851(18)30090-4.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Popa, Valentin. "Emergency Department Visits in Asthma." Chest 120, no. 4 (October 2001): 1058–61. http://dx.doi.org/10.1378/chest.120.4.1058.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Ostrow, Olivia, Alena Zelinka, Andrea Shim, Syed Khurram Azmat, Sameer Masood, and Lucas B. Chartier. "Pediatric Emergency Department Return Visits." Pediatric Emergency Care 36, no. 12 (December 2020): e726-e731. http://dx.doi.org/10.1097/pec.0000000000001999.

Full text

APA, Harvard, Vancouver, ISO, and other styles

13

Platts-Mills, T. F., and P. D. Sloane. "Emergency department visits and infections." Canadian Medical Association Journal 184, no. 6 (April 2, 2012): 678. http://dx.doi.org/10.1503/cmaj.112-2034.

Full text

APA, Harvard, Vancouver, ISO, and other styles

14

Quach, C., A. McGeer, and A. Simor. "Emergency department visits and infections." Canadian Medical Association Journal 184, no. 6 (April 2, 2012): 678–79. http://dx.doi.org/10.1503/cmaj.112-2035.

Full text

APA, Harvard, Vancouver, ISO, and other styles

15

Seguin, Jade, Esli Osmanlliu, Xun Zhang, Virginie Clavel, Harley Eisman, Robert Rodrigues, and Maryam Oskoui. "Frequent users of the pediatric emergency department." CJEM 20, no. 3 (April 6, 2017): 401–8. http://dx.doi.org/10.1017/cem.2017.15.

Full text

Abstract:

AbstractObjectivesEmergency department (ED) crowding is associated with increased morbidity and mortality. Its etiology is multifactorial, and frequent ED use (defined as more or equal to five visits per year) is a major contributor to high patient volumes. Our primary objective is to characterize the frequent user population. Our secondary objective is to examine risk factors for frequent emergency use.MethodsWe conducted a retrospective cohort study of pediatric emergency department (PED) visits at the Montreal Children’s Hospital using the Système Informatique Urgence (SIURGE), electronic medical record database. We analysed the relation between patient’s characteristics and the number of PED visits over a 1-year period following the index visit.ResultsPatients totalling 52,088 accounted for 94,155 visits. Of those, 2,474 (4.7%) patients had five and more recurrent visits and accounted for 16.6% (15,612 visits) of the total PED visits. Lower level of acuity at index visit (odds ratio [OR] 0.85) was associated with a lower number of recurrent visits. Lower socioeconomic status (social deprivation index OR 1.09, material deprivation index OR 1.08) was associated with a higher number of recurrent visits. Asthma (OR 1.57); infectious ear, nose, and sinus disorders (OR 1.33); and other respiratory disorders (OR 1.56) were independently associated with a higher incidence of a recurrent visit within the year following the first visit.ConclusionOur study is the first Canadian study to assess risk factors of frequent pediatric emergency use. The identified risk factors and diagnoses highlight the need for future evidence-based, targeted innovative research evaluating strategies to minimize ED crowding, to improve health outcomes and to improve patient satisfaction.

APA, Harvard, Vancouver, ISO, and other styles

16

Trivedi, Tarak. "Medicaid and Moral Hazard: Covering Emergency Department Visits Increases Emergency Department Visits…or Not?" Annals of Emergency Medicine 70, no. 5 (November 2017): 744–45. http://dx.doi.org/10.1016/j.annemergmed.2017.09.020.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Trivedi, Tarak. "Medicaid and Moral Hazard: Covering Emergency Department Visits Increases Emergency Department Visits…or Not?" Annals of Emergency Medicine 71, no. 4 (April 2018): 534–38. http://dx.doi.org/10.1016/j.annemergmed.2017.12.018.

Full text

APA, Harvard, Vancouver, ISO, and other styles

18

Werner, Brian C., Francis P. Bustos, Richard P. Gean, and Matthew J. Deasey. "Emergency Department Visits in the Year Prior to Total Shoulder Arthroplasty as a Risk Factor for Postoperative Emergency Department Visits." HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery 17, no. 2 (March 4, 2021): 200–206. http://dx.doi.org/10.1177/1556331621995775.

Full text

Abstract:

Background: Recent research has found a high rate of emergency department (ED) use after lower extremity arthroplasty; one study found a risk factor for ED presentation after lower extremity arthroplasty was presentation to the ED in the year prior to surgery. It is not known whether a similar association exists for total shoulder arthroplasty (TSA). Questions/Purposes: The goal of this study was to investigate the relationship between preoperative ED visits and postoperative ED visits after anatomic TSA. Methods: The 100% Medicare database was queried for patients who underwent anatomic TSA from 2005 to 2014. Emergency department visits within the year prior to the date of TSA were identified. Patients were additionally stratified by the number and timing of preoperative ED visits. The primary outcome measure was one or more postoperative ED visits within 90 days. A multivariate logistic regression analysis was used to control for patient demographics and comorbidities. Results: Of the 144,338 patients identified, 32,948 (22.8%) had an ED visit in the year prior to surgery. Patients with at least 1 ED visit in the year before surgery presented to the ED at a significantly higher rate than patients without preoperative ED visits (16% versus 6%). An ED visit in the year prior to TSA was the most significant risk factor for postoperative ED visits (in the multivariate analysis). The number of preoperative ED visits in the year prior to surgery demonstrated a significant dose-response relationship with increasing risk of postoperative ED visits. Conclusions: Postoperative ED visits occurred in nearly 10% of Medicare patients who underwent TSA in the period studied. More frequent presentation to the ED in the year prior to anatomic TSA was associated with increasing risk of postoperative ED visits. Future studies are needed to investigate the reasons for preoperative ED visits and if any modifiable risk factors are present to improve the ability to risk stratify and optimize patients for elective TSA.

APA, Harvard, Vancouver, ISO, and other styles

19

Alderman, Elizabeth M., Jeffrey Avner, and Andrew Racine. "Adolescents’ Use of the Emergency Department." Journal of Primary Care & Community Health 3, no. 1 (July 7, 2011): 36–41. http://dx.doi.org/10.1177/2150131911413595.

Full text

Abstract:

Background: Many of the 18 million emergency department visits by adolescents annually in the United States are for nonurgent problems that might be addressed in a primary care setting. Methods: As part of a larger randomized controlled intervention, 1023 adolescents aged 12 to 21 years registering in an urban pediatric emergency department (PED) were tracked over the subsequent 365 days to record all visits to the PED. Adolescents identifying an adolescent medicine service (AMS) as the primary care source were compared with adolescents receiving primary care elsewhere in an integrated urban medical system (non-AMS) to determine how often after the index PED visit they revisited the PED, returned to primary care (PC), visited a subspecialist (SS), or were hospitalized. Mean values and odds ratios of each type of visit were compared between AMS and non-AMS patients using multivariate logistic and ordinary least squares regressions to control for covariates. Results: AMS patients (n = 124, 12%), compared to non-AMS patients (n = 899, 88%), were more likely female (75% vs 48%, P < .001) and used public insurance (52% vs 40%, P = .017). In unadjusted comparisons, AMS and non-AMS patients did not differ in the probability of any return PED visit (46% vs 37%, P = .052) in the 365 days following the index PED visit but differed in the mean number of return PED visits (1.35 vs 0.93, P = .026). AMS patients were more likely to be hospitalized (15% vs 7%, P = .006) after the index PED visit and also had a greater mean number of hospitalizations (0.41 vs 0.19, P = .048). Multivariate analyses controlling for demographic variables, triage level of initial PED visit, and hospitalizations showed AMS patients returned to primary care after an index PED visit 24.6 days earlier than non-AMS patients ( P = .026). Conclusions: This study demonstrates attending an AMS for primary care predicted earlier return to the primary care provider after an index PED visit. Elements of adolescent specialty care producing such outcomes are worthy of further study.

APA, Harvard, Vancouver, ISO, and other styles

20

Hong, Arthur S., Thomas Froehlich, Stephanie Clayton Hobbs, Simon J. Craddock Lee, and Ethan A. Halm. "Impact of a Cancer Urgent Care Clinic on Regional Emergency Department Visits." Journal of Oncology Practice 15, no. 6 (June 2019): e501-e509. http://dx.doi.org/10.1200/jop.18.00743.

Full text

Abstract:

PURPOSE: Did the creation of an urgent care clinic specifically for patients with cancer affect emergency department visits among adults newly diagnosed with cancer? PATIENTS AND METHODS: We applied an interrupted time series analysis to adjusted monthly emergency department visits made by adults age 18 years or older who were diagnosed with cancer between 2009 and 2016 at a comprehensive cancer center. Cancer registry patients were linked to a longitudinal regional database of emergency department and hospital visits. Because the urgent care clinic was closed on weekends, we took advantage of the natural experiment by comparing weekend visits as a control group. Our primary outcome was emergency department visits within 180 days after a cancer diagnosis, compiled as adjusted monthly rates of emergency department visits per 1,000 patient-months. We analyzed subsequent hospitalizations as a secondary outcome. RESULTS: The rate of weekday emergency department visits was increasing at a rate of 0.43 visits (95% CI, 0.29 to 0.57 visits) per month before May 2012, then fell in half to a rate of 0.19 visits (95% CI, 0.11 to 0.28 visits) per month ( P = .007) after the urgent care clinic was established. In contrast, the weekend visit rate was growing at a rate of 0.08 visits (95% CI, −0.03 to 0.19 visits) per month before May 2012 and 0.05 (95% CI, −0.02 to 0.13 visits; P = .533) afterward. By the end of 2016, there were 15.3 fewer monthly weekday emergency department visits than expected ( P = .005). Trends in weekday hospitalizations were not significantly changed. CONCLUSION: Although only one in eight emergency department–visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.

APA, Harvard, Vancouver, ISO, and other styles

21

Hills, Jeffrey M., Inamullah Khan, Ahilan Sivaganesan, Benjamin Weisenthal, Joshua Daryoush, Marjorie Butler, Mohamad Bydon, Kristin R. Archer, Anthony Asher, and Clinton J. Devin. "Emergency Department Visits After Elective Spine Surgery." Neurosurgery 85, no. 2 (September 28, 2018): E258—E265. http://dx.doi.org/10.1093/neuros/nyy445.

Full text

Abstract:

Abstract BACKGROUND Emergency department (ED) overuse is a costly and often neglected source of postdischarge resource utilization after spine surgery. Failing to investigate drivers of ED visits represents a missed opportunity to improve the value of care in spine patients. OBJECTIVE To identify the prevalence, drivers, and timing of ED visits following elective spine surgery. METHODS Patients undergoing elective spine surgery for degenerative disease at a major medical center were enrolled in a prospective longitudinal registry. Patient and surgery characteristics, and patient-reported outcomes were recorded at baseline and 3 mo after surgery, along with self-reported 90-d ED visits. A multivariable regression model was used to identify independent factors associated with 90-d ED visits. For a sample of patients presenting to our institution's ED, charts were reviewed to identify the reason and time to ED postdischarge. RESULTS Of 2762 patients, we found a 90-d ED visit rate of 9.4%. One-third of patients presented to our institution's ED and of these, 70% presented due to pain or medical concerns at 9 and 7 d postdischarge, respectively, with 60% presenting outside normal clinic hours. Independent risk factors for 90-d ED visits included younger age, preoperative opioid use, chronic obstructive pulmonary disorder, and more vertebral levels involved. CONCLUSION Nearly 10% of elective spine patients had 90-d ED visits not requiring readmission. Pain and medical concerns accounted for 70% of visits at our center, occurring within 10 d of discharge. This study provides the clinical details and a timeline necessary to guide individualized interventions to prevent unnecessary, costly ED visits after spine surgery.

APA, Harvard, Vancouver, ISO, and other styles

22

Larkin, Gregory Luke, Rebecca P. Smith, and Annette L. Beautrais. "Trends in US Emergency Department Visits for Suicide Attempts, 1992–2001." Crisis 29, no. 2 (March 2008): 73–80. http://dx.doi.org/10.1027/0227-5910.29.2.73.

Full text

Abstract:

This article describes trends in suicide attempt visits to emergency departments in the United States (US). Data were obtained from the National Hospital Ambulatory Medical Care Survey using mental-health-related ICD-9-CM, E and V codes, and mental-health reasons for visit. From 1992 to 2001, mental-health-related visits increased 27.5% from 17.1 to 23.6 per 1000 (p < .001). Emergency Department (ED) visits for suicide attempt and self injury increased by 47%, from 0.8 to 1.5 visits per 1000 US population (ptrend = .04). Suicide-attempt-related visits increased significantly among males over the decade and among females from 1992/1993 to 1998/1999. Suicide attempt visits increased in non-Hispanic whites, patients under 15 years or those between 50–69 years of age, and the privately insured. Hospitalization rates for suicide attempt-related ED visits declined from 49% to 32% between 1992 and 2001 (p = .04). Suicide attempt-related visits increased significantly in urban areas, but in rural areas suicide attempt visits stayed relatively constant, despite significant rural decreases in mental-health related visits overall. Ten-year regional increases in suicide attempt-related visits were significant for the West and Northeast only. US emergency departments have witnessed increasing rates of ED visits for suicide attempts during a decade of significant reciprocal decreases in postattempt hospitalization. Emergency departments are increasingly important sites for identifying, assessing and treating individuals with suicidal behavior.

APA, Harvard, Vancouver, ISO, and other styles

23

Dalrymple, Lorien S., and Patrick S. Romano. "Emergency Department Visits after Kidney Transplantation." Clinical Journal of the American Society of Nephrology 11, no. 4 (March 24, 2016): 555–57. http://dx.doi.org/10.2215/cjn.02040216.

Full text

APA, Harvard, Vancouver, ISO, and other styles

24

Schold, Jesse D., Nissreen Elfadawy, Laura D. Buccini, David A. Goldfarb, Stuart M. Flechner, Michael P. Phelan, and Emilio D. Poggio. "Emergency Department Visits after Kidney Transplantation." Clinical Journal of the American Society of Nephrology 11, no. 4 (March 24, 2016): 674–83. http://dx.doi.org/10.2215/cjn.07950715.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Mitchell, Toni A. "Nonurgent emergency department visits—Whose definition?" Annals of Emergency Medicine 24, no. 5 (November 1994): 961–63. http://dx.doi.org/10.1016/s0196-0644(94)70228-4.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Brousseau, E. Christine, Valery Danilack, Fei Cai, and Kristen Matteson. "Emergency department visits for postpartum hypertension." Hypertension in Pregnancy 36, no. 2 (April 3, 2017): 212–16. http://dx.doi.org/10.1080/10641955.2017.1299171.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Brousseau, Erin Christine, Valery Danilack, Fei Cai, and Kristen A. Matteson. "Emergency Department Visits for Postpartum Complications." Journal of Women's Health 27, no. 3 (March 2018): 253–57. http://dx.doi.org/10.1089/jwh.2016.6309.

Full text

APA, Harvard, Vancouver, ISO, and other styles

28

Ali, Alliyia B., Rick Place, John Howell, and Sienna M. Malubay. "Early Pediatric Emergency Department Return Visits." Clinical Pediatrics 51, no. 7 (April 11, 2012): 651–58. http://dx.doi.org/10.1177/0009922812440840.

Full text

APA, Harvard, Vancouver, ISO, and other styles

29

Swavely, Deborah, Kathy Baker, Krista Bilger, David F. Zimmerman, and Andrew Martin. "Understanding Nonurgent Pediatric Emergency Department Visits." Journal of Nursing Care Quality 30, no. 4 (2015): 366–72. http://dx.doi.org/10.1097/ncq.0000000000000126.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

Agarwal, Parul, Thomas K. Bias, Suresh Madhavan, Nethra Sambamoorthi, Stephanie Frisbee, and Usha Sambamoorthi. "Factors Associated With Emergency Department Visits." Health Services Research and Managerial Epidemiology 3 (April 27, 2016): 233339281664854. http://dx.doi.org/10.1177/2333392816648549.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Jim??nez, S., O. Mir??, F. J. Tovilias-Moran, C. Alsina, M. S??nchez, A. Borr??s, and J. Mill?? "Return visits to the emergency department." European Journal of Emergency Medicine 5, no. 1 (March 1998): 118. http://dx.doi.org/10.1097/00063110-199803000-00067.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Ross, Joseph S. "Triage, Copayments, and Emergency Department Visits." JAMA Internal Medicine 176, no. 6 (June 1, 2016): 854. http://dx.doi.org/10.1001/jamainternmed.2016.0882.

Full text

APA, Harvard, Vancouver, ISO, and other styles

33

Pant, Chaitanya, Mojtaba Olyaee, Richard Gilroy, Prashant K. Pandya, Jody C. Olson, Melissa Oropeza-Vail, Tarun Rai, and Abhishek Deshpande. "Emergency Department Visits Related to Cirrhosis." Medicine 94, no. 1 (January 2015): e308. http://dx.doi.org/10.1097/md.0000000000000308.

Full text

APA, Harvard, Vancouver, ISO, and other styles

34

Michelen, Walid, Jacqueline Martinez, Anita Lee, and Darrell P. Wheeler. "Reducing Frequent Flyer Emergency Department Visits." Journal of Health Care for the Poor and Underserved 17, no. 1 (2006): 59–69. http://dx.doi.org/10.1353/hpu.2006.0010.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Michelen, Walid, Jacqueline Martinez, Anita Lee, and Darrell P. Wheeler. "Reducing Frequent Flyer Emergency Department Visits." Journal of Health Care for the Poor and Underserved 17, no. 1S (2006): 59–69. http://dx.doi.org/10.1353/hpu.2006.0048.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

&NA;. "ANALYSIS OF PEDIATRIC EMERGENCY DEPARTMENT VISITS." Pediatric Emergency Care 16, no. 1 (February 2000): 66. http://dx.doi.org/10.1097/00006565-200002000-00025.

Full text

APA, Harvard, Vancouver, ISO, and other styles

37

Lerman, Benjamin, and Michael S. Kobernick. "Return visits to the emergency department." Journal of Emergency Medicine 5, no. 5 (September 1987): 359–62. http://dx.doi.org/10.1016/0736-4679(87)90138-7.

Full text

APA, Harvard, Vancouver, ISO, and other styles

38

Kim, So Lim, Angela Everett, Susan J. Rehm, Steven Gordon, and Nabin Shrestha. "Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy: A Cohort Study." Open Forum Infectious Diseases 4, suppl_1 (2017): S333—S334. http://dx.doi.org/10.1093/ofid/ofx163.791.

Full text

Abstract:

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) carries risk of vascular access complications, antimicrobial adverse effects, and worsening of infection. Both OPAT-related and unrelated events may lead to emergency department (ED) visits. The purpose of this study was to describe adverse events that result in ED visits and risk factors associated with ED visits during OPAT. Methods OPAT courses between January 1, 2013 and December 31, 2016 at Cleveland Clinic were identified from the institution’s OPAT registry. ED visits within 30 days of OPAT initiation were reviewed. Reasons and potential risk factors for ED visits were sought in the medical record. Results Among 11,440 OPAT courses during the study period, 603 (5%) were associated with 1 or more ED visits within 30 days of OPAT initiation. Mean patient age was 58 years and 57% were males. 379 ED visits (49%) were OPAT-related; the most common visit reason was vascular access complication, which occurred in 211 (56%) of OPAT-related ED visits. The most common vascular access complications were occlusion and dislodgement, which occurred in 99 and 34 patients (47% and 16% of vascular access complications, respectively). In a multivariable logistic regression model, at least one prior ED visit in the preceding year (prior ED visit) was most strongly associated with one or more ED visits during an OPAT course (OR 2.96, 95% CI 2.38 – 3.71, p-value < 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P < 0.001), and having a PICC (p 0.05). 549 ED visits (71%) resulted in discharge from the ED within 24 hours, 18 (2%) left against medical advice, 46 (6%) were observed up to 24 hours, and 150 ED visits (20%) led to hospital admission. Prior ED visit was not associated with hospital admission among patients who visited the ED during OPAT. Conclusion OPAT-related ED visits are most often due to vascular access complications, especially line occlusions. Patients with a prior ED visit in the preceding year have a 3-fold higher odds of at least one ED visit during OPAT compared with patients without a prior ED visit. A strategy of managing occlusions at home and a focus on patients with prior ED visits could potentially prevent a substantial proportion of OPAT-related ED visits. Disclosures All authors: No reported disclosures.

APA, Harvard, Vancouver, ISO, and other styles

39

Latham, Lesley P., and Stacy Ackroyd-Stolarz. "Defining potentially preventable emergency department visits for older adults." International Journal of Healthcare 3, no. 2 (June 5, 2017): 1. http://dx.doi.org/10.5430/ijh.v3n2p1.

Full text

Abstract:

Objective: As older adults become increasingly reliant on emergency departments (EDs) for care, there is an interest in determining what types of ED visits by this population may be preventable, or amenable to other forms of care. The aim of this project was to explore the concept of preventable ED visits by older adults.Methods: We conducted a literature search to identify definitions of “preventable” or “avoidable” ED visits. We then applied a definition of preventable ED visits to an administrative data set consisting of ED visit data extracted from four sites in Halifax, Nova Scotia, Canada. Visits for patients 65 years of age or older were eligible for inclusion. Visits were categorized using triage level and discharge diagnosis.Results: Four methods of defining preventable ED visits were identified in our literature search: 1) Ambulatory Care Sensitive Conditions (ACSCs) (N = 7), 2) Low Acuity/low intensity visits (N = 5), 3) New York University (NYU) (Billings) Algorithm (N = 3) and 4) hospital admission vs. non-admission (N = 1). We categorized 34,454 ED visits from our dataset using a modified definition of preventable ED visits that included ACSCs (15.3%) as well as low acuity visits that required no testing or hospital admission (9.9%).Conclusions: Our results suggest that approximately 25% of ED visits by older adults may be preventable or amenable to other forms of care. This data may be useful in the planning of care delivery appropriate for the needs of this population.

APA, Harvard, Vancouver, ISO, and other styles

40

Nene, Rahul, Jesse Brennan, Edward Castillo, Peter Tran, Renee Hsia, and Christopher Coyne. "Cancer-related Emergency Department Visits: Comparing Characteristics and Outcomes." Western Journal of Emergency Medicine 22, no. 5 (August 21, 2021): 1117–23. http://dx.doi.org/10.5811/westjem.2021.5.51118.

Full text

Abstract:

Introduction: There is increasing appreciation of the challenges of providing safe and appropriate care to cancer patients in the emergency department (ED). Our goal here was to assess which patient characteristics are associated with more frequent ED revisits. Methods: This was a retrospective cohort study of all ED visits in California during the 2016 calendar year using data from the California Office of Statewide Health Planning and Development. We defined revisits as a return visit to an ED within seven days of the index visit. For both index and return visits, we assessed various patient characteristics, including age, cancer type, medical comorbidities, and ED disposition. Results: Among 12.9 million ED visits, we identified 73,465 adult cancer patients comprising 103,523 visits that met our inclusion criteria. Cancer patients had a 7-day revisit rate of 17.9% vs 13.2% for non-cancer patients. Cancer patients had a higher rate of admission upon 7-day revisit (36.7% vs 15.6%). Patients with cancers of the small intestine, stomach, and pancreas had the highest rate of 7-day revisits (22-24%). Cancer patients younger than 65 had a higher 7-day revisit rate than the elderly (20.0% vs 16.2%). Conclusion: In a review of all cancer-related ED visits in the state of California, we found a variety of characteristics associated with a higher rate of 7-day ED revisits. Our goal in this study was to inform future research to identify interventions on the index visit that may improve patient outcomes.

APA, Harvard, Vancouver, ISO, and other styles

41

Abdel-Rahman, Omar. "Gender, socioeconomic status and emergency department visits among cancer survivors in the USA: a population-based study." Journal of Comparative Effectiveness Research 10, no. 12 (August 2021): 969–77. http://dx.doi.org/10.2217/cer-2020-0278.

Full text

Abstract:

Aim: To assess patterns of emergency department visits and subsequent hospitalization in relation to gender and socioeconomic status among a cohort of cancer survivors in the USA. Materials & methods: National Health Interview Survey datasets (2011–2017) were reviewed and participants with a history of cancer and complete information about emergency department visits in the past 12 months were included. Multivariable logistic regression analyses were used to assess factors associated with emergency department visits and subsequent hospitalization after the most recent emergency department visit. Results: A total of 22,240 cancer survivors were included in the current analysis; of which 16,133 participants (72.5%) who have not visited an emergency department in the past 12 months and 6107 participants (27.5%) who have visited an emergency department in the past 12 months. Multivariable logistic regression analysis suggested the following factors are associated with emergency department visits; younger age (odds ratio [OR] with increasing age: 0.98; 95% CI: 0.98–0.99), female gender (OR: 1.07; 95% CI: 1.00–1.15), African American race (OR: 1.26; 95% CI: 1.13–1.40), unmarried status (OR for married vs unmarried: 0.79; 95% CI: 0.74–0.84), lower yearly earnings (OR: 1.36; 95% CI: 1.20–1.54), poor health status (OR: 7.02; 95% CI: 6.02–8.18) and incomplete health insurance coverage (OR for complete coverage vs incomplete coverage: 0.66; 95% CI: 0.54–0.80). On the other hand, the following factors were associated with subsequent hospitalization: older age (OR: 1.004; 95% CI: 1.000–1.008), male gender (OR for female vs male: 0.86; 95% CI: 0.78–0.94), unmarried status (OR for married vs unmarried status: 0.80; 95% CI: 0.73–0.88), not working (OR: 1.44; 95% CI: 1.23–1.68), lower yearly earnings (OR: 1.31; 95% CI: 1.07–1.60), poor health status (OR: 8.43; 95% CI: 6.76–10.51) and lack of health insurance coverage (OR for complete coverage vs incomplete coverage: 0.71; 95% CI: 0.55–0.93). Conclusion: Female cancer survivors were more likely to visit the emergency department, whereas they were less likely to be subsequently hospitalized. Cancer survivors with lower socioeconomic status were more likely to visit emergency departments and to be subsequently hospitalized.

APA, Harvard, Vancouver, ISO, and other styles

42

Abboud, Hesham, Karin Mente, Meagan Seay, Jeffrey Kim, Ashhar Ali, Robert Bermel, and Mary A. Willis. "Triaging Patients with Multiple Sclerosis in the Emergency Department." International Journal of MS Care 19, no. 6 (November 1, 2017): 290–96. http://dx.doi.org/10.7224/1537-2073.2016-069.

Full text

Abstract:

Background: Patients with multiple sclerosis (MS) present to the emergency department (ED) for various reasons. Although true relapse is rarely the underlying culprit, ED visits commonly result in new magnetic resonance imaging (MRI) and neurology admissions. We studied ED visits in patients with MS and evaluated decision making regarding diagnostic/therapeutic interventions and visit outcomes. We identified potential areas for improvement and used the data to propose a triaging algorithm for patients with MS in the ED. Methods: We reviewed the medical records from 176 ED visits for patients with MS in 2014. Results: Ninety-seven visits in 75 patients were MS related (66.6% female; mean ± SD age, 52.6 ± 13.8 years; mean ± SD disease duration, 18.5 ± 10.5 years). Thirty-three visits were for new neurologic symptoms (category 1), 29 for worsening preexisting symptoms (category 2), and 35 for MS-related complications (category 3). Eighty-nine visits (91.8%) resulted in hospital admission (42.7% to neurology). Only 39% of ordered MRIs showed radiographic activity. New relapses were determined in 27.8% of the visits and were more prevalent in category 1 compared with category 2 (P = .003); however, the two categories had similar rates of ordered MRIs and neurology admissions. Conclusions: New relapse is a rare cause of ED visits in MS. Unnecessary MRIs and neurology admissions can be avoided by developing a triaging system for patients with MS based on symptom stratification.

APA, Harvard, Vancouver, ISO, and other styles

43

Chen, Daniel, Alex M. Torstrick, Robert Crupi, Joseph E. Schwartz, Ira Frankel, and Elizabeth Brondolo. "Reducing emergency department visits among older adults." Journal of Integrated Care 27, no. 1 (February 11, 2019): 37–49. http://dx.doi.org/10.1108/jica-02-2018-0011.

Full text

Abstract:

Purpose There is mixed evidence regarding the efficacy of low-intensity integrated care interventions in reducing the use of emergency services and costs of care. The purpose of this paper is to examine the effects of a low-intensity intervention formulated for older adults and delivered in an urban medical center serving low-income individuals. Design/methodology/approach The intervention included an initial evaluation of stress, psychiatric symptomatology and health habits; potential referrals for lifestyle management and psychiatric treatment; and training for physicians about the impact of lifestyle change in older adults. Participants included older adults (at or above 50 years of age) seen as outpatients in an urban medical center serving a low-income community (n=945). Participants were entered into the intervention at any point during this two-year period. Mixed models analyses examined all visits for all enrolled individuals over a two-year period, comparing visits before the individual received the initial intervention evaluation to those received after this evaluation. Outcomes included total health care costs incurred, average cost per visit, and emergency department (ED) usage within the facility. Findings The intervention was associated with reduced likelihood of emergency department use and reduced costs per visit following the intervention. These effects were seen across all participants. Research limitations/implications Limitations of the study include the lack of control group. Practical implications This program is easy to disseminate and could improve the quality of care and costs. Originality/value This study is among the few available to document a decrease in medical costs, as well as decreased ED utilization following a low-intensity integrated care intervention.

APA, Harvard, Vancouver, ISO, and other styles

44

Tough, SC, PA Hessel, FHY Green, I. Mitchell, S. Rose, H. Aronson, and JC Butt. "Factors that Influence Emergency Department Visits for Asthma." Canadian Respiratory Journal 6, no. 5 (1999): 429–35. http://dx.doi.org/10.1155/1999/743628.

Full text

Abstract:

BACKGROUND: Asthma can usually be controlled through allergen avoidance and/or appropriate medication. An emergency department visit for an acute exacerbation of asthma often represents a breakdown in asthma management. Emergency department treatment results in significant health care expenditures and reflects a compromised quality of life.OBJECTIVES: To identify risk factors associated with an emergency department visit for asthma.METHODS: This case-control study compared 299 people (76% of 390 cases contacted) who attended one of two emergency departments in Alberta in 1992 and 1993 for an acute exacerbation of asthma (cases) with 212 unmatched community controls with asthma who were located by random digit dialing. Cases and controls were asked to complete a mailed questionnaire to obtain data regarding severity, visits to doctors and emergency departments, medication use, allergies and other triggers, and smoking history. Data analysis included bivariate analysis of risk factors and multivariate model development using logistic regression.RESULTS: The response rate was similar between cases and controls. Cases were younger than controls (odds ratio [OR] 2.16, 95% CI 1.34 to 3.48) and more often reported their asthma to be severe (OR 4.25, 95% CI 2.24 to 8.06), and had experienced nocturnal symptoms (stratified OR range 1.36 to 6.82). Cases used more health care services in the previous year, had been admitted to hospital at some time for asthma (OR 1.62, 95% CI 1.10 to 2.38) and used more medication than controls.CONCLUSIONS: Physicians and other health care workers should be sensitive to the risk factors and target interventions to high risk individuals.

APA, Harvard, Vancouver, ISO, and other styles

45

Sutradhar, Rinku, Lisa Barbera, and Hsien-Yeang Seow. "Palliative homecare is associated with reduced high- and low-acuity emergency department visits at the end of life: A population-based cohort study of cancer decedents." Palliative Medicine 31, no. 5 (August 9, 2016): 448–55. http://dx.doi.org/10.1177/0269216316663508.

Full text

Abstract:

Background: Prior work shows that palliative homecare services reduce the subsequent need for hospitalizations and emergency services; however, no study has investigated whether this association is present for emergency department visits of high acuity or whether it only applies to low-acuity emergency department visits. Aim: To examine the association between palliative versus standard homecare nursing and the rate of high-acuity and low-acuity emergency department visits among cancer decedents during their last 6 months of life. Design: This is a retrospective cohort study of end-of-life homecare patients in Ontario, Canada, who had confirmed cancer cause of death from 2004 to 2009. A multivariable Poisson regression analysis was implemented to examine the association between the receipt of palliative homecare nursing (vs standard homecare nursing) and the rate of high- and low-acuity emergency department visits, separately. Results: There were 54,743 decedents who received homecare nursing in the last 6 months of life. The receipt of palliative homecare nursing decreased the rate of low-acuity emergency department visits (relative rate = 0.53, 95% confidence interval = 0.50–0.56) and was significantly associated with a larger decrease in the rate of high-acuity emergency department visits (relative rate = 0.37, 95% confidence interval = 0.35–0.38). Conclusion: Receiving homecare nursing with palliative intent may decrease the need for dying cancer patients to visit the emergency department, for both high and low-acuity visits, compared to receiving general homecare nursing. Policy implications include building support for additional training in palliative care to generalist homecare nurses and increasing access to palliative homecare nursing.

APA, Harvard, Vancouver, ISO, and other styles

46

Geurts, Jill, Wes Palatnick, Trevor Strome, and Erin Weldon. "Frequent users of an inner-city emergency department." CJEM 14, no. 05 (September 2012): 306–13. http://dx.doi.org/10.2310/8000.2012.120670.

Full text

Abstract:

ABSTRACTBackground:Within the emergency department (ED) patient population there is a subset of patients who make frequent visits. This chart review sought to characterize this population and identify strategies to reduce frequent ED visits.Methods:Frequent use at an urban tertiary care centre was defined as 15 or more visits over 1 year. The details of each visit—demographics, entrance complaint, discharge diagnosis, arrival method, Canadian Triage and Acuity Scale (CTAS) score, and length of stay—were analyzed and compared to data from the entire ED population for the same period.Results:Ninety-two patients generated 2,390 ED visits (of 25,523 patients and 44,204 visits). This population was predominantly male (66%) and middle-aged (median 42 years), with no fixed address (27.2%). Patients arrived by ambulance in 59.3% of visits with less acute CTAS scores than the general population. Substance use accounted for 26.9% of entrance complaints. Increased lengths of stay were associated with female gender and abnormal vital signs, whereas shorter stays were associated with no fixed address and substance use (p< 0.05). Admissions were lower than the general population, and women were twice as likely as men to be admitted (p< 0.05). Patients left without being seen in 15.8% of visits.Conclusions:High-frequency ED users are more likely to be male, younger, and marginally housed and to present secondary to substance use. Although admissions among this population are low, the costs associated with these presentations are high. Interventions designed to decrease visits and improve the health of this population appear warranted.

APA, Harvard, Vancouver, ISO, and other styles

47

Becker, Justin Craig, Thomas Godfrey, Teresa Kern, Lindsey Ratliff, and Nora Anderson. "Emergency Department Visits Between Inpatient Visits: An Overlooked Quality Measure?" Journal of Student Research 5, no. 1 (April 14, 2016): 8–10. http://dx.doi.org/10.47611/jsr.v5i1.337.

Full text

Abstract:

Healthcare costs are rapidly accelerating in the United States and payers are looking for a solution to contain out-of-control expenditures. Readmissions can be easily measured thus making them an attractive metric of quality care. The Centers for Medicare and Medicaid Services (CMS) wants to minimize its financial outlay while pushing for increased quality. By this theory, if a patient remains out of the hospital, then the care delivered is considered to be high quality. Currently, emergency department (ED) visits between inpatient visits are not calculated into readmission rates. This review examined the sparse literature on this issue and proposed ideas to better examine readmissions as a quality measure overall. CMS has targeted patient readmissions to hospitals as a quality-based means of adjusting financial reimbursement. In 2013, the national patient readmission rate reduced from 19.5% to 17.5%. This review determined that (a) the overlooked ED visits could be a metric for delivery of quality care; (b) decision analysis methods should be employed to determine whether or not these ED visits are actually a cost-effective means of keeping readmissions down and quality up; and (c) numerous process-based obstacles must be overcome before any reimbursement system would be impacted by ED visits. It is critical that changes to reimbursement or quality measures be fair and meaningful for providers and quality care for patients must remain the top priority to address ED visits between inpatient visits.

APA, Harvard, Vancouver, ISO, and other styles

48

Frei-Jones, Melissa J., Amy L. Baxter, Charles T. Quinn, and George R. Buchanan. "Emergency Department Management of Children with Sickle Cell Disease." Blood 104, no. 11 (November 16, 2004): 1660. http://dx.doi.org/10.1182/blood.v104.11.1660.1660.

Full text

Abstract:

Abstract Vaso-occlusive crises (VOC) are a common cause of emergency department (ED) visits for children with sickle cell disease (SCD). To better understand our patient population and compare with reports from other centers, we sought to describe the presentation, management, and disposition of children with VOC at our center’s ED. We also aimed to identify predictors of hospital admission. We retrospectively reviewed hospital records of all patients with SCD, age 8–19 years, who presented to our urban pediatric ED in 2003 with a chief complaint of pain. We identified all subjects diagnosed with VOC and not another cause of pain. We obtained the following data for each: SCD genotype; duration of VOC and treatment prior to ED presentation; the nature of analgesia and use of intravenous fluids (IVF) in the ED; hemoglobin (Hgb) concentration; and disposition (admitted, discharged, discharged with subsequent ED visit for same crisis). Categorical variables were evaluated by the χ2 and Fisher exact tests and continuous variables by the t-test. Odds ratios (OR) and 95% confidence intervals (CI) were calculated where appropriate. In 2003, there were 320 ED visits for patients with SCD and pain. Among these, there were 279 diagnoses of VOC in 105 individual patients: 45 had one visit, 25 two visits, and 16 ≥5 visits. Mean number of visits per patient was 2.7; 23 (22%) patients accounted for 145 (55%) visits. Homozygous sickle cell anemia (Hgb SS) was present in 73/105 patients, accounting for 222 (79%) ED visits. Overall admission rate was 179/279 (64%), with 167/179 admitted on their first visit and 12 on their return visit. Subjects with Hgb SS accounted for 147/179 (82%) admissions. Among those discharged who later returned to the ED during the same VOC, the admission rate was 86% (5 returned in 24 hours, 5 in 48 hours, 3 in 72 hours, and one 4 days later). Pre-ED home opioid use was reported in 75% of visits and was associated with increased likelihood of discharge (OR 1.63, CI 0.94–2.84, p=0.082). Duration of VOC before presentation did not significantly affect admission rate and averaged 53.2 hours for admitted patients and 49.7 hours for those discharged (p=0.689). Patients who received IVF in the ED (219/279; 79%) were less likely to be admitted (31% vs 56%, p<0.001). Hgb concentration was increased in 61%, decreased in 36% and unchanged in 3% of patients from steady-state values and was not associated with admission. After receiving 2 doses of morphine, 31 patients were discharged from the ED, while only 5 patients were discharged after receiving 3 or 4 doses of morphine. A departmental VOC protocol was followed for 25.4% of patients, with no impact on admission rate (p=0.290). In this retrospective analysis of a large series of pediatric sickle cell ED visits, patients presented later in their VOC, and admission rate was higher than previously reported. A small proportion of older patients with SCD accounted for most ED visits and hospitalizations. Hgb variation from steady-state was neither clinically significant nor predictive of admission or discharge. In contrast to previous studies, receiving IVF in the ED was associated with a greater likelihood of discharge. Home opioids prior to ED presentation seemed to decrease hospital admission. Adherence to our center’s VOC protocol did not appear to influence disposition from the ED.

APA, Harvard, Vancouver, ISO, and other styles

49

Bishop, Kenneth D., Mary Anne Fenton, Tara Szymanski, and Megan Begnoche. "Reduction of emergency department utilization via access to outpatient cancer care." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 128. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.128.

Full text

Abstract:

128 Background: Emergency department (ED) utilization for non-emergent medical problems is an inefficient use of medical resources. During calendar year 2013, 224 RIH adult cancer patients presented to the RIH ED. Retrospective review indicated up to 50% of these ED visits were avoidable. Methods: This project was developed for the ASCO Quality Training Program. A multidisciplinary team was assembled to address ED utilization. Retrospective chart review of ED visits included time and reason for visit and primary tumor site. The team selected the Lung Cancer as the target group, developed a cause-and-effect analysis for ED visits, administered a patient survey, and implemented a series of Plan-Do-Study-Act (PDSA) cycles. The team implemented a patient education process of nurse sick-line symptom management and same-day sick visits at RIH CCC as well as developing a single-page patient “sick-line tool” with oncology nurse sick-line contact telephone numbers. A patient navigator introduced the sick-line tool at the first visit and its usage was reinforced at subsequent visits. Results: For RIH CCC lung cancer patients, a standardized symptom-control education process correlated with 30% decrease in ED visits for any presenting complaint (42 visits vs. 60 visits) and 32% decrease in ED visits with presenting complaint of pain (13 visits vs. 19 visits) during January/February 2014 compared to January/February 2013. We did not find significant differences between the proportion of ED visits during Cancer Center business hours, evenings, or weekends. Sick-line calls were found to increase by 53% during January 2014 compared to December 2013 with an additional 35% increase in February 2014. Conclusions: A standardized patient education process resulted in a significant decrease in ED visits, concurrent with an increase in outpatient sick-line utilization. This may reflect an improvement in efficiency of outpatient cancer patient care in a single-institution setting. Given other reports of increased ED utilization by lung cancer patients for similar presenting reasons, these improvements may be generalizable to other institutions.

APA, Harvard, Vancouver, ISO, and other styles

50

Jaroudi, Sarah, Shengping Yang, and Gilbert Berdine. "Trends in emergency department visits in Lubbock from 2011-2017." Southwest Respiratory and Critical Care Chronicles 7, no. 27 (January 18, 2019): 50–54. http://dx.doi.org/10.12746/swrccc.v7i27.513.

Full text

Abstract:

To determine trends in daily emergency department (ED) visits, a preliminary retrospective study was done to analyze the relationship of long-term trends, day of week, and month of year to ED volume at University Medical Center in Lubbock, TX. Local data were collected from January 1, 2011, through December 31, 2017. An increase in ED visits from 2011 to 2014 was followed by a decrease in ED visits from 2014 to 2017. The best fit third order polynomial was “ ” with y=number of ED visits and x=cumulative day. The busiest day of the week was Monday with an average of 235.6 visits per day. Throughout the week, ED visits decreased to a minimum value of 201.9 visits per day on Saturday. The differences between each day of the week were significant (p < 0.001). Seasonal trends were present with peaks during February and September. The differences among months were significant (p < 0.001). The total variance of the ED visit data was decreased after adjusting for the long-term trend, day of week, and month of year. These adjustments remove noises not relevant to the study goal and are necessary for further studies testing hypotheses about factors affecting ED visits that may not be uniformly distributed over time.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Emergency department visits'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles