Consultative-Cardiology
CARDIOLOGY SERVICES
We implement an ED referral triage system for outpatient cardiology promises among patients with cardiovascular head complaints that are considered safe to leave the emergency room but require follow -up of outpatient. There are 303 and 267 unique patients in the implementation of Pre -Triage and Cohort Post -Triage Implementation, each. We collect retrospective billing data to assess ED return visits, inpatients, cardioological outpatient visits, and cardiovascular testing. Pra -Triage Implementation Cohort including patients with ED visits between January 1, 2014, and December 31, 2014. Post -Triage Implementation Cohort including patients with ED visits between July 1, 2015, and 30 June 2016.
Results
The triage model reduces the number of ed-referred cardiovascular services promises by 73.0% (195 of 267 patients). In addition, the “without performance” level for the promise decreased from 17.8% (54 of 303 patients) to 7.9% (21 of 267 patients). There was no increase in the visit of ED or inpatient returns that were not planned in post -triage cohort. Finally, the triage model is not associated with increasing intensive cardiovascular testing resources (for example, a computated imaging stress test).
Conclusion
TRIAGE REFERRAL ED for cardiovascular service promises Reduces the utilization of cardiological promises without impact on returning visits, inpatients, or cardiovascular testing. Llorem ipsum dolor sitting Amet, elite adipiscing connecting. Ut Elite Tellus, Luctus Nec Ullamcorper Mattis, Pulvinar Dapibus Leo.
To test the hypothesis that, in the population -based cohort of people undergoing stress tests, the female sex negatively is related to the use of cardiological visits in people who do not have documented coronary artery disease (CAD) but that this relationship does not exist when CAD was founded. Differences in sex in the use of invasive heart heart procedures have been clearly documented, but data about doctor’s meeting, the integral part of treatment, lacking. Population -based cohort consisting of all regions of Olmsted, Minnesota residents who underwent early stress tests in 1987, 1988 and 1989 at Olmsted County were examined. Medical records are reviewed for the initial characteristics including CAD diagnosis status, test results, and cardiological visits in the year after the stress test. The regression model is built to determine whether the sex is independently related to the probability of visits. In the year after stress testing, there is no difference between the sex in the use of inpatients (or for female sex 0.88, 95% CI 0.62-0.97, p = 0.365) and outpatient/consultative (or for type Female genitals 1.24, 95% CI 0.95-1.61, p = 0.6) cardiology visits. However, women are less likely to receive preventive cardiology visits (or for female sex 0.77, 95% CI 0.62-0.97, p = 0.02). This is mostly related to the use of less use of precautions between older women with documented coronary artery disease (CAD). In the absence of documented CAD, when the stress test is positive, women tend to receive preventive visits. In this geographical defined population in one year after the initial stress test, there is no difference in sex in the use of inpatient or outpatient visits but women tend to receive preventive cardiology visits in the year after stress testing. Further studies are needed to understand the reasons and impacts of this treatment pattern.