OBJECTIVES: Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for such programs. A variety of perceived and actual barriers inhibit widespread implementation of ED-based public health programs. Collaboration between local health departments and EDs may overcome such barriers. The goal of this study was to assess the effectiveness of a health department-funded, ED-based public health program in comparison with other similar community-based programs through analysis of data reported by health department-funded HIV counseling and testing centers in one Ohio county. METHOD: Data for HIV counseling and testing at publicly funded sites in southwestern Ohio from January 1999 through December 2002 were obtained from the Ohio Department of Health. Demographic and risk-factor profiles were compared between the counseling and testing program located in the ED of a large, urban teaching hospital and the other publicly funded centers in the same county. RESULTS: A total of 26,382 patients were counseled and tested; 5,232 were ED patients, and 21,150 were from community sites. HIV positivity was 0.86% (95% confidence interval [CI] 0.64%, 1.15%) in the ED and 0.65% (95% CI 0.55%, 0.77%) elsewhere. The ED program accounted for 19.8% of all tests and 24.7% of all positive results. The ED notified 77.3% of individuals testing positive and 84.4% of individuals testing negative. At community program centers, 88.3% of patients testing positive and 63.8% of patients testing negative were notified of results. All ED patients notified of positive status were successfully referred to infectious disease specialists. CONCLUSIONS: Public health programs can operate effectively in the ED. EDs should have a rapidly expanding role in the national public health system.
OBJECTIVES: Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for such programs. A variety of perceived and actual barriers inhibit widespread implementation of ED-based public health programs. Collaboration between local health departments and EDs may overcome such barriers. The goal of this study was to assess the effectiveness of a health department-funded, ED-based public health program in comparison with other similar community-based programs through analysis of data reported by health department-funded HIV counseling and testing centers in one Ohio county. METHOD: Data for HIV counseling and testing at publicly funded sites in southwestern Ohio from January 1999 through December 2002 were obtained from the Ohio Department of Health. Demographic and risk-factor profiles were compared between the counseling and testing program located in the ED of a large, urban teaching hospital and the other publicly funded centers in the same county. RESULTS: A total of 26,382 patients were counseled and tested; 5,232 were ED patients, and 21,150 were from community sites. HIV positivity was 0.86% (95% confidence interval [CI] 0.64%, 1.15%) in the ED and 0.65% (95% CI 0.55%, 0.77%) elsewhere. The ED program accounted for 19.8% of all tests and 24.7% of all positive results. The ED notified 77.3% of individuals testing positive and 84.4% of individuals testing negative. At community program centers, 88.3% of patients testing positive and 63.8% of patients testing negative were notified of results. All ED patients notified of positive status were successfully referred to infectious disease specialists. CONCLUSIONS: Public health programs can operate effectively in the ED. EDs should have a rapidly expanding role in the national public health system.
Authors: Samuel A McLean; Frederic C Blow; Maureen A Walton; Mary Ann Gregor; Kristen L Barry; Ronald F Maio; Steven R Knutzen Journal: Acad Emerg Med Date: 2003-12 Impact factor: 3.451
Authors: Roland C Merchant; Bethany M Catanzaro; George R Seage; Kenneth H Mayer; Melissa A Clark; Victor G Degruttola; Bruce M Becker Journal: J Med Screen Date: 2009 Impact factor: 2.136
Authors: Michael S Lyons; Christopher J Lindsell; D Beth Wayne; Andrew H Ruffner; Kimberly W Hart; Carl J Fichtenbaum; Alexander T Trott; Patrick S Sullivan Journal: Ann Emerg Med Date: 2011-07 Impact factor: 5.721
Authors: Roland C Merchant; George R Seage; Kenneth H Mayer; Melissa A Clark; Victor G DeGruttola; Bruce M Becker Journal: Public Health Rep Date: 2008 Nov-Dec Impact factor: 2.792
Authors: Gretchen Williams Torres; Juliet Yonek; Jeremy Pickreign; Heidi Whitmore; Romana Hasnain-Wynia Journal: Public Health Rep Date: 2009 May-Jun Impact factor: 2.792
Authors: Yvette Calderon; Jason Leider; Susan Hailpern; Robert Chin; Reena Ghosh; Jade Fettig; Paul Gennis; Polly Bijur; Laurie Bauman Journal: AIDS Patient Care STDS Date: 2009-09 Impact factor: 5.078
Authors: Laura M Bogart; Devery Howerton; James Lange; Kirsten Becker; Claude Messan Setodji; Steven M Asch Journal: Public Health Rep Date: 2008 Jul-Aug Impact factor: 2.792
Authors: Phillip C Moschella; Kimberly W Hart; Andrew H Ruffner; Christopher J Lindsell; D Beth Wayne; Matthew I Sperling; Alexander T Trott; Carl J Fichtenbaum; Michael S Lyons Journal: Am J Public Health Date: 2014-07-17 Impact factor: 9.308