BACKGROUND: Many people rely on EDs for routine health care. Often, however, screening and counseling for health risks are not provided. OBJECTIVE: To determine prevalence rates of chronic disease and injury risk factors and access to routine health care in a random sample of ED patients in 3 cities. METHODS: A prospective survey was conducted at 3 hospital EDs in Akron, OH, Boston, MA, and Denver, CO. A modified version of the national Behavioral Risk Factor Surveillance Survey was administered by trained researchers to a convenience sample of non-critically ill patients during randomly selected shifts. RESULTS: Of 1,143 eligible patients, 923 (81%) agreed to participate. Their mean age was 39 (range = 17-96) years. Most were female (58%), white (60%), and unmarried (68%). Thirty-eight percent had no access to primary care. Injury-prone behaviors were prevalent: 53% of the respondents did not wear seat belts regularly; 15% had no working smoke detector; 3% kept loaded, unlocked handguns in their homes; 11% had attempted suicide; 23% had a positive CAGE screen for alcoholism; 3% had operated a motor vehicle in the preceding month while alcohol-intoxicated; and 11% had ridden in an automobile with an intoxicated driver. Cancer and chronic disease risks were also common: 48% smoked; 16% had not received a blood pressure check in the preceding year; and 4% reported unsafe sexual practices. Among women aged > 50 years, 42% had not received a Pap test in the prior 2 years and 14% had never had mammography. Many prevalence rates and access to care varied among the 3 sites. However, for most risk factors, prevalence rates did not differ in patients with and without access to primary health care. CONCLUSIONS: ED patients have high rates of injury and chronic disease risks, and many have no other source of routine health care. Research is needed to determine whether ED-based programs, designed to reduce injury and chronic disease risks, are feasible and cost-effective.
BACKGROUND: Many people rely on EDs for routine health care. Often, however, screening and counseling for health risks are not provided. OBJECTIVE: To determine prevalence rates of chronic disease and injury risk factors and access to routine health care in a random sample of ED patients in 3 cities. METHODS: A prospective survey was conducted at 3 hospital EDs in Akron, OH, Boston, MA, and Denver, CO. A modified version of the national Behavioral Risk Factor Surveillance Survey was administered by trained researchers to a convenience sample of non-critically ill patients during randomly selected shifts. RESULTS: Of 1,143 eligible patients, 923 (81%) agreed to participate. Their mean age was 39 (range = 17-96) years. Most were female (58%), white (60%), and unmarried (68%). Thirty-eight percent had no access to primary care. Injury-prone behaviors were prevalent: 53% of the respondents did not wear seat belts regularly; 15% had no working smoke detector; 3% kept loaded, unlocked handguns in their homes; 11% had attempted suicide; 23% had a positive CAGE screen for alcoholism; 3% had operated a motor vehicle in the preceding month while alcohol-intoxicated; and 11% had ridden in an automobile with an intoxicated driver. Cancer and chronic disease risks were also common: 48% smoked; 16% had not received a blood pressure check in the preceding year; and 4% reported unsafe sexual practices. Among women aged > 50 years, 42% had not received a Pap test in the prior 2 years and 14% had never had mammography. Many prevalence rates and access to care varied among the 3 sites. However, for most risk factors, prevalence rates did not differ in patients with and without access to primary health care. CONCLUSIONS: ED patients have high rates of injury and chronic disease risks, and many have no other source of routine health care. Research is needed to determine whether ED-based programs, designed to reduce injury and chronic disease risks, are feasible and cost-effective.
Authors: Marian E Betz; Steven L Bernstein; Deborah C Gutman; Carrie D Tibbles; Nina R Joyce; Robert I Lipton; Lisa M Schweigler; Jonathan Fisher Journal: Am J Prev Med Date: 2011-10 Impact factor: 5.043
Authors: Edward Bernstein; Judith Bernstein; James Feldman; William Fernandez; Melissa Hagan; Patricia Mitchell; Clara Safi; Robert Woolard; Mike Mello; Janette Baird; Christina Lee; Shahrzad Bazargan-Hejazi; Kerry Broderick; Kathryn A Laperrier; Arthur Kellermann; Marlena M Wald; Robert E Taylor; Kim Walton; Michelle Grant-Ervin; Denise Rollinson; David Edwards; Theodore Chan; Dan Davis; Jean Buchanan Marshall; Robert Aseltine; Amy James; Elizabeth Schilling; Khamis Abu-Hasaballah; Brigitte M Baumann; Edwin D Boudreaux; Ronald F Maio; Rebecca M Cunningham; Teresa Murrell; David Doezema; Deirdre Anglin; Adriana Eliassen; Marcus Martin; Jesse Pines; Leslie Buchanan; James Turner; Gail D'Onofrio; Linda C Degutis; Patricia Owens Journal: Subst Abus Date: 2007 Impact factor: 3.716
Authors: David A Katz; John E Holman; Andrew S Nugent; Laurence J Baker; Skyler R Johnson; Stephen L Hillis; David G Tinkelman; Marita G Titler; Mark W Vander Weg Journal: Nicotine Tob Res Date: 2012-11-02 Impact factor: 4.244
Authors: Steven L Bernstein; Polly Bijur; Nina Cooperman; Saba Jearld; Julia H Arnsten; Alyson Moadel; E John Gallagher Journal: Acad Emerg Med Date: 2011-06 Impact factor: 3.451