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3 results

  • Effect of the COVID-19 Pandemic on Musculoskeletal Care in the Emergency Room

  • Walter R. Frontera, Marcos R. Latimer, Kevin de Jesús, Angel Pabón, Juan González, José G. Conde
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
    Published online by Cambridge University Press:
    06 December 2022, e310
    • Article
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  • Objective:

    Study the effect of the coronavirus disease (COVID-19) pandemic on emergency room (ER) utilization for musculoskeletal (MSK) complaints.

    Methods:

    Data from ER encounters in a teaching hospital for years 2019 and 2020 were extracted from an electronic database. The ICD-10-CM codes were used to assign the primary diagnosis. Joinpoint regression was applied to a time-series to detect changes in daily encounters (all-cause and MSK). Total number and median daily encounters were calculated by year, sex, age groups, and diagnostic codes for each year.

    Results:

    Overlapping intervals within March 2020 showed drops of 8.1 all-cause encounters per day (95% CI: 4.8-11.5), and 1.2 MSK encounters per day (95% CI: 0.8-1.7), resulting in net losses for the year of 33.2% for all-cause and 35.8% for MSK encounters. Reductions were observed for both sexes and all age groups. MSK codes with largest declines were low back pain, joint pain, and limb pain.

    Conclusion:

    The COVID-19 pandemic resulted in major reductions in all-cause and MSK encounters in the ER of an academic hospital probably due to governmental restrictions and a change in patients behaviors. Persistence of the observed reduction suggests that patients requiring ER services delayed seeking care for MSK and other health conditions.

  • Changes in Access to Australian Disability Support Benefits During a Period of Social Welfare Reform

  • ALEX COLLIE, LUKE R SHEEHAN, TYLER J LANE
  • Journal:
    Journal of Social Policy / Volume 51 / Issue 1 / January 2022
    Published online by Cambridge University Press:
    23 February 2021, pp. 132-154
    Print publication:
    January 2022

  • The Disability Support Pension (DSP) is the major Australian government financial benefit program for people of working age with medical conditions and disabilities that restrict work capacity. Between 2012 and 2018 a series of policy reforms sought to restrict the growth in DSP payments and encourage more people with some work capacity to seek employment. We characterise changes in three markers of access to disability financial support over the reform period (1) DSP recipient rates (2) DSP grant (approval) rates and (3) the rate of unemployment benefit receipt in people with impaired work capacity. Results demonstrate a significant reduction in DSP receipt and grant rates, and significant increase in the rate of unemployment benefit receipt in working-age Australians with work disabling medical conditions and disability. These changes were not distributed uniformly. People whose primary medical condition was a musculoskeletal or circulatory system disorder demonstrated greater declines in DSP receipt and grant rates, while there was a more rapid increase in unemployment benefit receipt among people with primary mental health conditions. Some trend changes occur in periods during which new disability assessment and pension eligibility policies were introduced, though our ability to attribute changes to specific policy changes is limited.

  • Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture: a multicenter exploratory study

  • Margaret Fry, Glenn Arendts, Lynn Chenoweth, Casimir MacGregor
  • Journal:
    International Psychogeriatrics / Volume 27 / Issue 2 / February 2015
    Published online by Cambridge University Press:
    27 August 2014, pp. 323-328
  • Background:

    Older people who present to the emergency department (ED) often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture.

    Methods:

    The aim of the study was to determine if cognitive impairment is associated with a delayed analgesic response. A 12-month exploratory study, using patient data, was conducted across four EDs. Medical records of 264 patients with long bone fractures were randomly selected.

    Results:

    The majority of patients waited longer than 60 minutes for analgesia. The median time to analgesia was longer for the cognitively impaired (149 minutes) compared with cognitively intact (72 minutes; Mann–Whitney U test: p < 0.001).

    Conclusions:

    This study suggests that cognitive impairment is a significant risk factor for delayed analgesia response in the ED.