Patients with multiple health issues and who are at higher risk of adverse events are less likely to receive follow-up care from a physician after visiting an emergency department for chest pain, reports a study published in Canadian Medical Association Journal ( CMAJ).
Chest pain is one of the most common reasons people visit emergency departments, with about 500 000 visits every year in Canada alone.
The study looked at 56 767 patients with chest pain who visited an emergency department in Ontario between April 2004 and March 2010. Of these, 42 535 (75%) were seen by a primary care physician or cardiologist within 30 days after discharge, and 14 232 (25%) did not receive follow-up care. Patients with multiple illnesses such as heart disease, kidney disease and dementia, and rural residency were less likely than others to receive follow-up care in the following month. Patients who had visited a primary care physician or cardiologist in the preceding year were more likely to see a physician after discharge.
"We initially thought that emergency department physicians would risk stratify patients such that those with more medical and cardiac comorbidities would receive more physician follow-up care," writes Dr. Dennis Ko, a senior scientist at the Institute for Clinical Evaluative Sciences (ICES) and an interventional cardiologist at the Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, with coauthors. "However, patients with more medical comorbidities in our cohort were less likely to receive physician follow-up postdischarge."
Current guidelines strongly suggest that patients discharged from emergency departments for chest pain should be seen by a physician within 72 hours for further assessment or treatment.
"Our study suggests that system factors such as access to care and emergency department annual chest pain volume are the strongest predictors of follow-up rather than patient factors. An improved strategy to ensure follow-up of patients particularly for those who have not previously seen a physician, is needed to improve the transition of care," the authors conclude.
Explore further: Physician continuity is key after ER visit for heart failure
More information: Canadian Medical Association Journal DOI: 10.1503/cmaj.141294
Medical Xpress on facebook
Related Stories
Post-ER care for chest pain reduces risk of heart attack, death
Apr 01, 2013
Seeing a doctor within a month of an emergency room visit for chest pain significantly reduced the risk of heart attack or death among high risk patients, according to research published the American Heart Association journal ...
Physician continuity is key after ER visit for heart failure
Jul 21, 2014
(HealthDay)—Heart failure patients who follow up with a familiar physician after release from the emergency department have better outcomes, according to research published online July 9 in the Journal of ...
Initial diagnostic test in ED for chest pain did not affect low rate of heart attack
Jan 26, 2015
Patients seen in the emergency department (ED) for chest pain who did not have a heart attack appeared to be at low risk of experiencing a heart attack during short- and longer-term follow-up and that risk was not affected ...
Chest pain duration can signal heart attack
Sep 11, 2013
Patients with longer-lasting chest pain are more likely having a heart attack than those with pain of a shorter duration, according to a study by researchers at Henry Ford Hospital.
Discharged patients return to the ER because 'better safe than sorry'
Sep 02, 2014
Patients who return to the emergency department within a few days of discharge do so principally because they are anxious about their symptoms and have lost trust in other parts of the health care system, according to the ...
Recommended for you
Immunization rates improve with centralized reminder system
29 minutes ago
Childhood immunization rates would improve with a centralized notification system that reminded families when immunizations were due, according to a new study, published online by JAMA Pediatrics, developed by researchers at the ...
Troops in middle east may be at risk for lung problems
1 hour ago
(HealthDay)—U.S. soldiers serving in the Middle East and Afghanistan may be at risk for lung damage from exposure to dust there, a new study suggests.
Why don't more women rise to leadership positions in academic medicine?
1 hour ago
Even as more women are pursuing careers in academic medicine, and now comprise 20% of full-time faculty in medical schools, they are not rising to senior leadership positions in similar numbers as men. The National Faculty ...
Research finds females, males use sexual assault hotlines differently
3 hours ago
When victims of sexual assault dial a telephone hotline for help, what they ask and how long they stay on the line might very well be related to whether they are male or female, according to new University ...
Research says hospital consolidation isn't a cure-all for health care
3 hours ago
In his new book, America's Bitter Pill, Steven Brill dives deep into the history of the Affordable Care Act (ACA) and how it was passed. He concludes that, although providing more Americans with health in ...
Avoiding winter health hazards
3 hours ago
Have you had enough of winter? UConn Today sought out experts at UConn Health for a roundup of common threats to our health and well-being this time of year. Their information won't make spring come any faster, ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here to reset your password.
Sign in to get notified via email when new comments are made.
© Medical Xpress 2011-2014, Science X network
Patients with multiple health issues and who are at higher risk of adverse events are less likely to receive follow-up care from a physician after visiting an emergency department for chest pain, reports a study published in Canadian Medical Association Journal ( CMAJ).
Chest pain is one of the most common reasons people visit emergency departments, with about 500 000 visits every year in Canada alone.
The study looked at 56 767 patients with chest pain who visited an emergency department in Ontario between April 2004 and March 2010. Of these, 42 535 (75%) were seen by a primary care physician or cardiologist within 30 days after discharge, and 14 232 (25%) did not receive follow-up care. Patients with multiple illnesses such as heart disease, kidney disease and dementia, and rural residency were less likely than others to receive follow-up care in the following month. Patients who had visited a primary care physician or cardiologist in the preceding year were more likely to see a physician after discharge.
"We initially thought that emergency department physicians would risk stratify patients such that those with more medical and cardiac comorbidities would receive more physician follow-up care," writes Dr. Dennis Ko, a senior scientist at the Institute for Clinical Evaluative Sciences (ICES) and an interventional cardiologist at the Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, with coauthors. "However, patients with more medical comorbidities in our cohort were less likely to receive physician follow-up postdischarge."
Current guidelines strongly suggest that patients discharged from emergency departments for chest pain should be seen by a physician within 72 hours for further assessment or treatment.
"Our study suggests that system factors such as access to care and emergency department annual chest pain volume are the strongest predictors of follow-up rather than patient factors. An improved strategy to ensure follow-up of patients particularly for those who have not previously seen a physician, is needed to improve the transition of care," the authors conclude.
Explore further: Physician continuity is key after ER visit for heart failure
More information: Canadian Medical Association Journal DOI: 10.1503/cmaj.141294
Medical Xpress on facebook
Related Stories
Post-ER care for chest pain reduces risk of heart attack, death
Apr 01, 2013
Seeing a doctor within a month of an emergency room visit for chest pain significantly reduced the risk of heart attack or death among high risk patients, according to research published the American Heart Association journal ...
Physician continuity is key after ER visit for heart failure
Jul 21, 2014
(HealthDay)—Heart failure patients who follow up with a familiar physician after release from the emergency department have better outcomes, according to research published online July 9 in the Journal of ...
Initial diagnostic test in ED for chest pain did not affect low rate of heart attack
Jan 26, 2015
Patients seen in the emergency department (ED) for chest pain who did not have a heart attack appeared to be at low risk of experiencing a heart attack during short- and longer-term follow-up and that risk was not affected ...
Chest pain duration can signal heart attack
Sep 11, 2013
Patients with longer-lasting chest pain are more likely having a heart attack than those with pain of a shorter duration, according to a study by researchers at Henry Ford Hospital.
Discharged patients return to the ER because 'better safe than sorry'
Sep 02, 2014
Patients who return to the emergency department within a few days of discharge do so principally because they are anxious about their symptoms and have lost trust in other parts of the health care system, according to the ...
Recommended for you
Immunization rates improve with centralized reminder system
29 minutes ago
Childhood immunization rates would improve with a centralized notification system that reminded families when immunizations were due, according to a new study, published online by JAMA Pediatrics, developed by researchers at the ...
Troops in middle east may be at risk for lung problems
1 hour ago
(HealthDay)—U.S. soldiers serving in the Middle East and Afghanistan may be at risk for lung damage from exposure to dust there, a new study suggests.
Why don't more women rise to leadership positions in academic medicine?
1 hour ago
Even as more women are pursuing careers in academic medicine, and now comprise 20% of full-time faculty in medical schools, they are not rising to senior leadership positions in similar numbers as men. The National Faculty ...
Research finds females, males use sexual assault hotlines differently
3 hours ago
When victims of sexual assault dial a telephone hotline for help, what they ask and how long they stay on the line might very well be related to whether they are male or female, according to new University ...
Research says hospital consolidation isn't a cure-all for health care
3 hours ago
In his new book, America's Bitter Pill, Steven Brill dives deep into the history of the Affordable Care Act (ACA) and how it was passed. He concludes that, although providing more Americans with health in ...
Avoiding winter health hazards
3 hours ago
Have you had enough of winter? UConn Today sought out experts at UConn Health for a roundup of common threats to our health and well-being this time of year. Their information won't make spring come any faster, ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here
to reset your password.
Sign in to get notified via email when new comments are made.
© Medical Xpress 2011-2014, Science X network
0 comments:
Post a Comment