Typical Hospitalization Or Emergency Department
Describe the processes that take place during a typical hospitalization, or emergency department visit for a consumer under the Affordable Care Act. From admission to discharge, including aftercare, rehab, and acquisition of medications; address the differences, with the same experience from before the ACA was passed into law?
Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) were searched using the following terms: emergency services/care/visits, emergency medicine, emergencies, emergency department use/utilization/visits, accidents, crowding/crowds, healthcare surveys, health service needs and demand, access block, ambulatory care/utilization, emergency room, frequent ED utilization/users, heat wave, influenza, homelessness, non-urgent visits, perception, regular source of care, predictors, emergency health-care system, health care reform, medicare, Australia, health insurance, insurance policies, and national health insurance.
In addition, seven leading international emergency medicine journals were searched for relevant articles. Annual reports from the Australian Bureau of Statistics, the Australasian College for Emergency Medicine, the Australian Institute of Health and Welfare, the Private Health Insurance Administration Council, the Productivity Commission, and the Queensland Ambulance Service were retrieved via Google. All titles and abstracts were screened by the research team for relevance to the question, and those that addressed the particular issue were examined in detail.
The search yielded 602 articles. Studies were excluded if they were for pediatric patients‘ ED utilization; ambulance utilization; health services not directly related to ED utilization; and psychiatric emergency services utilization. Studies published earlier than 1990 (except Andersen & Newman’s seminal work from 1973) or written in languages other than English were also excluded. This review was based on the remaining 100 articles. The vast majority of these derived from the USA, and therefore tended to reflect the particular environment of the US health system. All were examined for evidence of factors that influence demand or that explain the relationship between such factors. Particular attention was paid to those articles that may explain variances between private and public hospital utilization.
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