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The association between the lunar cycle and patterns of patient presentation to the emergency departmentFutcher, Grant Dudley January 2015 (has links)
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, in partial fulfilment of the requirements for the degree
of
Master of Science in Medicine in Emergency Medicine.
Johannesburg, 2015 / Aim: To determine any association between the lunar synodic or anomalistic
months and the nature and volume of emergency department patient consultations
and hospital admissions from the emergency department (ED).
Design: A retrospective, descriptive study.
Setting: All South African EDs of a private hospital group.
Patients: All patients consulted from 01 January 2005 to 31 December 2010.
Methods: Data was extracted from monthly records and statistically evaluated,
controlling for calendric variables. Lunar variables were modelled with volumes of
differing priority of hospital admissions and consultation categories including;
trauma, medical, paediatric, work injuries, obstetrics and gynaecology, intentional
self harm, sexual assault, dog bites and total ED consultations.
Main Results: No significant differences were found in all anomalistic and most
synodic models with the consultation categories. Small but significant increases
were found with a small number of synodic models around full moon with some
categories, P2 medical, total paediatric consultations and total admissions.
Significant decreases in admissions, particulary total admissions, were found
around perigee. The effect sizes of all significant lunar associations were smaller
than those of the calendric variables.
Conclusions: Most comparisons demonstrated no lunar association. Small but
significant associations were demonstrated around full moon with some synodic
models. A number of anomalistic admission models demonstrated small but
significant decreases in admissions at perigee.
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Planning study emergency facilities in Monroe, Michigan : submitted ... in partial fulfillment ... Master of Hospital Administration /Stroebel, James K. January 1979 (has links)
Thesis (M.H.A.)--University of Michigan, 1979.
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A study of emergency room utilization submitted ... in partial fulfillment ... Master of Hospital Administration /Case, Alan Robinson. January 1960 (has links)
Thesis (M.H.A.)--University of Michigan, 1960.
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Planning study emergency facilities in Monroe, Michigan : submitted ... in partial fulfillment ... Master of Hospital Administration /Stroebel, James K. January 1979 (has links)
Thesis (M.H.A.)--University of Michigan, 1979.
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A study of emergency room utilization submitted ... in partial fulfillment ... Master of Hospital Administration /Case, Alan Robinson. January 1960 (has links)
Thesis (M.H.A.)--University of Michigan, 1960.
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An analysis of the practical experiences and confidence in performing emergency medical skills in South African medical internsAllen, Mark 27 August 2014 (has links)
Thesis (M.Sc.(Med.) Emergency Medicine--University of the Witwatersrand, Faculty of Health Sciences, 2014. / This study was designed to investigate how confident South African medical interns are to perform emergency medical procedures and to investigate how their experiences or demographic differences might influence these confidences. A transverse descriptive study using a cross sectional questionnaire was undertaken. A combination of the paper-based and electronic questionnaires were distributed to doctors currently performing their internship in South Africa. The data were analysed using a Fishers exact test and applying a Bonferroni correction where necessary. The study showed a high level of confidence in the majority of procedures studied and identified some points of influence on this confidence. The confidence of South African interns compares favourably with international colleagues at a similar qualification level.
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Utilization of Emergency Point of Care Ultrasound in an Emergency Department in JohannesburgStanton, Tamsyn B. B. January 2017 (has links)
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree
of Master of Medicine in Emergency Medicine, Johannesburg / Introduction
Point-of-care ultrasound (PoCUS) is a widely utilized tool in Emergency Medicine (EM). The core PoCUS curriculum in South Africa (SA) does not currently include lung ultrasound or basic bedside echocardiography, although the burden of disease in a typical South African Emergency Department (ED) is skewed towards respiratory and cardiac pathologies. This study was undertaken to determine the profile of PoCUS examinations actually performed and potentially indicated in this ED, and whether current training in PoCUS is meeting the need in clinical practice.
Methods
This was a prospective observational audit of bedside PoCUS examinations actually performed, and potentially indicated, over a two-week period in the Helen Joseph Hospital ED in Johannesburg.
Results
The study included 372 patients. Ultrasound aided in the diagnosis and management of 107 (28,8%) of the patients. A total of 137 PoCUS investigations were performed. A total of 38,9% of the patients had positive ultrasound findings.
The most frequently performed PoCUS applications were e-FAST (extended focused assessment by sonography in trauma) (32,8%), DVT assessment (13,9%) and procedural guidance (10,9%).
A total of 758 PoCUS examinations were indicated in 307 (82,5%) of the patients.
Overall, 18,1% of the potentially indicated PoCUS investigations were performed.
The most frequently potentially indicated PoCUS applications were lung ultrasound (28,2%), basic cardiac (28%) and haemodynamic assessments (20,4%).
Conclusions
These findings reflect the high number of respiratory and cardiac cases seen in South African EDs. This highlights the consequent need for additional ultrasound skills to assist in the emergency management of such cases. Training of future South African EM specialist consultants should include both lung ultrasound and basic bedside echocardiography. It is time to update to the South African core PoCUS curriculum. / LM2019
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The costs of emergency department services dissertation submitted in partial fulfillment ... for the degree of Doctor of Public Health (Health Policy) ... /Williams, Robert Melvin. January 1994 (has links)
Thesis (D.P.H.)--University of Michigan, 1994.
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The costs of emergency department services dissertation submitted in partial fulfillment ... for the degree of Doctor of Public Health (Health Policy) ... /Williams, Robert Melvin. January 1994 (has links)
Thesis (D.P.H.)--University of Michigan, 1994.
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Evaluation of the casuality department at Polokwane Mankweng Hospital Complex in the Limpopo ProvinceMohapi, Morongwa Caroline January 2014 (has links)
research report submitted to the Faculty of Health Sciences, University of
the Witwatersrand in partial fulfilment of the requirements for the degree of
Master of Public Health in the field of Hospital Management
MAY 2014 / BACKGROUND: One of the key challenges facing the Limpopo Department
of Health and Social Development in the area of Casualty Care is the lack of
trained personnel and the inappropriate referral and utilisation of these
services. There has been no known study conducted in this area in the South
African context and therefore this study was undertaken to evaluate the
services rendered within the Casualty Department at the Polokwane
Mankweng Hospital Complex with specific reference to material and human
resources as well as efficiency of the unit.
AIM: To evaluate the Hospital Casualty Department in the Polokwane
Mankweng Hospital Complex in terms of caseload, influencing factors and
implications on resource utilisation during a one year study period.
METHODOLOGY: A cross sectional study design was employed in this study.
A retrospective record review was done and information was extracted from
various sources of hospital information systems. No primary data was
collected for this study. The setting of this study was the Casualty
Departments at Polokwane Mankweng Hospital Complex. The two hospitals
constituting this complex are situated 30 km apart in Polokwane and Turfloop
respectively. Data was collected on various variables that are relevant to the
functioning of, and resource utilisation in the Casualty Unit of this Complex.
Variables including that of caseload, patient profiles, service costs and
workload on human resources were measured.
RESULTS: This study based on retrospective review of records of 250
patients’ records selected by a simple random sample from a cohort of 14,113
patients who attended the Casualty Department of the Polokwane Mankweng
Hospital Complex during one year study period. One fifth of the patients were
referred from other health facilities and more than 60% of the patients were
discharged after receiving treatment which implied that these patients could
be managed at a regional or district hospital. More patients with medical aid
bypassed the referral system. Almost half of the patients arrived after-hours
(from 18h00 to 6h00).
This is the first study in the Limpopo Province which looked at the direct cost
per patient at the Casualty Department. In 2008/09, overall expenditure was
R 10,321,401.42 (including R 954,168.45 for pharmacy products, other
consumables R 177,261.16 and Laboratory tests R 1,866,233.25). Overall the
Department accounts for an estimated R 7,323,804 in personnel annual
expenditure of the hospital. Unit personnel cost per patient was estimated at
R518.94 (70.96% of total recurrent cost), while the unit costs for the
Pharmaceuticals, Stores and Laboratory tests were; R67.23 (9.24%), R12.56
(1.72%) and R132.24 (18.08%) per patient respectively. Overall the combined
unit cost was estimated at R731.34 per single emergency care patient
excluding the capital costs.
CONCLUSION: The results of the study will be used to guide the allocation of
appropriate resources, and to highlight the need to implement an effective
referral system, which will assist in reducing the workload.
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