Research forum abstractPoster session 1: Public health61: National Survey of Preventive Health Services in United States Emergency Departments
Section snippets
Study Objectives
Emergency departments (EDs) see a high proportion of patients with unmet primary care needs and who present with illnesses related to unhealthy behaviors. Although various ED-based preventive health services have been reported, nationwide data are sparse. Our goals are to determine: 1) the availability of 11 different preventive health services in U.S. EDs; 2) ED directors' opinions whether these services could be provided with existing funding and staff; 3) ED directors' preferences of
Methods
350 (7%) of the 4,828 U.S. EDs were randomly selected from the 2005 National Emergency Department Inventory (NEDI)-USA database. A survey was sent to ED directors to determine the prevalence of: 1) screening, intervention, and referral programs for alcohol, tobacco use, geriatric falls, intimate partner violence, HIV, diabetes, and hypertension; 2) vaccination programs for influenza and pneumococcus; and 3) linkage programs to primary care and health insurance. ED directors were asked to rank
Results
The authors have collected responses from 257 institutions (75% response rate). In this random sample of EDs, the median annual patient visit volume was 21,682 (interquartile range 8,543–37,674); 54% [95% confidence interval - CI 51–63] were urban, 18% [CI 14–23] suburban, and 23% [CI 19–30] rural; 24% [CI 19–29] participated in the Critical Access Hospital program; and 8% [CI 4–11] were teaching hospitals. The three most commonly offered preventive services were for: intimate partner violence
Conclusion
EDs offer different types of preventive services at varying rates. The perceived capacity to offer new preventive services with existing funding and staff varies by type of service. The service that ED directors would most like to provide is primary care linkage. The three services that have the most capacity for expansion based on utilizing existing resources are: diabetes screening and referral, pneumococcal vaccines, and smoking cessation counseling. Overall, ED directors perceive cost to be