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  • 标题:Disproportionate Availability Between Emergency and Elective Hand Coverage: A National Trend?
  • 本地全文:下载
  • 作者:Stella Y. Chung ; Aditya Sood ; Mark S. Granick
  • 期刊名称:ePlasty: Open Access Journal of Plastic and Reconstructive Surgery
  • 印刷版ISSN:1937-5719
  • 出版年度:2016
  • 卷号:16
  • 语种:English
  • 出版社:Open Science Co. LLC
  • 摘要:Background: Traumatic hand injuries represent approximately 20% of emergency department visits; yet, access to emergency care remains inadequate. Recent surveys from several states report a wider availability of hand specialists providing elective care than emergency care. The authors aim to examine this phenomenon in the state of New Jersey and whether there is a national trend toward disproportionate availability between emergency and elective hand coverage.Methods: A survey was conducted of all New Jersey hospitals, excepting university hospitals, in August 2014. To assess the availability of hand surgery coverage, the following questions were asked: (1) Does your hospital provide elective hand surgery? and (2) Is there a hand specialist/surgeon on call always, sometimes, or never?Results: A total of 58 hospitals were called, with a 67.2% response rate (n= 39). The majority (87.2%) of hospitals offered elective hand surgery, whereas only 64.1% provided immediate 24/7 hand coverage. Only 38.5% of hospitals located in the same county as a level I trauma center provided 24/7 emergency hand care, whereas 76.9% of hospitals in counties without any level I trauma center did (P< .05). Cities with a higher poverty level were less likely to provide emergency coverage than cities with a lower poverty level (47.4% vs 80.0%;P< .05).Conclusions: There is a discrepancy between emergency and elective hand care in New Jersey. Similar findings across the nation suggest a concerning trend of limited access to emergency hand health care. Alternative systems that can appropriately triage and treat patients are warranted.
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