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Public Health Rep. 2005 May-Jun;120(3):259-65.

Health department collaboration with emergency departments as a model for public health programs among at-risk populations.

Author information

1
Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA. lyonsme@ucmail.uc.edu

Abstract

OBJECTIVES:

Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for such programs. A variety of perceived and actual barriers inhibit widespread implementation of ED-based public health programs. Collaboration between local health departments and EDs may overcome such barriers. The goal of this study was to assess the effectiveness of a health department-funded, ED-based public health program in comparison with other similar community-based programs through analysis of data reported by health department-funded HIV counseling and testing centers in one Ohio county.

METHOD:

Data for HIV counseling and testing at publicly funded sites in southwestern Ohio from January 1999 through December 2002 were obtained from the Ohio Department of Health. Demographic and risk-factor profiles were compared between the counseling and testing program located in the ED of a large, urban teaching hospital and the other publicly funded centers in the same county.

RESULTS:

A total of 26,382 patients were counseled and tested; 5,232 were ED patients, and 21,150 were from community sites. HIV positivity was 0.86% (95% confidence interval [CI] 0.64%, 1.15%) in the ED and 0.65% (95% CI 0.55%, 0.77%) elsewhere. The ED program accounted for 19.8% of all tests and 24.7% of all positive results. The ED notified 77.3% of individuals testing positive and 84.4% of individuals testing negative. At community program centers, 88.3% of patients testing positive and 63.8% of patients testing negative were notified of results. All ED patients notified of positive status were successfully referred to infectious disease specialists.

CONCLUSIONS:

Public health programs can operate effectively in the ED. EDs should have a rapidly expanding role in the national public health system.

PMID:
16134565
PMCID:
PMC1497724
DOI:
10.1177/003335490512000307
[Indexed for MEDLINE]
Free PMC Article
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