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Title: Emergency room utilization by ethnicity and alternative health care practices in Hawaii 
Author: Alimineti, Kavitha
Date: 2007
Abstract: Between 1992 and 2002, emergency department (ED) hospitalization in the United States increased 23%, from 89.8 million to 110 million visits.[1] Various factors contribute to increased demand in ED utilization, such as insurance status, lack of usual source of care, general health status and economic statos.[2] Sorondo et al., for example, found that statistically significant factors associated with those utilizing ED services included females, unmarried persons who are lacking prescription medical insurance, and the poor who have less than a college education.[3] Race and/or ethnicity are also factors Sorondo et al reported influencing ED hospital visits; [4,5] however, others reported that it was not an important determinant of ED visitation status after adjusting for age, insurance, regular source of care, and difficulty obtaining transportation to physician's office.[6] Stratmann and Ullman found, after adjusting for insurance and health status, that race was not significantly associated with ED visitation status.[7] The use of complimentary and alternative medicine (CAM) increased substantially during the 1990's in the United States. The 2002 National Health Interview Survey (NHIS) conducted by the Centers for Disease Control and Prevention (COC) reported that 74% of people have engaged in some forms of CAM therapy while 62% of adults have been treated with CAM in the last 12 months.[8] Complimentary and alternative medicines are being used by a majority of ED patients.[8] An examination of the association of ED and CAM use indicates that CAM users do not differ in their utilization of ED when compared to non-users. A prospective observational study found that many ED patients have either tried or are willing to use alternative medicine. [10] Among ED users, 54% bad tried alternative medicine. Also, 87% of ED users felt alternative medicine was effective. Most patients were willing to try alternative medicine (63%) for their current problems, and wanted their personal physicians to know more about alternative medicine (75%), and also wanted their physicians to use alternative medicine (84%).[10] These authors (Singer AJ, Gulla J) suggested that emergency room physicians should specifically query patients regarding prior use of alternative medicine and explore the use of alternative medicine for their patients. These studies have limitations and the results cannot be generalized to a broad population since most of these studies were done in a clinical setting or an individual department. So far, there is limited research on the use of ED and CAM in the general population in Hawai'i, particularly among native Hawai'ians and Pacific Islanders. A better understanding of the relationship between ethnicity and the use of CAM in an emergency department is essential for directing or re-directing resources in order to improve health care services. Also, cultora1 beliefs may influence a particular individual's utilization of CAM and ER. This thesis analyzes the Hawai'i Health Survey data to provide a deeper understanding of ED and CAM use in Hawai'i
Description: Thesis (M.S.)--University of Hawaii at Manoa, 2007. Includes bibliographical references (leaves 16-17). vi, 17 leaves, bound 29 cm
URI: http://hdl.handle.net/10125/20881
Rights: All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Keywords: Hospitals -- Emergency services -- Utilization -- Hawaii

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Restricted for viewing only M.S.Q111.H3_4195 MAY 2007_r.pdf 617.3Kb PDF View/Open
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