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Asthma readmission

Julie Burn, Andrew J Sims, Kim Keltie, Hannah Patrick, Sally A Welham, Liam G Heaney, Robert Niven
OBJECTIVE: Bronchial thermoplasty (BT) is a novel treatment for severe asthma. Its mode of action and ideal target patient group remain poorly defined, though clinical trials provided some evidence on efficacy and safety. This study presents procedural and short-term safety evidence from routine UK clinical practice. METHODS: Patient characteristics and safety outcomes (procedural complications, 30-day readmission and A&E attendance, length of stay) were assessed using two independent data sources, the British Thoracic Society UK Difficult Asthma Registry (DAR) and Hospital Episodes Statistics (HES) database...
December 1, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Mark Brittan, Troy Richardson, Chén Kenyon, Marion Sills, Evan Fieldston, Matt Hall, David Fox, Samir Shah, Jay Berry
OBJECTIVES: To assess the relationships between postdischarge emergency department visits, oral corticosteroid (OCS) use, and 15- to 90-day asthma readmission in children. STUDY DESIGN: Retrospective study of 9288 children from 12 states in the Truven MarketScan Database, ages 2-18 years, hospitalized between January 1, 2009, and June 30, 2011, with asthma, and continuously enrolled in Medicaid for 6 months prior and 3 months after hospitalization. The primary outcome was 15- to 90-day readmission for asthma...
October 18, 2016: Journal of Pediatrics
A Brad Hall, April Novotny, Donna M Bhisitkul, James Melton, Tim Regan, Maureen Leckie
Introduction While pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. Methods We conducted a retrospective cohort study of pediatric patients discharged from the pediatric ED with a diagnosis of asthma. Our primary outcome measured the rate of asthma revisits to the ED or admissions to the hospital within 28 days...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
M J Connolly, A M Yohannes
Respiratory diseases are common in older people. However, the impact of comorbid depression in older patients with chronic obstructive pulmonary disease (COPD) and asthma has not been fully explored. This narrative review examines the impact of comorbid depression and its management in COPD and asthma in older adults. The causes of depression in patients with COPD and asthma are multifactorial and include physical, physiological and behavioural factors. Depression is associated with hospital readmission in older adults with asthma and COPD...
October 2016: Maturitas
Hsueh-Fen Chen, Sharon Homan, Erin Carlson, Taiye Popoola, Kavita Radhakrishnan
BACKGROUND: The recommended home health financial penalty program for preventable readmission does not factor race/ethnicity and neighborhood racial compositions into the determination of preventable readmission rates. Home health agencies may avoid beneficiaries from certain racial/ethnic groups and neighborhoods if these two factors have an effect on preventable readmissions. We examined the association between preventable readmissions with race/ethnicity and neighborhood racial composition...
August 11, 2016: Journal of Racial and Ethnic Health Disparities
Karan Dua, William C McAvoy, Sybil A Klaus, David I Rappaport, Rebecca E Rosenberg, Joshua M Abzug
PURPOSE: The benefits of hospitalist co-management of pediatric surgical patients include bettering patient safety, decreasing negative patient outcomes, providing comprehensive medical care, and establishing a dedicated resource to patients for postoperative care. The purpose of this study was to characterize the nature of patients co-managed by a pediatric hospitalist. The authors hypothesize that hospitalist co-management is safe and efficacious in pediatric orthopaedic surgical patients who are admitted to a community hospital...
2016: Maryland Medicine: MM: a Publication of MEDCHI, the Maryland State Medical Society
Joanna Abraham, Thomas Kannampallil, Rachel N Caskey, Spyros Kitsiou
CONTEXT: Successful care transitions between emergency departments (EDs) and outpatient settings have implications for quality, safety, and cost of care. OBJECTIVE: To investigate the effectiveness of ED-based care transition interventions in achieving outpatient follow-up among pediatric patients. DATA SOURCES: Medline, Embase, CINAHL, Cochrane Library, trial registers, and reference lists of relevant articles. STUDY SELECTION AND DATA EXTRACTION: Eligible studies included randomized controlled trials of ED-based care transition interventions involving pediatric patients (aged ≤18 years)...
August 2016: Pediatrics
Charlie Strange, Suchit Kumbhare
No abstract text is available yet for this article.
July 2016: Annals of the American Thoracic Society
Jordan B Glaser, Bhavi Pandya, Mark Jarrett
No abstract text is available yet for this article.
July 2016: Annals of the American Thoracic Society
Karen D LaRoché, Carl R Hinkson, Brett A Thomazin, Paula K Minton-Foltz, David J Carlbom
BACKGROUND: In the United States, care for COPD patients is frequently delivered by respiratory therapists (RTs). After implementing a therapist-driven protocol for COPD treatment, we sought to improve identification of COPD patients. We hypothesized that using an electronic medical record screening tool to identify subjects with COPD combined with a therapist-driven protocol would positively impact length of stay (LOS) and readmission rates. METHODS: Utilizing the electronic medical record to search the provider's admission notes for the terms COPD/Asthma, a report was generated...
September 2016: Respiratory Care
Andrew F Beck, Bin Huang, Katherine A Auger, Patrick H Ryan, Chen Chen, Robert S Kahn
IMPORTANCE: Childhood asthma is characterized by disparities in the experience of morbidity, including the risk for readmission to the hospital after an initial hospitalization. African American children have been shown to have more than 2 times the hazard of readmission when compared with their white counterparts. OBJECTIVE: To explain why African American children are at greater risk for asthma-related readmissions than white children. DESIGN, SETTING, AND PARTICIPANTS: This study was completed as part of the Greater Cincinnati Asthma Risks Study, a population-based, prospective, observational cohort...
July 1, 2016: JAMA Pediatrics
(no author information available yet)
A NATIONAL care bundle has been launched for NHS hospitals discharging asthma patients.
May 9, 2016: Nursing Children and Young People
P Minale, D Bignardi, C Troise, S Voltolini, P Dignetti
Allergic diseases are under-diagnosed and undertreated despite their wide prevalence, and particularly anaphylaxis is often under-estimated. Evidence-based anaphylaxis guidelines developed by principal allergy organizations agree on increased prevalence of anaphylaxis, especially in patients younger than 18 years (18-27,30): this trend highlights the need for actions on anaphylaxis management and prevention (3,4). Lack of prompt connection between emergency department and allergy unit after discharge, and of a dedicated ICD-9th identification code (18-26), can delay diagnosis and treatment of anaphylaxis (28,29)...
May 2016: European Annals of Allergy and Clinical Immunology
Larisa V Buyantseva, Joel Brooks, Melissa Rossi, Erik Lehman, Timothy J Craig
OBJECTIVES: Assess factors that increase the odds of 30-day asthma readmissions to hospitals. METHODS: Retrospective chart review between 1/1/2002 to 12/31/2012 of pediatric and adult patients with the primary diagnosis of asthma readmitted within 30 days after the index admission was performed. Patients were identified from billing database for asthma ICD 9 code (493.9). Inclusion criteria were: physician confirmed asthma diagnosis, one or more asthma admissions and accessible medical records...
September 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Hadley S Sauers-Ford, Jennifer L Moore, Amy B Guiot, Blair E Simpson, Caitlin R Clohessy, David Yost, David C Mayhaus, Jeffrey M Simmons, Craig H Gosdin
OBJECTIVES: In our previous work, providing medications in-hand at discharge was a key strategy to reduce asthma reutilization (readmissions and emergency revisits) among children in a large, urban county. We sought to spread this work to our satellite hospital in an adjacent county. A key initial barrier was the lack of an outpatient pharmacy on site, so we sought to determine if a partnership with community pharmacies could improve the percentage of patients with medications in-hand at discharge, thus decreasing reutilization...
April 2016: Pediatrics
Robert Chen, Hang Su, Mohammed Khalilia, Sizhe Lin, Yue Peng, Tod Davis, Daniel A Hirsh, Elizabeth Searles, Javier Tejedor-Sojo, Michael Thompson, Jimeng Sun
The predictive modeling process is time consuming and requires clinical researchers to handle complex electronic health record (EHR) data in restricted computational environments. To address this problem, we implemented a cloud-based predictive modeling system via a hybrid setup combining a secure private server with the Amazon Web Services (AWS) Elastic MapReduce platform. EHR data is preprocessed on a private server and the resulting de-identified event sequences are hosted on AWS. Based on user-specified modeling configurations, an on-demand web service launches a cluster of Elastic Compute 2 (EC2) instances on AWS to perform feature selection and classification algorithms in a distributed fashion...
2015: AMIA ... Annual Symposium Proceedings
Melissa L Harris, Xenia Dolja-Gore, Hal Kendig, Julie E Byles
There are increasing concerns regarding high hospital use among older adults and the capacity to manage the economic impact of the ageing population trend on healthcare systems. First hospitalisation in old age may act as a catalyst for ongoing intensification of health problems and acute care use. This study examined factors associated with first incident hospitalisation in women aged over 70, accounting for the health inequalities associated with geographic location. Survey data from 3780 women from the 1921 to 1926 cohort of the Australian Longitudinal Study on Women's Health were matched with the Admitted Patients Data Collection and National Death Index...
May 2016: Archives of Gerontology and Geriatrics
Kohei Hasegawa, Koichiro Gibo, Yusuke Tsugawa, Yuichi J Shimada, Carlos A Camargo
BACKGROUND: Reducing hospital readmissions has attracted attention from many stakeholders. However, the characteristics of 30-day readmissions after asthma-related hospital admissions in adults are not known. It is also unclear whether older adults are at higher risk of 30-day readmission. OBJECTIVES: To investigate the rate, timing, and principal diagnosis of 30-day readmissions in adults with asthma and to determine age-related differences. METHODS: Retrospective cohort study of adults hospitalized for asthma exacerbation using the population-based inpatient samples of three states (California, Florida, and Nebraska) from 2005 through 2011...
April 2016: Chest
Aziz Sheikh, Markus F C Steiner, Genevieve Cezard, Narinder Bansal, Colin Fischbacher, Colin R Simpson, Anne Douglas, Raj Bhopal
BACKGROUND: Our previous meta-analysis found that South Asians and Blacks in the UK were at a substantially increased risk of hospital admission from asthma. These estimates were, however, derived from pooling data from a limited number of now dated studies, confined to only three very broad ethnic groups (i.e. Whites, South Asians and Blacks) and failed to take account of possible sex-related differences in outcomes within these ethnic groups. We undertook the first study investigating ethnic variations in asthma outcomes across an entire population...
2016: BMC Medicine
Kai C Johnson, Michael T Miller, Margaret A Plymale, Salomon Levy, Daniel L Davenport, J Scott Roth
BACKGROUND: Abdominal wall reconstruction for complex ventral and incisional hernias is associated with significant complications. Commonly, the peritoneal cavity is opened and adhesiolysis is performed with the potential for enterotomy. A totally extraperitoneal (TE) approach to abdominal wall reconstruction is feasible in many ventral hernia repairs and can reduce visceral injuries without impacting other outcomes. This study compares outcomes after retro-rectus ventral hernia repairs with TE and transabdominal (TA) preperitoneal approaches...
February 2016: Journal of the American College of Surgeons
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