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"Avoidable admissions"

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https://www.readbyqxmd.com/read/28992984/avoidable-hospitalizations-due-to-adverse-drug-reactions-in-an-acute-geriatric-unit-analysis-of-3-292-patients
#1
Mateu Cabré, Lorena Elias, Mireia Garcia, Elisabet Palomera, Mateu Serra-Prat
OBJECTIVE: To determine prevalence of admissions due to an adverse drug reaction (ADR) and determine whether or not admission was avoidable, and what drugs and risk factors were implicated. DESIGN: Cross-sectional observational study. STUDY SAMPLE: All patients hospitalized in an acute geriatric unit during the period January 2001 to December 2010 were studied. MEASUREMENT: To determine whether admissions were due toADR, we used the World Health Organization-Uppsala Monitoring Centre criteria and the Naranjo scale...
October 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28971143/glasgow-blatchford-score-of-limited-benefit-for-low-risk-urban-patients-a-mixed-methods-study
#2
David A Leiman, Angela M Mills, Frances S Shofer, Andrew T Weber, Erin R Leiman, Brian P Riff, James D Lewis, Shivan J Mehta
BACKGROUND AND STUDY AIMS:  Most patients with upper gastrointestinal bleeding (UGIB) are hospitalized. Risk-stratifying UGIB with scoring tools may decrease avoidable admissions, thereby reducing the cost of care. We sought to describe how frequently low-risk UGIB patients present to urban emergency departments (ED) and the proportion who are admitted to examine how incorporating risk scores into decision support might diminish healthcare utilization in this population. PATIENTS AND METHODS:  This is a retrospective cohort study of ED patients presenting from 2009 - 2013 to three urban hospitals that do not use electronic UGIB decision support...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28957486/admissions-to-inpatient-care-facilities-in-the-last-year-of-life-of-community-dwelling-older-people-in-europe
#3
Anouk Overbeek, Lieve Van den Block, Ida J Korfage, Yolanda W H Penders, Agnes van der Heide, Judith A C Rietjens
Background: In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Methods: Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life...
October 1, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28892716/neuroscience-step-down-unit-admission-criteria-for-patients-with-intracerebral-hemorrhage
#4
Ayham M Alkhachroum, Oladi Bentho, Neel Chari, Ashish Kulhari, Wei Xiong
OBJECTIVES: The goal of our study is to determine optimal criteria which can be used to avoid admission to neuroscience intensive care units for patients with intracerebral hemorrhage (ICH). PATIENTS AND METHODS: This is a retrospective cohort study of 431 patients with primary ICH from January 2013 to the end of December 2015 and reviewed multiple admitting characteristics. Based on these needs, we tested the following step-down unit admission criteria: Supratentorial ICH, ICH volume <20 cc, no Intraventricular hemorrhage (IVH), systolic BP <200mmHg, no respiratory failure, GCS≥12...
September 5, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28874939/rapid-primary-care-follow-up-from-the-ed-to-reduce-avoidable-hospital-admissions
#5
Amanda S Carmel, Peter Steel, Robert Tanouye, Aleksey Novikov, Sunday Clark, Sanjai Sinha, Judy Tung
INTRODUCTION: Hospital admissions from the emergency department (ED) now account for approximately 50% of all admissions. Some patients admitted from the ED may not require inpatient care if outpatient care could be optimized. However, access to primary care especially immediately after ED discharge is challenging. Studies have not addressed the extent to which hospital admissions from the ED may be averted with access to rapid (next business day) primary care follow-up. We evaluated the impact of an ED-to-rapid-primary-care protocol on avoidance of hospitalizations in a large, urban medical center...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#6
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28754601/magnesium-sulfate-infusion-for-acute-asthma-in-the-emergency-department
#7
REVIEW
Jose Enrique Irazuzta, Nicolas Chiriboga
OBJECTIVES: To describe the role of intravenous magnesium sulfate (MgSO4) as therapy for acute severe asthma in the pediatric emergency department (ED). SOURCE: Publications were searched in the PubMed and Cochrane databases using the following keywords: magnesium AND asthma AND children AND clinical trial. A total of 53 publications were retrieved using this criteria. References of relevant articles were also screened. The authors included the summary of relevant publications where intravenous magnesium sulfate was studied in children (age <18 years) with acute asthma...
July 26, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#8
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28560903/-susan-and-dena-s-vision-hard-work-and-enthusiasm-were-unbeatable
#9
Elaine Cole
Susan Wills and Dena Ross have reduced unplanned and avoidable admissions by supporting the carers to manage residents safely in their nursing homes.
May 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#10
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28414540/the-future-of-community-nursing-hospital-in-the-home
#11
Gerry Lee, Nicola Pickstone, Jose Facultad, Karen Titchener
With an increasing ageing population who often have multiple long-term conditions, there is a growing need to provide an alternative type of care to the traditional hospital-based model. 'Hospital in the Home' is a model that provides integrated care for patients in their home. The @home service was established in 2013 by Guy's and St Thomas' NHS Foundation Trust. The service provides health care in patients' home, supporting early discharge from hospital as well as preventing avoidable admissions and readmissions saving valuable hospital bed days and reducing length of stay...
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28340935/individual-and-hospital-related-determinants-of-potentially-inappropriate-admissions-emerging-from-administrative-records
#12
Marco Fusco, Alessandra Buja, Paolo Piergentili, Maria Teresa Golfetto, Gianni Serafin, Silvia Gallo, Livio Dalla Barba, Vincenzo Baldo
INTRODUCTION: The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. METHODS: Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards...
November 2016: Health Policy
https://www.readbyqxmd.com/read/28196949/referral-pathways-for-patients-with-tia-avoiding-hospital-admission-a-scoping-review
#13
Bridie Angela Evans, Khalid Ali, Jenna Bulger, Gary A Ford, Matthew Jones, Chris Moore, Alison Porter, Alan David Pryce, Tom Quinn, Anne C Seagrove, Helen Snooks, Shirley Whitman, Nigel Rees
OBJECTIVE: To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital. DESIGN: Scoping review. DATA SOURCES: PubMed, CINAHL Web of Science, Scopus. STUDY SELECTION: Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services. DATA EXTRACTION: We screened studies for eligibility and extracted data from relevant studies...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28167713/health-care-use-and-spending-patterns-vary-by-wage-level-in-employer-sponsored-plans
#14
Bruce W Sherman, Teresa B Gibson, Wendy D Lynch, Carol Addy
Employees face an increasing financial burden for health services as health care costs increase relative to earnings. Yet little is known about health care utilization patterns relative to employee wages. To better understand this association and the resulting implications, we examined patterns of health care use and spending by wage category during 2014 among 42,936 employees of four self-insured employers enrolled in a private health insurance exchange. When demographics and other characteristics were controlled for, employees in the lowest-wage group had half the usage of preventive care (19 percent versus 38 percent), nearly twice the hospital admission rate (31 individuals per 1,000 versus 17 per 1,000), more than four times the rate of avoidable admissions (4...
February 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28061794/process-evaluation-of-the-data-driven-quality-improvement-in-primary-care-dqip-trial-active-and-less-active-ingredients-of-a-multi-component-complex-intervention-to-reduce-high-risk-primary-care-prescribing
#15
Aileen Grant, Tobias Dreischulte, Bruce Guthrie
BACKGROUND: Two to 4% of emergency hospital admissions are caused by preventable adverse drug events. The estimated costs of such avoidable admissions in England were £530 million in 2015. The data-driven quality improvement in primary care (DQIP) intervention was designed to prompt review of patients vulnerable from currently prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and anti-platelets and was found to be effective at reducing this prescribing. A process evaluation was conducted parallel to the trial, and this paper reports the analysis which aimed to explore response to the intervention delivered to clusters in relation to participants' perceptions about which intervention elements were active in changing their practice...
January 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/27846005/novel-emergency-department-risk-score-discriminates-acute-coronary-syndrome-among-chest-pain-patients-with-known-coronary-artery-disease
#16
Matthew T Crim, Scott A Berkowitz, Mustapha Saheed, Jason Miller, Amy Deutschendorf, Gary Gerstenblith, Peter Hill, Frederick K Korley
BACKGROUND: Patients with known coronary artery disease presenting to the emergency department (ED) with chest pain are often admitted, yet may not be having an acute coronary syndrome (ACS). METHODS: We assessed whether the use of a novel risk score and a modified thrombolysis in myocardial infarction risk score obtained in the ED could discriminate which of these high-risk patients have ACS. Chart review was performed on a cohort of 285 patients with known coronary artery disease presenting to the ED with chest pain thought to be of ischemic origin and admitted to the hospital...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27714762/reductions-in-medication-related-hospitalizations-in-older-adults-with-medication-management-by-hospital-and-community-pharmacists-a-quasi-experimental-study
#17
Karen L Pellegrin, Les Krenk, Sheena Jolson Oakes, Anita Ciarleglio, Joanne Lynn, Terry McInnis, Alistair W Bairos, Lara Gomez, Mercedes Benitez McCrary, Alexandra L Hanlon, Jill Miyamura
OBJECTIVES: To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of medication-related hospitalization in older adults. DESIGN: Quasi-experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed-effects analysis that modeled the intervention as a time-dependent variable. SETTING: Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014...
January 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27612980/increase-in-avoidable-hospital-admissions-after-the-great-east-japan-earthquake
#18
Yusuke Sasabuchi, Hiroki Matsui, Hideo Yasunaga, Kiyohide Fushimi
BACKGROUND: The Great East Japan Earthquake and subsequent tsunami and nuclear disaster on 11 March 2011 had a short-term influence on the increase in emergency department visits and hospital admissions due to various diseases. However, it remains unclear whether the earthquake and tsunami disaster affected the long-term health conditions of people in the affected areas. METHODS: Using a national inpatient database in Japan, we investigated people's ambulatory care sensitive conditions (ACSCs), which are defined as conditions for which effective management and treatment should prevent admission to a hospital...
September 9, 2016: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/27551062/predictors-of-fever-related-admissions-to-a-paediatric-assessment-unit-ward-and-reattendances-in-a-south-london-emergency-department-the-cabin-2-study
#19
Amaya L Bustinduy, Irina Chis Ster, Rebecca Shaw, Adam Irwin, Jaiganesh Thiagarajan, Rhys Beynon, Shamez Ladhani, Mike Sharland
OBJECTIVE: To explore the risk factors for ward and paediatric assessment unit (PAU) admissions from the emergency department (ED). DESIGN: Prospective observational study. SETTING AND PATIENTS: Febrile children attending a large tertiary care ED during the winter of 2014-2015. MAIN OUTCOME MEASURES: Ward and PAU admissions, National Institute for Health and Care Excellence (NICE) guidelines classification, reattendance to the ED within 28 days and antibiotic use...
January 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27380901/reducing-avoidable-admissions-in-rural-community-palliative-care-a-pilot-study-of-care-coordination-by-general-practice-registrars
#20
Thea F van de Mortel, Kenneth Marr, Elizabeth Burmeister, Hilton Koppe, Christine Ahern, Robert Walsh, Susan Tyler-Freer, Dan Ewald
OBJECTIVE: To investigate the feasibility of using a General Practice registrar (GPR) to coordinate rural palliative care services. DESIGN: A quasi-experimental design was used. Intervention group participants received the GPR service, which involved liaison among the patient, family, General Practitioner, specialist palliative care team and community nurses. Specified risk assessment, care planning and continuity of care were provided. Patients in the comparison group received the standard service...
June 2017: Australian Journal of Rural Health
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