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"Avoidable admissions"

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https://www.readbyqxmd.com/read/27846005/novel-emergency-department-risk-score-discriminates-acute-coronary-syndrome-among-chest-pain-patients-with-known-coronary-artery-disease
#1
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
#2
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...
October 7, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27612980/increase-in-avoidable-hospital-admissions-after-the-great-east-japan-earthquake
#3
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
#4
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...
August 22, 2016: 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
#5
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...
July 6, 2016: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/27182030/intravenous-home-infusion-therapy-instituted-from-a-24-hour-clinical-decision-unit-for-patients-with-cellulitis
#6
Manjusha Rentala, Shari Andrews, Allison Tiberio, Kumar Alagappan, Tammy Tavdy, Patrick Sheppard, Robert Silverman
OBJECTIVES: The objective of the study is to evaluate whether patients with cellulitis can be safely discharged from a 24-hour clinical decision unit (CDU) with home infusion of intravenous (IV) antibiotics. METHODS: Clinical decision unit patients receiving IV antibiotics for cellulitis were screened for enrollment in a home infusion therapy (HIT) program. Inclusion criteria were patient ability and willingness to administer IV antibiotics at home and insurers' approval of home infusion services...
July 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27139520/a-pilot-programme-of-clinical-practice-improvement-for-future-consultant-doctors
#7
Kim Oates, Cathy Vinters, John Cass-Verco, Mandy Fletcher, Narinder Kaur, Martha Mherekumombe, Alice Tang
BACKGROUND: To provide junior doctors with tools to improve patient care in their workplace, a partnership was developed between the Clinical Excellence Commission (CEC) and the Royal Australasian College of Physicians (RACP) to help trainee consultants carry out clinical practice improvement (CPI) projects during clinical work. METHODS: Based on a patient-care problem they wished to resolve, trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods, describe their proposals and refine them using CPI methodology...
May 3, 2016: Clinical Teacher
https://www.readbyqxmd.com/read/26932140/costs-effects-and-implementation-of-routine-data-emergency-admission-risk-prediction-models-in-primary-care-for-patients-with-or-at-risk-of-chronic-conditions-a-systematic-review-protocol
#8
Mark Rhys Kingston, Bridie Angela Evans, Kayleigh Nelson, Hayley Hutchings, Ian Russell, Helen Snooks
INTRODUCTION: Emergency admission risk prediction models are increasingly used to identify patients, typically with one or more chronic conditions, for proactive management in primary care to avoid admissions, save costs and improve patient experience. AIM: To identify and review the published evidence on the costs, effects and implementation of emergency admission risk prediction models in primary care for patients with, or at risk of, chronic conditions. METHODS: We shall search for studies of healthcare interventions using routine data-generated emergency admission risk models...
2016: BMJ Open
https://www.readbyqxmd.com/read/26931507/integrated-health-service-delivery-networks-and-tuberculosis-avoidable-hospitalizations-is-there-a-relation-between-them-in-brazil
#9
Marcela Paschoal Popolin, Michelle Mosna Touso, Mellina Yamamura, Ludmila Barbosa Bandeira Rodrigues, Maria Concebida da Cunha Garcia, Luiz Henrique Arroyo, Antônio Carlos Vieira Ramos, Thais Zamboni Berra, Marcelino Santos Neto, Juliane de Almeida Crispim, Francisco Chiaravalotti Neto, Ione Carvalho Pinto, Pedro Fredemir Palha, Severina Alice da Costa Uchoa, Luís Velez Lapão, Inês Fronteira, Ricardo Alexandre Arcêncio
BACKGROUND: The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is also one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. The purpose of this study is to consider which attributes and which territories have shown the most significant progress in Primary Health Care, in terms of coordination of Health Care Networks, and also check if those areas of Primary Health Care that are most critical regarding coordination, there were more or less cases of avoidable hospitalizations for tuberculosis...
March 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/26916687/qualitative-critical-incident-study-of-patients-experiences-leading-to-emergency-hospital-admission-with-advanced-respiratory-illness
#10
MULTICENTER STUDY
Eleni Karasouli, Daniel Munday, Cara Bailey, Sophie Staniszewska, Alistair Hewison, Frances Griffiths
OBJECTIVES: The high volume of emergency admissions to hospital is a challenge for health systems internationally. Patients with lung cancer and chronic obstructive pulmonary disease (COPD) are frequently admitted to hospital as emergency cases. While the frequency of emergency admission has been investigated, few studies report patient experiences, particularly in relation to the decision-making process prior to emergency admission. We sought to explore patient and carer experiences and those of their healthcare professionals in the period leading up to emergency admission to hospital...
February 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/26720507/using-avoidable-admissions-to-measure-quality-of-care-for-cardiometabolic-and-other-physical-comorbidities-of-psychiatric-disorders-a-population-based-record-linkage-analysis
#11
Steve Kisely, Carolyn Ehrlich, Elizabeth Kendall, David Lawrence
OBJECTIVE: Quality of care for comorbid physical disorders in psychiatric patients can be assessed by the number of avoidable admissions for ambulatory care sensitive (ACS) conditions. These are admissions for physical conditions that, with appropriate primary care, should not require inpatient treatment. Avoidable admissions for ACS conditions feature prominently in Australia's National Health Performance Framework and have been used to assess health care provision for marginalized groups, such as Indigenous patients or those of lower socioeconomic status...
November 2015: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/26667862/-characterization-and-evolution-of-avoidable-admissions-in-portugal-the-impact-of-two-methodologic-approaches
#12
João Sarmento, Conceição Alves, Paula Oliveira, Rita Sebastião, Rui Santana
INTRODUCTION: The aim of this study is to evaluate the health systems performance through the avoidable hospital admissions, once these have gained international relevance. We used two different methods to identify the admissions for Ambulatory Care Sensitive Conditions, describing the Portuguese reality and evolution. MATERIAL AND METHODS: Over 12 million hospitalizations were analyzed between 2000 and 2012 using the national hospital discharge databases. We used two different methodologies to identify the hospitalizations for Ambulatory Care Sensitive Conditions, determining their concordance...
September 2015: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/26489696/identifying-the-causes-prevention-and-management-of-crises-in-dementia-an-online-survey-of-stakeholders
#13
Ritchard Ledgerd, Juanita Hoe, Zoë Hoare, Mike Devine, Sandeep Toot, David Challis, Martin Orrell
BACKGROUND: Crisis situations in dementia can lead to hospital admission or institutionalisation. Offering immediate interventions may help avoid admission, whilst stabilising measures can help prevent future crises. OBJECTIVE: Our objective was to identify the main causes of crisis and interventions to treat or prevent crisis in persons with dementia based on different stakeholder perspectives. METHODS: An online questionnaire was developed to identify the causes of crisis and appropriate interventions in a crisis...
June 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/26439460/room-for-one-more-a-review-of-the-literature-on-inappropriate-admissions-to-hospital-for-older-people-in-the-english-nhs
#14
Rachel Thwaites, Jon Glasby, Nick le Mesurier, Rosemary Littlechild
This paper reports the findings of a review of the literature on emergency admissions to hospital for older people in the UK, undertaken between May and June 2014 at the Health Services Management Centre, University of Birmingham. This review sought to explore: the rate of in/appropriate emergency admissions of older people in the UK; the way this is defined in the literature; solutions proposed to reduce the rate of inappropriate admissions; and the methodological issues which particular definitions of 'inappropriateness' raise...
October 5, 2015: Health & Social Care in the Community
https://www.readbyqxmd.com/read/26248621/variation-in-avoidable-emergency-admissions-multiple-case-studies-of-emergency-and-urgent-care-systems
#15
Alicia O'Cathain, Emma Knowles, Janette Turner, Enid Hirst, Steve Goodacre, Jon Nicholl
OBJECTIVE: To identify factors affecting variation in avoidable emergency admissions that are not usually identified in statistical regression. METHODS: As part of an ethnographic residual analysis, we compared six emergency and urgent care systems in England, interviewing 82 commissioners and providers of key emergency and urgent care services. RESULTS: There was variation between the six cases in how interviewees described three parts of their emergency and urgent care systems...
January 2016: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/26230436/-hiv-aids-patients-in-a-critical-care-unit-the-experience-of-a-general-hospital-in-a-developing-country
#16
Fernando Verdugo, Francisco Pinto, Paulo Charpentier, Christian Von Mühlenbrock, Andrés Soto, Jeannette Dabanch, Alberto Fica
INTRODUCTION AND AIMS: Despite general availability of HAART in Chile, admissions of HIV/AIDS patients to Intensive-Intermediate Care Units (IICU) are still happening, and a characterization of patient's profile, mortality and potentially avoidable admissions is necessary. METHODS: Observational retrospective study in one general hospital in Chile of HIV/AIDS patients admitted to IICU during 9 years. RESULTS: During 2005-2013, 32 patients were admitted to IICU, with 87,5% in AIDS stage, only 53,1% knew his/her condition, 43,8% were receiving HAART and 16...
June 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/26186598/effectiveness-of-case-management-for-at-risk-patients-in-primary-care-a-systematic-review-and-meta-analysis
#17
REVIEW
Jonathan Stokes, Maria Panagioti, Rahul Alam, Kath Checkland, Sudeh Cheraghi-Sohi, Peter Bower
BACKGROUND: An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. METHODS AND FINDINGS: We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care...
2015: PloS One
https://www.readbyqxmd.com/read/26141211/a-case-of-an-avoidable-admission-to-an-ebola-treatment-unit-with-malaria-and-an-associated-heat-illness
#18
Andrew T Cox, I Schoonbaert, T Trinick, A Phillips, D Marion
We present a 27-year old British nurse admitted to the Kerry Town Ebola Treatment Unit, Sierra Leone, with symptoms fitting suspect-Ebola virus disease (EVD) case criteria. A diagnosis of Plasmodium falciparum malaria and heat illness was ultimately made, both of which could have been prevented through employing simple measures not utilised in this case. The dual pathology of her presentation was atypical for either disease meaning EVD could not be immediately excluded. She remained isolated in the red zone until 72 h from symptom onset...
June 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/25848622/enhancing-a-geriatric-emergency-department-care-coordination-intervention-using-automated-health-information-exchange-based-clinical-event-notifications
#19
David L Gutteridge, Nicholas Genes, Ula Hwang, Benjamin Kaplan, Jason S Shapiro
PURPOSE: In a health care system where patients often have numerous providers and multiple chronic medical conditions, interoperability of health information technology (HIT) is of paramount importance. Regional health information organizations (RHIO) often provide a health information exchange (HIE) as a solution, which gives stakeholders access to clinical data that they otherwise would not otherwise have. A secondary use of preexisting HIE infrastructure is clinical event notification (CEN) services, which send automated notifications to stakeholders...
2014: EGEMS
https://www.readbyqxmd.com/read/25690128/potentially-avoidable-hospitalizations-in-five-european-countries-in-2009-and-time-trends-from-2002-to-2009-based-on-administrative-data
#20
COMPARATIVE STUDY
Lau C Thygesen, Terkel Christiansen, Sandra Garcia-Armesto, Ester Angulo-Pueyo, Natalia Martínez-Lizaga, Enrique Bernal-Delgado
INTRODUCTION: Potentially avoidable hospitalizations in chronic conditions are used to evaluate health-care performance. However, evidence comparing different countries at small geographical areas is still scarce. The aim of the present study is to describe and discuss differences in rates and time-trends across health-care areas from five European countries. METHODS: Observational, ecological study, on virtually all discharges produced in five European countries between 2002 and 2009...
February 2015: European Journal of Public Health
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