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https://www.readbyqxmd.com/read/28535285/delayed-hospital-discharges-of-older-patients-a-systematic-review-on-prevalence-and-costs
#1
Filipa Landeiro, Kenny Roberts, Alastair Mcintosh Gray, José Leal
Purpose of the Study: To determine the prevalence of delayed discharges of elderly inpatients and associated costs. Design and Methods: We searched Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO - CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE - Social Care Online for evidence published between 1990 and 2015 on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals...
May 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28529021/frail-older-adults-perceptions-of-an-in-hospital-structured-exercise-intervention
#2
Louise O'Hare, Eileen Savage, Ruth McCullagh, Eleanor Bantry White, Eilis Fitzgerald, Suzanne Timmons
BACKGROUND: Exercise interventions need to be assessed qualitatively to establish how people participate in and perceive the intervention and how interventions should be delivered for maximal effect. OBJECTIVES: To explore how frail older inpatients perceived the effects of a pilot augmented prescribed exercise programme (APEP). DESIGN: An interpretive phenomenological design using open-ended semi-structured interviews. Data were analysed using thematic content analysis...
April 24, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28528882/mortality-and-atrial-fibrillation-in-the-fiaca-study-evidence-of-a-differential-effect-according-to-admission-diagnosis
#3
Francisco Guillermo Clavel-Ruipérez, Luciano Consuegra-Sánchez, Francisco Javier Félix Redondo, Luis Lozano Mera, Pedro Mellado-Delgado, Juan José Martínez-Díaz, José Ramón López Mínguez, Daniel Fernández-Bergés
INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is an independent risk factor for mortality in several diseases. However, data published in acute decompensated heart failure (DHF) are contradictory. Our objective was to investigate the impact of AF on mortality in patients admitted to hospital for DHF compared with those admitted for other reasons. METHODS: This retrospective cohort study included all patients admitted to hospital within a 10-year period due to DHF, acute myocardial infarction (AMI), or ischemic stroke (IS), with a median follow-up of 6...
May 18, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28528221/bronchopulmonary-dysplasia-and-perinatal-characteristics-predict-1-year-respiratory-outcomes-in-newborns-born-at-extremely-low-gestational-age-a-prospective-cohort-study
#4
Roberta L Keller, Rui Feng, Sara B DeMauro, Thomas Ferkol, William Hardie, Elizabeth E Rogers, Timothy P Stevens, Judith A Voynow, Scarlett L Bellamy, Pamela A Shaw, Paul E Moore
OBJECTIVE: To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). STUDY DESIGN: We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze)...
May 17, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28526371/the-psychosocial-needs-of-adolescent-males-following-interpersonal-assault
#5
Rachel K Myers, Laura Vega, Alison J Culyba, Joel A Fein
PURPOSE: We examined the self-identified, postassault psychosocial needs of male adolescents to guide recovery and healing after being seen in an emergency department (ED) for a violence-related injury. METHODS: We analyzed deidentified data from 49 adolescent male adolescents who participated in a postdischarge case management program following a violence-related injury. Descriptive statistics summarized youths' demographic characteristics and self-identified needs and goals for postassault recovery...
May 8, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28521598/malnutrition-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#6
Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28511191/death-by-suicide-within-1-week-of-hospital-discharge-a-retrospective-study-of-root-cause-analysis-reports
#7
Natalie Riblet, Brian Shiner, Bradley V Watts, Peter Mills, Brett Rusch, Robin R Hemphill
There is a high risk for death by suicide after discharge from an inpatient mental health unit. To better understand system and organizational factors associated with postdischarge suicide, we reviewed root cause analysis reports of suicide within 7 days of discharge from across all Veterans Health Administration inpatient mental health units between 2002 and 2015. There were 141 reports of suicide within 7 days of discharge, and a large proportion (43.3%, n = 61) followed an unplanned discharge. Root causes fell into three major themes including challenges for clinicians and patients after the established process of care, awareness and communication of suicide risk, and flaws in the established process of care...
May 16, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28506980/sex-differences-in-trajectories-of-risk-after-rehospitalization-for-heart-failure-acute-myocardial-infarction-or-pneumonia
#8
Rachel P Dreyer, Kumar Dharmarajan, Angela F Hsieh, John Welsh, Li Qin, Harlan M Krumholz
BACKGROUND: Women have an increased risk of rehospitalization in the immediate postdischarge period; however, few studies have determined how readmission risk dynamically changes on a day-to-day basis over the full year after hospitalization by sex and how these differences compare with the risk for mortality. METHODS AND RESULTS: We identified >3 000 000 hospitalizations of patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia and estimated sex differences in the daily risk of rehospitalization/death 1 year after discharge from a population of Medicare fee-for-service beneficiaries aged 65 years and older...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506976/implementation-of-postdischarge-follow-up-telephone-calls-at-a-comprehensive-cancer-center
#9
Shrina D Patel, Phuoc Anh Anne Nguyen, Melissa Bachler, Bradley Atkinson
PURPOSE: The development and implementation of a pharmacy-driven, postdischarge follow-up telephone call program to assess medication adherence, provide education, and address medication-related concerns are discussed. SUMMARY: Many readmissions are avoidable through effective discharge planning and patient follow-up after hospitalization. However, there is limited information on how to effectuate this process. To address this barrier, a team consisting of a clinical pharmacy specialist, a clinical pharmacy manager, a postgraduate year 1 pharmacy resident, and an education specialist at The University of Texas MD Anderson Cancer Center collaborated to create a postdischarge telephone call program within a transitions-of-care (TOC) pilot program...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28501416/digoxin-and-30-day-all-cause-readmission-in-long-term-care-residents-hospitalized-for-heart-failure
#10
Helen M Sheriff, Manik R Thogaripally, Gurusher Panjrath, Cherinne Arundel, Qing Zeng, Gregg C Fonarow, Javed Butler, Ross D Fletcher, Charity Morgan, Marc R Blackman, Prakash Deedwania, Thomas E Love, Wilbert S Aronow, Stefan D Anker, Richard M Allman, Ali Ahmed
BACKGROUND: Digoxin use has been shown to be associated with a lower risk of 30-day all-cause hospital readmissions in older patients with heart failure (HF). In the current study, we examined this association among long-term care (LTC) residents hospitalized for HF. METHODS: Of the 8049 Medicare beneficiaries discharged alive after hospitalization for HF from 106 Alabama hospitals, 545 (7%) were LTC residents, of which 227 (42%) received discharge prescriptions for digoxin...
May 11, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28500063/oral-antibiotics-are-as-effective-as-intravenous-antibiotics-for-postdischarge-treatment-of-complicated-pneumonia-in-children
#11
Igho Onakpoya
No abstract text is available yet for this article.
May 12, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28498938/healthcare-resource-utilization-and-patient-reported-outcomes-following-elective-surgery-for-intradural-extramedullary-spinal-tumors
#12
Silky Chotai, Scott L Zuckerman, Scott L Parker, Joseph B Wick, David P Stonko, Andrew T Hale, Matthew J McGirt, Joseph S Cheng, Clinton J Devin
BACKGROUND: Healthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported. OBJECTIVE: To analyze the PROs, costs, and resource utilization 1 year following surgical resection of IDEM tumors. METHODS: Patients undergoing elective spine surgery for IDEM tumors and enrolled in a single-center, prospective, longitudinal registry were analyzed. Baseline and postoperative 1-year PROs were recorded...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498068/predictors-of-extended-length-of-stay-discharge-to-inpatient-rehab-and-hospital-readmission-following-elective-lumbar-spine-surgery-introduction-of-the-carolina-semmes-grading-scale
#13
Matthew J McGirt, Scott L Parker, Silky Chotai, Deborah Pfortmiller, Jeffrey M Sorenson, Kevin Foley, Anthony L Asher
OBJECTIVE Extended hospital length of stay (LOS), unplanned hospital readmission, and need for inpatient rehabilitation after elective spine surgery contribute significantly to the variation in surgical health care costs. As novel payment models shift the risk of cost overruns from payers to providers, understanding patient-level risk of LOS, readmission, and inpatient rehabilitation is critical. The authors set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28495660/geriatric-patient-safety-indicators-based-on-linked-administrative-health-data-to-assess-anticoagulant-related-thromboembolic-and-hemorrhagic-adverse-events-in-older-inpatients-a-study-proposal
#14
Marie-Annick Le Pogam, Catherine Quantin, Oliver Reich, Philippe Tuppin, Anne Fagot-Campagna, Fred Paccaud, Isabelle Peytremann-Bridevaux, Bernard Burnand
BACKGROUND: Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide...
May 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28490429/closing-the-care-gap-a-primer-on-quality-improvement-for-heart-failure-clinicians
#15
REVIEW
Yasbanoo Moayedi, Toni Schofield, Edward Etchells, Samuel A Silver, Jeremy Kobulnik, Rory McQuillan, Chaim Bell, Meredith Linghorne, Heather J Ross
Quality improvement (QI) initiatives have become an integral part of patient-centered care. In this primer, we outline 6 steps for initiating, implementing, and monitoring improvement in heart failure care. These steps include acknowledging that improvement is needed and setting a culture for improvement; forming a QI team; understanding the local problem; generating improvement strategies that will fit with the local problem; monitoring; testing; and refining improvements, analysis of data, and interpretation of run charts...
May 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28486325/experiences-of-older-adult-trauma-patients-discharged-home-from-a-level-i-trauma-center
#16
Nathalie Rodrigue, Andréa Maria Laizner, Nancy Tze, Maida Sewitch
The number of patients 65 years and older has been rising steadily every year at our Level I trauma center. Our clinical experience demonstrated that once discharged, some of these patients were not managing well. Postdischarge portrait is difficult to ascertain because this information is not captured in the trauma registry database. The purpose of this study was to describe the experiences of hospitalized trauma patients 65 years and older who are discharged home. A descriptive cross-sectional study of hospitalized trauma patients was conducted 1 month postdischarge using PREPARED Patient and 36-item Short Form Health Survey questionnaires...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28485527/contributions-of-cognitions-psychological-flexibility-and-therapeutic-alliance-to-suicidal-ideation-in-psychiatric-inpatients
#17
Katrina A Rufino, Thomas E Ellis
Although suicide treatment is an expanding area of research, there is relatively less in the literature with respect to how specific vulnerabilities to suicide are addressed by treatment. Utilizing measures of suicide cognitions, therapeutic alliance, and psychological flexibility, we compared their relative contributions to suicidal ideation during and posttreatment among a group of adult psychiatric inpatients (N = 434). Results revealed that cognitions contributed considerably more unique variance to suicidal ideation than alliance and flexibility at discharge and at 2 weeks postdischarge, and to change in suicidal ideation over the course of treatment...
May 9, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28485315/assessment-of-1-year-outcomes-in-survivors-of-severe-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation-or-mechanical-ventilation-a-prospective-observational-study
#18
Zhi-Yong Wang, Tong Li, Chun-Ting Wang, Lei Xu, Xin-Jing Gao
BACKGROUND: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population. METHODS: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28483774/observed-cost-and-variations-in-short-term-cost-effectiveness-of-therapy-for-ischemic-stroke-in-interventional-management-of-stroke-ims-iii
#19
Kit N Simpson, Annie N Simpson, Patrick D Mauldin, Yuko Y Palesch, Sharon D Yeatts, Dawn Kleindorfer, Thomas A Tomsick, Lydia D Foster, Andrew M Demchuk, Pooja Khatri, Michael D Hill, Edward C Jauch, Tudor G Jovin, Bernard Yan, Rüdiger von Kummer, Carlos A Molina, Mayank Goyal, Wouter J Schonewille, Mikael Mazighi, Stefan T Engelter, Craig Anderson, Judith Spilker, Janice Carrozzella, Karla J Ryckborst, L Scott Janis, Joseph P Broderick
BACKGROUND: Examination of linked data on patient outcomes and cost of care may help identify areas where stroke care can be improved. We report on the association between variations in stroke severity, patient outcomes, cost, and treatment patterns observed over the acute hospital stay and through the 12-month follow-up for subjects receiving endovascular therapy compared to intravenous tissue plasminogen activator alone in the IMS (Interventional Management of Stroke) III Trial. METHODS AND RESULTS: Prospective data collected for a prespecified economic analysis of the trial were used...
May 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28468726/erratum-to-postdischarge-complications-following-nonoperative-management-of-blunt-splenic-injury-am-j-surg-211-4-2016-744-749
#20
Gil Freitas, Olubode A Olufajo, Khaled Hammouda, Elissa Lin, Zara Cooper, Joaquim M Havens, Reza Askari, Ali Salim
No abstract text is available yet for this article.
April 30, 2017: American Journal of Surgery
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