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https://www.readbyqxmd.com/read/29785689/the-impact-of-hospital-costing-methods-on-cost-effectiveness-analysis-a-case-study
#1
José Leal, Stefania Manetti, James Buchanan
BACKGROUND: Several methods exist to cost hospital contacts when estimating the cost effectiveness of a new intervention. However, the implications of choosing a particular approach remain unclear. We compare the use of the three main diagnosis-related group (DRG)-based national unit costs in England to determine whether choice of approach can impact on economic evaluation results. METHODS: A cost-utility model was developed to compare secondary fracture prevention models of care for hip fracture patients, using data from large primary and hospital care administrative datasets in England...
May 22, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29784001/appropriateness-of-malaria-diagnosis-and-treatment-for-fever-episodes-according-to-patient-history-and-anti-malarial-blood-measurement-a-cross-sectional-survey-from-tanzania
#2
Joanna Gallay, Dominic Mosha, Erick Lutahakana, Festo Mazuguni, Martin Zuakulu, Laurent Arthur Decosterd, Blaise Genton, Emilie Pothin
BACKGROUND: Monitoring the impact of case management strategies at large scale is essential to evaluate the public health benefit they confer. The use of methodologies relying on objective and standardized endpoints, such as drug levels in the blood, should be encouraged. Population drug use, diagnosis and treatment appropriateness in case of fever according to patient history and anti-malarials blood concentration was evaluated. METHODS: A cross-sectional survey took place between May and August 2015 in three regions of Tanzania with different levels of malaria endemicity...
May 21, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29783977/effective-coverage-of-essential-inpatient-care-for-small-and-sick-newborns-in-a-high-mortality-urban-setting-a-cross-sectional-study-in-nairobi-city-county-kenya
#3
Georgina A V Murphy, David Gathara, Jacintah Mwachiro, Nancy Abuya, Jalemba Aluvaala, Mike English
BACKGROUND: Effective coverage requires that those in need can access skilled care supported by adequate resources. There are, however, few studies of effective coverage of facility-based neonatal care in low-income settings, despite the recognition that improving newborn survival is a global priority. METHODS: We used a detailed retrospective review of medical records for neonatal admissions to public, private not-for-profit (mission) and private-for-profit (private) sector facilities providing 24×7 inpatient neonatal care in Nairobi City County to estimate the proportion of small and sick newborns receiving nationally recommended care across six process domains...
May 22, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#4
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29780847/community-acquired-respiratory-paramyxovirus-infection-after-allogeneic-hematopoietic-cell-transplantation-a-single-center-experience
#5
Yasmin Spahr, Sarah Tschudin-Sutter, Veronika Baettig, Francesca Compagno, Michael Tamm, Jörg Halter, Sabine Gerull, Jakob Passweg, Hans H Hirsch, Nina Khanna
Background: Paramyxoviruses include respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (MPV), which may cause significant respiratory tract infectious disease (RTID) and mortality after allogeneic hematopoietic cell transplantation (HCT). However, clinical data regarding frequency and outcome are scarce. Methods: We identified all paramyxovirus RTIDs in allogeneic HCT recipients diagnosed by multiplex polymerase chain reaction between 2010 and 2014...
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29779797/the-function-of-the-heart-is-historically-contingent
#6
Nicholas Binney
Some philosophers of medicine argue that there are objective facts about the biological function of organs, and that these facts are used to objectively define diseases. The function of the heart is taken to be particularly obvious and well established. Contrary to this, I argue that the function of the heart is not fixed by nature, but rather that it is historically contingent. The disease heart failure results from the dysfunction of the heart. In opposition to the common-sense intuitions of philosophers, medics do not define heart failure simply as a reduced cardiac output, and up to half of patients with heart failure have a normal cardiac output...
May 17, 2018: Studies in History and Philosophy of Biological and Biomedical Sciences
https://www.readbyqxmd.com/read/29777967/rates-and-correlates-of-disordered-eating-among-women-veterans-in-primary-care
#7
Laura J Buchholz, Paul R King, Laura O Wray
Rates of disordered eating may be higher among women veterans than civilians, and are associated with co-occurring mental health (MH) conditions, such as depression, post-traumatic stress disorder (PTSD), and alcohol misuse. Although evidence suggests that these conditions are common in primary care settings, limited research has examined symptoms of disordered eating among women veterans in primary care. This study used a cross-sectional design to examine rates and MH correlates of disordered eating among women veterans treated in a primary care setting...
May 16, 2018: Eating Behaviors
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#8
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29777470/prevalence-of-depression-among-caregivers-of-indian-children-with-cystic-fibrosis
#9
Javeed Iqbal Bhat, Wasim Ahmad Wani, Bashir A Charoo, Syed Wajid Ali, Qazi Iqbal Ahmad, Ambreen Ali Ahangar
OBJECTIVE: To study the prevalence of depression among caregivers of children with cystic fibrosis and its impact on the health and well being of these children. METHODS: This cross-sectional study was conducted in a tertiary care hospital from September 2015 through August 2016. Forty one parents of children receiving treatment at the Cystic fibrosis (CF) clinic were approached to be part of the study. Six families declined the request resulting in 85% recruitment rate...
May 19, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29777461/hiv-aids-and-an-overweight-body-mass-are-associated-with-excessive-intra-individual-variability-in-response-preparation
#10
Lance O Bauer
Factors other than HIV/AIDS may influence the cognitive function of patients living with this disease. The present study tested the influence of a common comorbid problem-an overweight body mass. It also examined intra-task variabilities in performance and brain activation as potentially more sensitive indicators of dysfunction than their mean levels. One-hundred seventy-eight participants were recruited and categorized by HIV-1 serostatus (-/+) and body mass (BMI < 26/≥ 26 kg/m2 ). They performed a simple time estimation task during which response time accuracy and electroencephalographic readiness potentials were recorded...
May 17, 2018: Journal of Neurovirology
https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#11
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29776452/work-related-musculoskeletal-disorders-among-registered-general-nurses-a-case-of-a-large-central-hospital-in-harare-zimbabwe
#12
M Chiwaridzo, V Makotore, J M Dambi, N Munambah, M Mhlanga
OBJECTIVE: Worldwide, work-related musculoskeletal disorders (WMSDs) are a common cause of morbidity affecting occupational individuals such as health-care professionals. However, nothing is known about WMSDs in hospital nurses in Zimbabwe. This study was conducted to provide cross-sectional evidence of the 12-month prevalence, consequences and factors associated with WMSDs among 208 nurses at Parirenyatwa Group of Hospitals (PGH). RESULTS: The response rate for the study was 55...
May 18, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29775967/bilateral-breast-calciphylaxis-in-a-patient-who-survived-earlier-extensive-tissue-necrosis-5-years-previously-a-case-report
#13
E M J Verstappen, A J G Maaskant-Braat, M R Scheltinga
INTRODUCTION: Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. PRESENTATION OF CASE: A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29775774/hospital-admissions-2000-2014-a-retrospective-analysis-of-288-096-events-in-patients-with-dementia
#14
Catarina Bernardes, João Massano, Alberto Freitas
INTRODUCTION: Dementia is a leading cause of disability worldwide. It is associated with an increased risk of hospitalization, imposing a significant burden on healthcare systems. The evidence on the long-term evolution of this issue and broadly on healthcare systems is currently limited. This study aims to describe the hospitalizations of people who received a diagnosis of dementia admitted to public general hospitals in a western European country with universal health coverage, over more than a decade...
May 8, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29775557/symptoms-of-obstructive-sleep-apnea-nasal-obstruction-and-enuresis-in-children-with-nonsyndromic-cleft-lip-and-palate-a-prevalence-study
#15
Marilyse de Bragança Lopes Fernandes, Alícia Graziela Noronha Silva Salgueiro, Eliete Janaína Bueno Bighetti, Ivy Kiemle Trindade-Suedam, Inge Elly Kiemle Trindade
OBJECTIVE: To estimate the prevalence of symptoms of obstructive sleep apnea (OSA), nasal obstruction, and enuresis in children with nonsyndromic unilateral cleft lip and palate. DESIGN: Prospective cross-sectional study. SETTING: Referral care center. PARTICIPANTS: One hundred seventy-four children aged 6 to 12 years of both genders. INTERVENTIONS: Symptoms of OSA and nasal obstruction were investigated by analysis of scores obtained by the Sleep Disturbance Scale for Children (SDSC) and Congestion Quantifier (CQ-5)...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29775513/conflicting-priorities-observation-of-medicines-administration
#16
Johanne Alteren, Marit Hermstad, Jo White, Susan Jordan
AIMS AND OBJECTIVES: To identify sources of interruptions and distractions to medicine administration rounds in hospitals. BACKGROUND: Nurses are frequently interrupted during medicine administration. There is no systematic description of nurses' behaviours and interruptions during administration of medicines to patients. DESIGN: Exploratory non-participant observational study. METHODS: Three hundred and fifty-one episodes of medicines administration with 32 nurses from three hospitals in Norway were observed using paper-based observation grids between December 2013 and March 2014...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775088/an-assessment-of-the-uk-inpatient-care-for-heart-failure-patients-with-diabetes
#17
Lihua Wu, Jackie Cleator, Mamas Mamas, Christi Deaton
BACKGROUND: Diabetes is a common co-morbidity for patients with heart failure. Diabetes as a co-morbidity means that inpatient care should focus on both conditions to maximize the treatment regimen. However, this pressing issue is not widely researched and so it is unclear whether the acute care management needs of these patients are being met. AIMS: (1) To assess the differences in the number of hospital readmissions between patients with heart failure and patients with heart failure-diabetes; (2) to assess the use of integrated care approach for patients with heart failure-diabetes during the index heart failure-related admission; (3) to explore patient experiences of admissions...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29773516/lymphoedema-management-to-prevent-acute-dermatolymphangioadenitis-in-podoconiosis-in-northern-ethiopia-golbet-a-pragmatic-randomised-controlled-trial
#18
Henok Negussie, Meseret Molla, Moses Ngari, James A Berkley, Esther Kivaya, Patricia Njuguna, Greg Fegan, Abreham Tamiru, Abebe Kelemework, Trudie Lang, Melanie J Newport, Andy McKay, Fikre Enquoselassie, Gail Davey
BACKGROUND: Podoconiosis (also known as endemic, non-filarial elephantiasis) affects about 4 million subsistence farmers in tropical Africa. Poor awareness of the condition and inadequate evidence for the efficacy of treatment mean that no government in an endemic country yet offers lymphoedema management for patients with podoconiosis. Among patients with filarial lymphoedema, trials suggest that limb care is effective in reducing the most disabling sequelae: episodes of acute dermatolymphangioadenitis...
May 14, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29773304/outpatient-total-elbow-arthroplasty-90-day-outcomes
#19
Michael A Stone, Paramjit Singh, Santano L Rosario, Reza Omid
BACKGROUND: Interest in outpatient arthroplasty has grown in response to increasing emphasis on the efficient delivery of safe, high-quality medical care. This study evaluated 90-day episode-of-care complications after outpatient total elbow arthroplasty (TEA). MATERIALS AND METHODS: We retrospectively evaluated 28 patients discharged the same day after primary TEA for 90-day episode-of-care complications, reoperations, and readmissions. Postoperative complications and elbow range of motion measurements were recorded and evaluated at the latest follow-up...
May 14, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#20
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
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