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"multiple hospitalizations"

Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin
BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS...
2018: PloS One
Craig D Newgard, Rochelle Fu, Susan Malveau, Tom Rea, Denise E Griffiths, Eileen Bulger, Pat Klotz, Abbie Tirrell, Dana Zive
Conducting out-of-hospital research is unique and challenging and requires tracking patients across multiple phases of care, using multiple sources of patient records and multiple hospitals. The logistics and strategies used for out-of-hospital research are distinct from other forms of clinical research. The increasing use of electronic health records (EHRs) by hospitals and emergency medical services (EMS) agencies presents a large opportunity for accelerating out-of-hospital research, as well as particular challenges...
March 1, 2018: Prehospital Emergency Care
Mohammad Jafferany, Zaira Khalid, Katherine A McDonald, Amanda J Shelley
Factitious disorder can present in multiple health care settings, with patients intentionally producing symptoms to assume the sick role. This assumption of the sick role can result in multiple hospitalizations with unnecessary diagnostic workup, as well as invasive diagnostic procedures that can lead to worrisome side effects. Differential diagnoses that should be ruled out include malingering, somatic symptom disorder, and anxiety disorders. For many providers, patients with factitious disorder can be a challenge to treat because the etiology of the disorder remains unclear...
February 22, 2018: Primary Care Companion to CNS Disorders
Melissa Horlait, Simon Van Belle, Mark Leys
BACKGROUND: Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects-such as the patients' living situation, possible family problems, patients' mental state, and patients' perceptions and values or preferences towards treatment or care-are considered and discussed during MDTMs...
February 26, 2018: JMIR Research Protocols
Shunsuke Takadama, Hidemasa Nakaminami, Asami Sato, Manami Shoshi, Takeshi Fujii, Norihisa Noguchi
OBJECTIVE: Panton-Valentine leukocidin (PVL) gene (lukS/F-PV)-positive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly the USA300 clone, is a health concern worldwide. Recently, CA-MRSA clones have been found to spread and persist in hospital settings. In this study, we aimed to investigate the prevalence and molecular epidemiological features of lukS/F-PV-positive MRSA in Japanese hospitals. METHODS: A total of 3,433 MRSA isolated from nine hospitals in 2011-2015 were used...
February 15, 2018: Clinical Microbiology and Infection
E C Deasy, E M Moloney, M A Boyle, J S Swan, D A Geoghegan, G I Brennan, T E Fleming, M J O'Donnell, D C Coleman
BACKGROUND: Outbreaks of infection associated with microbial biofilm in hospital hand washbasin U-bends are increasingly being reported. In a previous study the efficacy of a prototype automated U-bend decontamination method was demonstrated for a single non-hospital pattern washbasin. It used two electrochemically-activated solutions generated from brine; a catholyte with detergent properties and anolyte with disinfectant properties. AIM: To develop and test a large-scale automated ECA-treatment system to simultaneously decontaminate 10 hospital pattern washbasin U-bends in a busy hospital clinic...
February 1, 2018: Journal of Hospital Infection
Katharina L van Santen, Jonathan R Edwards, Amy K Webb, Lori A Pollack, Erin O'Leary, Melinda M Neuhauser, Arjun Srinivasan, Daniel A Pollock
Background: To provide a standardized, risk-adjusted method for summarizing antibiotic use (AU) and to enable hospitals to track their AU over time and compare their AU data to national benchmarks, CDC developed a new metric, the Standardized Antimicrobial Administration Ratio (SAAR). Methods: Hospitals reporting to the National Healthcare Safety Network (NHSN) AU Option collect and submit aggregated AU data electronically as antimicrobial days of therapy per patient days present...
February 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
S Suresh, G S De Oliveira
BACKGROUND: The knowledge regarding appropriate dosage of local anaesthetics for peripheral nerve blocks in children is very scarce. The main objective of the current investigation was to evaluate dosing patterns of local anaesthetics in children receiving peripheral nerve blocks across multiple paediatric hospitals in the USA. We also sought to estimate the incidence of local anaesthetic systemic toxicity. METHODS: This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database...
February 2018: British Journal of Anaesthesia
Mei-Feng Huang, Chen-Hsiang Su, Hung-Pin Tu, Tai-Ling Liu, Chih-Lung Lin, Cheng-Sheng Chen, Yi-Chun Yeh
Mental disorders may confer a high risk of traumatic brain injury, but only rare studies have investigated mood disorders. This nationwide cohort study compared the risk of traumatic brain injury in patients with and without bipolar disorder. We compared 1017 patients with bipolar disorder who received inpatient treatment and 9080 compared patients. The annual incidence rate of traumatic brain injury was calculated as the number of new cases divided by the total number of person-years in the available records...
January 10, 2018: Psychiatry Research
Rebekah J Nevel, Errine T Garnett, Deneen A Schaudies, Lisa R Young
RATIONALE: Neuroendocrine cell hyperplasia of infancy (NEHI) typically presents in infancy with tachypnea, retractions, and hypoxemia. Some infants have failure to thrive, yet the frequency of this and other non-respiratory phenotypic features have not been delineated. While gradual improvement occurs, the clinical course is variable and the duration of supplemental oxygen requirement has not been defined. OBJECTIVES: Our objective was to identify factors in NEHI that may drive differences in clinical course...
February 2, 2018: Pediatric Pulmonology
Joseph M Banno, Katherine Shield, Krunal Patel, Anupam A Sule
Mycobacterium abscessus is a fast growing, non-tubercular mycobacterium (NTM) found in water. NTM bacteremia is usually seen in immunocompromised patients who have intravascular catheters. Mycobacterium abscessus bacteremia is often caused by exposure to contaminated water supply in hemodialysis units. A 28-year-old female with poorly controlled diabetes mellitus, end stage renal disease (on hemodialysis via Ash catheter), and recurrent deep vein thrombosis presented to the hospital with proximal right leg deep vein thrombosis...
November 27, 2017: Curēus
Suiyao Chen, Nan Kong, Xuxue Sun, Hongdao Meng, Mingyang Li
Hospital readmission risk modeling is of great interest to both hospital administrators and health care policy makers, for reducing preventable readmission and advancing care service quality. To accommodate the needs of both stakeholders, a readmission risk model is preferable if it (i) exhibits superior prediction performance; (ii) identifies risk factors to help target the most at-risk individuals; and (iii) constructs composite metrics to evaluate multiple hospitals, hospital networks, and geographic regions...
January 25, 2018: Health Care Management Science
Danielle Ní Chróinín, Chantelle Ní Chróinín, Layan Akijian, Elizabeth L Callaly, Niamh Hannon, Lisa Kelly, Michael Marnane, Áine Merwick, Órla Sheehan, Gillian Horgan, Joseph Duggan, Lorraine Kyne, Eamon Dolan, Seán Murphy, David Williams, Peter J Kelly
BACKGROUND: Few population-based studies have assessed lipid adherence to international guidelines for primary and secondary prevention in stroke/transient ischaemic attack (TIA) patients. AIMS: This study aims to evaluate adherence to lipid-lowering therapy (LLT) guidelines amongst patients with ischaemic stroke/TIA. METHODS: Using hot and cold pursuit methods from multiple hospital/community sources, all stroke and TIA cases in North Dublin City were prospectively ascertained over a 1-year period...
January 24, 2018: Irish Journal of Medical Science
Gabriel Caetano Pereira, Igor Fiorese Vieira, Mateus Mazorra Coelho Vieira, Eliezer Moreno Romano, Luiz Eduardo Bersani Amado
Patients with chronic kidney disease (CDK) can develop several diseases caused by the renal replacement therapy. Here we report a rare complication of peritoneal dialysis, the encapsulating peritoneal sclerosis (EPS) in which the peritoneal tissue is gradually replaced by fibrous tissue. The patient in question, after late loss of renal graft and conversion to peritoneal dialysis, evolved with multiple hospitalizations for spontaneous bacterial infections, in recent admission, he was diagnosed with sub-occlusive abdomen secondary to the EPS...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Kotaro Aoki, Sohei Harada, Koji Yahara, Yoshikazu Ishii, Daisuke Motooka, Shota Nakamura, Yukihiro Akeda, Tetsuya Iida, Kazunori Tomono, Satoshi Iwata, Kyoji Moriya, Kazuhiro Tateda
Although KPC enzymes are most common among carbapenemases produced by Enterobacter cloacae complex globally, the epidemiology varies from one country to another. While previous studies have suggested that IMP enzymes are most common in Japan, detailed analysis has been scarce thus far. Here we carried out a molecular epidemiological study and plasmid analysis of IMP-1-producing E. cloacae complex isolates collected from 3 hospitals in central Tokyo using whole genome sequencing. Seventy-one isolates were classified into several STs and 49 isolates were identified as Enterobacter hormaechei ST78...
January 8, 2018: Antimicrobial Agents and Chemotherapy
Mary-Anne Aarts, Ori D Rotstein, Emily A Pearsall, J Charles Victor, Allan Okrainec, Marg McKenzie, Stuart A McCluskey, Lesley Gotlib Conn, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact. OBJECTIVE: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. METHODS: An iERAS program was implemented in 15 academic hospitals...
January 4, 2018: Annals of Surgery
Jure Baloh, Xi Zhu, Marcia M Ward
AIMS: To examine how the process of change prescribed in Kotter's change model applies in implementing team huddles, and to assess the impact of the execution of early change phases on change success in later phases. BACKGROUND: Kotter's model can help to guide hospital leaders to implement change and potentially to improve success rates. However, the model is under studied, particularly in health care. METHODS: We followed eight hospitals implementing team huddles for 2 years, interviewing the change teams quarterly to inquire about implementation progress...
December 17, 2017: Journal of Nursing Management
Ya Hu, Lu Liu, Xiaoxia Zhang, Yu Feng, Zhiyong Zong
We determined the in vitro susceptibility of four aminoglycosides, which are not of the 4,6-disubstituted deoxystreptamine (DOS) subclass against a collection of carbapenem-resistant Enterobacteriaceae (CRE). CRE clinical strains (n = 134) were collected from multiple hospitals in China and carried blaNDM (blaNDM-1, blaNDM-5 or blaNDM-7; n = 66), blaKPC-2 (n = 62) or blaIMP-4 (n = 7; including one carrying blaNDM-1 and blaIMP-4). MICs of neomycin, paromomycin, streptomycin and apramycin as well as three 4,6-disubstituted DOS aminoglycosides (amikacin, gentamicin and tobramycin) were determined using the broth microdilution with breakpoints defined by the Clinical Laboratory Standards Institute (for amikacin, gentamicin and tobramycin), US Food and Drug Administration (streptomycin), the National Antimicrobial Resistance Monitoring System (apramycin) or la Société Française de Microbiologie (neomycin and paromomycin)...
2017: Frontiers in Microbiology
Huidi Tchero, Lazarre Noubou, Beatrice Becsangele, Martin Mukisi-Mukaza, Gerald-Reparate Retali, Emmanuel Rusch
The care of individuals with diabetic foot ulcers is costly and requires multiple hospital visits. Inadequate care leads to serious complications and a high risk of lower extremity amputation. In this review, we aimed at evaluating whether telemedicine can be effective in diabetic foot patient care. We searched Medline through Embase and PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant studies, published up to April 2017. The studies were summarized and discussed in a narrative method and a meta-analysis of 2 controlled trials was conducted using the fixed-effects model...
November 1, 2017: International Journal of Lower Extremity Wounds
Ying Cai, Junhua Cao, Ruixue Kan, Yuping Liu, Li Zhao, Ming Hu, Xuemei Zhang
Background: To analyze and summarize the effect of continuous care on the life quality and control of asthma of pediatric patients with asthma discharged from multiple hospitals. Methods: Retrospective analysis was carried out on 172 pediatric patients with asthma aged between 6 and 11 yr old randomly selected from those admitted to five hospitals between January 2014 and December 2015. Among these 172 patients, only 86 (intervention group) received the continuous care between January 2015 and December 2015, while the rest (control group) did not receive from January 2014 and December 2014...
November 2017: Iranian Journal of Public Health
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