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"multiple hospitalizations"

Joobong June Park Oh
PURPOSE OF STUDY: The study was conducted to examine the hospital readmission patterns of two groups of Medicare beneficiaries-those covered by traditional Medicare (Medicare fee-for-service [FFS]) and those enrolled in a Medicare risk plan (Medicare Advantage [MA])-and to determine the characteristics that significantly increase the likelihood of multiple hospital readmissions. PRIMARY PRACTICE SETTING: The study setting is the Hospital of the University of Pennsylvania (HUP) located in Philadelphia, PA...
January 2017: Professional Case Management
S Chusri, V Chongsuvivatwong, J I Rivera, K Silpapojakul, K Singkhamanan, E McNeil, Y Doi
BACKGROUND: Acinetobacter baumannii is a major hospital-acquired pathogen in Thailand that has a negative effect on patient survival. The nature of its transmission is poorly understood. AIM: To investigate the genotypic and spatiotemporal pattern of A. baumannii infection at a hospital in Thailand. METHODS: The medical records of patients infected with A. baumannii at an 800-bed tertiary care hospital in southern Thailand between January 2010 and December 2011 were reviewed retrospectively...
October 22, 2016: Journal of Hospital Infection
Barbara Wadsworth, Catherine A Harmer
In the 2nd of a 3-part series on the value of patient and family advisory councils, an early adopter at a large, Magnet®-recognized healthcare system reveals ways in which an environment focused on strong partnerships, a culture of safety, and a commitment to transparency led to the creation of successful councils at multiple hospitals. The authors discuss nursing's integral role in championing and leading the councils, as well as the benefits of a strong patient-family voice in hospital operations and care processes...
December 2016: Journal of Nursing Administration
Karin Kato, Yasufumi Matsumura, Masaki Yamamoto, Miki Nagao, Shunji Takakura, Satoshi Ichiyama
AIMS: In this study, we analyzed the molecular epidemiology of extended-spectrum β-lactamase (ESBL)-producing Proteus mirabilis isolates collected from the central region of Japan. MATERIALS AND METHODS: Between 2005 and 2012, 820 clinical P. mirabilis isolates were obtained from ten acute care hospitals in Japan. We characterized ESBL confirmatory test-positive isolates by sequencing the ESBL genes and their flanking regions, detecting plasmid replicons, and performing pulsed-field gel electrophoresis (PFGE)...
November 11, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Xiao-Ping Ye, Fei-Fei Yuan, Le-Le Zhang, Yu-Ru Ma, Man-Man Zhang, Wei Liu, Feng Sun, Jing Wu, Meng Lu, Li-Qiong Xue, Jing-Yi Shi, Shuang-Xia Zhao, Huai-Dong Song, Jun Liang, Cui-Xia Zheng
CONTEXT: Graves' disease (GD) is a common autoimmune disease triggered by genetic predisposition and environmental factors. However, the mechanisms of interaction between genetic and environmental factors contributing to the development of GD remain unknown. OBJECTIVE: To identify GD susceptibility variants and genes on Xq21.1 locus and interpret the contribution of interaction between genetic predisposition on Xq21.1 and environmental factors to GD. DESIGN: We performed refining study on Xq21...
November 3, 2016: Journal of Clinical Endocrinology and Metabolism
Saberio Lo Presti, Prashanth Kanagarajah, Daniela Pirela, Diana Morlote, Mike Cusnir
We report a case of a 38-year-old man presenting with bilateral lower extremity weakness and paresthesias that progressed during a 4-month period to severe polyneuropathy forcing the patient to be bed bound. Throughout his multiple hospitalizations, he was treated erroneously for chronic inflammatory demyelinating polyneuropathy, without significant improvement in his symptoms. In addition, he developed hepatosplenomegaly (organomegaly); endocrinopathies such as diabetes mellitus, central hypogonadism, and hypothyroidism; monoclonal spike evidenced in the serum electrophoresis; and hyperpigmentation of skin, altogether consistent with POEMS syndrome...
October 2016: Journal of Investigative Medicine High Impact Case Reports
Bente Olesen, Jacob Anhøj, Kenneth Palle Rasmussen, Kåre Mølbak, Marianne Voldstedlund
BACKGROUND: Although the timely isolation of patients is an essential intervention to limit spread of drug-resistant bacteria, information about the colonization status is often unavailable or lost when patients are readmitted or transferred between hospitals. Therefore, carriers of drug resistant bacteria are not recognized sufficiently early, and proper and timely isolation precautions are not taken. Consequently, resistant bacteria of public health concerns including vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) can spread epidemically...
November 2016: International Journal of Medical Informatics
Mayra Tisminetzky, Han-Yang Chen, David D McManus, Jerry Gurwitz, Edgard Granillo, Jorge Yarzebski, Joel M Gore, Robert J Goldberg
There are limited contemporary data available describing recent trends in the magnitude and characteristics of patients who are rehospitalized multiple times after hospital discharge for an acute myocardial infarction (AMI). We reviewed the medical records of 4,480 residents of the Worcester, Massachusetts, metropolitan area, who were discharged from 3 Central Massachusetts medical centers after an AMI in 6 biennial periods from 2001 to 2011 and were followed for all-cause and cause-specific hospital readmissions over the subsequent 6 months...
October 15, 2016: American Journal of Cardiology
Diego A Martinez, Felipe Feijoo, Jose L Zayas-Castro, Scott Levin, Tapas K Das
Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7...
September 6, 2016: Health Care Management Science
Mary I Yarbrough, Meredith E Ficken, Christoph U Lehmann, Thomas R Talbot, Melanie D Swift, Paula W McGown, Robert F Wheaton, Michele Bruer, Steven W Little, Charles A Oke
: Information that details use and supply of respirators in acute care hospitals is vital to prevent disease transmission, assure the safety of health care personnel, and inform national guidelines and regulations. OBJECTIVE: To develop measures of respirator use and supply in the acute care hospital setting to aid evaluation of respirator programs, allow benchmarking among hospitals, and serve as a foundation for national surveillance to enhance effective Personal Protective Equipment (PPE) use and management...
2016: Journal of the International Society for Respiratory Protection
Joseph B Richardson, Christopher St Vil, Tanya Sharpe, Michael Wagner, Carnell Cooper
BACKGROUND: Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists...
July 2016: Journal of Surgical Research
Lindsey A Herrel, Samuel R Kaufman, Phyllis Yan, David C Miller, Florian R Schroeck, Ted A Skolarus, Vahakn B Shahinian, Brent K Hollenbeck
PURPOSE: The delivery of high quality prostate cancer care is increasingly important for health systems, physicians and patients. Integrated delivery systems may have the greatest ability to deliver high quality, efficient care. We sought to understand the association between health care integration and quality of prostate cancer care. MATERIALS AND METHODS: We used SEER-Medicare data to perform a retrospective cohort study of men older than age 65 with prostate cancer diagnosed between 2007 and 2011...
July 15, 2016: Journal of Urology
Akshay S Desai, Brian L Claggett, Milton Packer, Michael R Zile, Jean L Rouleau, Karl Swedberg, Victor Shi, Martin Lefkowitz, Randall Starling, John Teerlink, John J V McMurray, Scott D Solomon
BACKGROUND: Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES: This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS: We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril...
July 19, 2016: Journal of the American College of Cardiology
Julia R Berian, Sanjay Mohanty, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
IMPORTANCE: Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure. OBJECTIVE: To evaluate LOI among older adult patients after surgical procedures and examine the association of LOI with readmission and death after discharge in this population. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study examined 9972 patients 65 years and older with known baseline function, mobility, and living situation undergoing inpatient operations from January 2014 to December 2014 at 26 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot Project...
September 21, 2016: JAMA Surgery
Christine Marie Carr, Steven Howard Saef, Jingwen Zhang, Zemin Su, Cathy L Melvin, Jihad S Obeid, Wenle Zhao, J Christophe Arnaud, Justin Marsden, Adam B Sendor, Leslie Lenert, William P Moran, Patrick D Mauldin
OBJECTIVES: Health information exchanges (HIEs) make possible the construction of databases to characterize patients as multisystem users (MSUs), those visiting emergency departments (EDs) of more than one hospital system within a region during a 1-year period. HIE data can inform an algorithm highlighting patients for whom information is more likely to be present in the HIE, leading to a higher yield HIE experience for ED clinicians and incentivizing their adoption of HIE. Our objective was to describe patient characteristics that determine which ED patients are likely to be MSUs and therefore have information in an HIE, thereby improving the efficacy of HIE use and increasing ED clinician perception of HIE benefit...
July 2016: Southern Medical Journal
Cheryl Culver Schultz, Sheila Shaffer, Darlene Fink-Bennett, Kay Winokur
Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal)...
August 2016: Health Physics
Daan Westra, Federica Angeli, Evelina Jatautaitė, Martin Carree, Dirk Ruwaard
INTRODUCTION: Medical specialists seem to increasingly work in- and be affiliated to- multiple organizations. We define this phenomenon as specialist sharing. This form of inter-organizational cooperation has received scant scholarly attention. We investigate the extent of- and motives behind- specialist sharing, in the price-competitive hospital market of the Netherlands. METHODS: A mixed-method was adopted. Social network analysis was used to quantitatively examine the extent of the phenomenon...
August 2016: Social Science & Medicine
Mark Zhu, Saiprasad Ravi, Chris Frampton, Chris Luey, Simon Young
Background and purpose - Recent studies have revealed deficiencies in the accuracy of data from joint registries when reoperations for prosthetic joint infections (PJIs) are reported, particularly when no components are changed. We compared the accuracy of data from the New Zealand Joint Registry (NZJR) to a multicenter audit of hospital records to establish the rate of capture for PJI reoperations. Methods - 4,009 cases undergoing total knee or hip arthroplasty performed at 3 tertiary referral hospitals over a 3-year period were audited using multiple hospital datasets and the NZJR...
August 2016: Acta Orthopaedica
Zhi Qu, Lue Ping Zhao, Xiemin Ma, Siyan Zhan
BACKGROUND There is increasing interest in clinical research with electronic medical data, but it often faces the challenges of heterogeneity between hospitals. Our objective was to develop a single numerical score for characterizing such heterogeneity via computing inpatient mortality in treating acute myocardial infarction (AMI) patients based on diagnostic information recorded in the database of Discharge Summary Reports (DSR). MATERIAL AND METHODS Using 4 216 135 DSRs of 49 tertiary hospitals from 2006 to 2010 in Beijing, more than 200 secondary diagnoses were identified to develop a risk score for AMI (n=50 531)...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sobha Sivaprasad, Sesan Oyetunde
PURPOSE: An important factor in the choice of therapy is the impact it has on the patient's quality of life. This survey aimed to understand treatment burden, treatment-related anxiety and worry, and practical issues such as appointment attendance and work absence in patients receiving injection therapy for diabetic macular edema (DME) or retinal vein occlusion (RVO). PATIENTS AND METHODS: A European sample of 131 retinal patients completed a detailed questionnaire to elucidate the impact of injection therapy on individuals with DME or RVO...
2016: Clinical Ophthalmology
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