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"multiple hospitalizations"

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 healthcare integration and quality of prostate cancer care. MATERIALS AND METHODS: We used SEER-Medicare data to perform a retrospective cohort study of men > 65 years old with prostate cancer diagnosed between 2007 and 2011...
July 13, 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
Lisa M Kern, Zachary Grinspan, Jason S Shapiro, Rainu Kaushal
Understanding how often patients seek care from multiple hospitals is important for care of individuals and populations, but it is not routinely measured because of lack of data. This study used data from a health information exchange (HIE) to measure the frequency with which patients seek care from multiple hospitals. This was a retrospective cohort study (2010-2011) of all patients who sought emergency department (ED) or inpatient care at 6 participating hospitals in Manhattan. The study found that all 6 hospitals shared patients with each of the other hospitals and that 10...
June 7, 2016: Population Health Management
Henry K Su, Umut Ozbek, Ilya Likhterov, Jason Brant, Eric M Genden, Mark L Urken, Raymond L Chai
OBJECTIVES/HYPOTHESIS: Minimally invasive transoral surgical approaches for the resection of oropharyngeal tumors offer unique opportunities to achieve oncologically sound results while reducing treatment-related morbidity. The objective of this study is to characterize the mortality and complication rates of transoral oncologic resections in a large, prospective, de-identified national dataset from multiple hospitals. STUDY DESIGN: Retrospective, multi-institutional cohort study of 305 patients...
May 31, 2016: Laryngoscope
Deepak Agrawal, Cheng-Bang Chen, Ronald W Dravenstott, Christopher T B Strömblad, John Andrew Schmid, Jonathan D Darer, Priyantha Devapriya, Soundar Kumara
BACKGROUND: Transitional care interventions can be utilized to reduce post-hospital discharge adverse events (AEs). However, no methodology exists to effectively identify high-risk patients of any disease across multiple hospital sites and patient populations for short-term postdischarge AEs. OBJECTIVES: To develop and validate a 3-day (72 h) AEs prediction model using electronic health records data available at the time of an indexed discharge. RESEARCH DESIGN: Retrospective cohort study of admissions between June 2012 and June 2014...
May 20, 2016: Medical Care
S Reza Jafarzadeh, Benjamin S Thomas, David K Warren, Jeff Gill, Victoria J Fraser
BACKGROUND: The long-term and cumulative effect of multiple episodes of bacteremia and sepsis across multiple hospitalizations on the development of cardiovascular (CV) events is uncertain. METHODS: We conducted a longitudinal study of 156 380 hospitalizations in 47 009 patients (≥18 years old) who had at least 2 inpatient admissions at an academic tertiary care center in St Louis, Missouri, from 1 January 2008 through 31 December 2012. We used marginal structural models, estimated by inverse probability weighting (IPW) of bacteremia or sepsis and IPW of censoring, to estimate the marginal causal effects of bacteremia and sepsis on developing the first observed incident CV event, including stroke, transient ischemic attack, and myocardial infarction (MI), during the study period...
August 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Abhishek Chinya, Prince Raj Pandey, Shandip Kumar Sinha, Yogesh Kumar Sarin
Congenital lobar emphysema (CLE) is a rare but life-threatening congenital anomaly leading to respiratory distress in early childhood. Diagnosis requires a strong clinical suspicion. We report a case of a 31/2-month-old infant who was initially diagnosed with pneumonia requiring multiple hospital admissions. After computed tomography of the thorax, a diagnosis on CLE was made. The child was planned for surgery in the next available routine operation theatre. However, suddenly in the evening, she developed respiratory distress and needed emergency surgical intervention...
May 2016: Lung India: Official Organ of Indian Chest Society
Austin C Remington, Tina Hernandez-Boussard, Nicholus M Warstadt, Micaela A Finnegan, Robyn Shaffer, Jereen Z Kwong, Catherine Curtin
Rates of diabetes and its associated comorbidities have been increasing in the United States, with diabetic foot ulcer treatment representing a large cost to the patient and healthcare system. These ulcers often result in multiple hospital admissions. This study examined readmissions following inpatient care for a diabetic foot ulcer and identified modifiable factors associated with all-cause 30-day readmissions to the inpatient or emergency department (ED) setting. We hypothesized that patients undergoing aggressive treatment would have lower 30-day readmission rates...
July 2016: Wound Repair and Regeneration
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