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Hospital information system

Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Baltica Cabieses, Macarena Chepo, Marcela Oyarte, Niina Markkula, Patricia Bustos, Víctor Pedrero, Iris Delgado
INTRODUCTION: Children and young international migrants face different health challenges compa red with the local population, particularly if they live in insecure environments or adverse social conditions. This study seeks to identify gaps in health outcomes of children between immigrant and local population in Chile. METHODS: This study analyses data from three sources: (i) Born in Chile: Electronic records of antenatal visits from all municipal antenatal clinics of Recoleta in 2012; (ii) Growing up in Chile: Population survey "National Socioeconomic Characterization" (CASEN) from 2013 and (iii) Getting sick in Chile: Data of all hospital discharges in 2012, provided by the department of statistics and health information (DEIS) of the Ministry of Health...
December 2017: Revista Chilena de Pediatría
Ana Carolina Lima Cavaletti, Célia Pereira Caldas, Kenio Costa de Lima
OBJECTIVES: To identify the diseases that lead older persons to hospitalizations in the public health system in the state of Rio de Janeiro and, through a study of spatial distribution among hospitalization rates of the municipal districts, discuss the social contexts involved in the hospitalization of the elderly. METHODS: An ecological cross-sectional study using secondary data from the Brazilian hospital information system from the period 2009 to 2015 was performed...
March 12, 2018: Value in Health Regional Issues
Hendramoorthy Maheswaran, Stavros Petrou, Danielle Cohen, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
INTRODUCTION: Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence...
2018: PloS One
Mikkel Brabrand, Daniel Pilsgaard Henriksen
IMPORTANCE: The CURB-65 score is widely implemented as a prediction tool for identifying patients with community-acquired pneumonia (cap) at increased risk of 30-day mortality. However, since most ingredients of CURB-65 are used as general prediction tools, it is likely that other prediction tools, e.g. the British National Early Warning Score (NEWS), could be as good as CURB-65 at predicting the fate of CAP patients. OBJECTIVE: To determine whether NEWS is better than CURB-65 at predicting 30-day mortality of CAP patients...
March 14, 2018: Lung
Nicholas Agyepong, Usha Govinden, Alex Owusu-Ofori, Sabiha Yusuf Essack
Background: Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana. Methods: Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system...
2018: Antimicrobial Resistance and Infection Control
Rachael M Hunter, Naomi J Fulop, Ruth J Boaden, Christopher McKevitt, Catherine Perry, Angus I G Ramsay, Anthony G Rudd, Simon J Turner, Pippa J Tyrrell, Charles D A Wolfe, Stephen Morris
BACKGROUND: The economic implications of major system change are an important component of the decision to implement health service reconfigurations. Little is known about how best to report the results of economic evaluations of major system change to inform decision-makers. Reconfiguration of acute stroke care in two metropolitan areas in England, namely London and Greater Manchester (GM), was used to analyse the economic implications of two different implementation strategies for major system change...
March 14, 2018: Health Research Policy and Systems
Sana B Ali, Juana Romero, Kevin Morrison, Baria Hafeez, Jessica S Ancker
OBJECTIVES:  Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge. METHODS:  Three evaluators applied heuristic usability evaluation and conducted 23 individual user testing sessions with patients with chronic disease or managing the care of family members with chronic disease...
January 2018: Applied Clinical Informatics
Caroline Daly, Eve Griffin, Darren M Ashcroft, Roger T Webb, Ivan J Perry, Ella Arensman
Background: Intentional drug overdose (IDO) is the most common form of hospital-treated self-harm, yet no national study has systematically classified the range of drugs involved using a validated system. We aimed to determine the profile of patients engaging in overdose, to identify drugs frequently used and to quantify the contributions of multiple drug use and alcohol involvement. Methods: Between 2012 and 2014, the National Self-Harm Registry, Ireland recorded 18 329 presentations of non-fatal IDO to Irish emergency departments...
March 12, 2018: European Journal of Public Health
Adrian Blanco Machin, Luiz Fernando Costa Nascimento
Exposure to air pollutants, usually measured by environmental agencies that are not present in all states, may be associated with respiratory admissions in children. An ecological time series study was conducted with data on hospitalizations due to selected respiratory diseases in children under 10 years of age in 2012 in the city of Cuiabá, Mato Grosso State, Brazil. Mean levels of fine particulate matter (PM2.5) were estimated with a mathematical model, data on low temperatures and relative humidity were obtained from the Brazilian National Institute of Meteorology, and the numbers of brush burnings were obtained from the Environmental Information System...
March 8, 2018: Cadernos de Saúde Pública
Kelly McGuire, Matthew Siegel
Children with Autism Spectrum Disorder (ASD) are admitted to inpatient psychiatric units at markedly high rates. As health insurance companies and government healthcare systems and regulators seek more evidence for healthcare outcomes, it is important to learn more about the effectiveness of psychiatric inpatient admissions for children with ASD to best inform decisions on provision and access to this level of care. Evidence for models of inpatient treatment for youth with ASD is presented, and key characteristics and consensus recommendations for care are discussed...
March 14, 2018: International Review of Psychiatry
Areej El-Jawahri, Sarah R Fishman, Julie Vanderklish, Don S Dizon, Nicole Pensak, Lara Traeger, Joseph A Greer, Elyse R Park, Netana Markovitz, Lauren Waldman, Chrisa Hunnewell, Meredith Saylor, Jessica Driscoll, Zhigang Li, Thomas R Spitzer, Steven McAfee, Yi-Bin Chen, Jennifer S Temel
BACKGROUND: Although sexual dysfunction is common after hematopoietic stem cell transplantation (HCT), interventions to address sexual function are lacking. METHODS: We conducted a pilot study to assess the feasibility and preliminary efficacy of a multimodal intervention to address sexual dysfunction in allogeneic HCT survivors. Transplant clinicians screened HCT survivors ≥3 months post-HCT for sexual dysfunction causing distress. Those who screened positive attended monthly visits with a trained transplant clinician who: 1) performed an assessment of the causes of sexual dysfunction; 2) educated and empowered the patient to address his or her sexual concerns; and 3) implemented therapeutic interventions targeting the patient's needs...
March 14, 2018: Cancer
Carina Carnlöf, Per Insulander, Mats Jensen-Urstad, Marie Iwarzon, Fredrik Gadler
OBJECTIVES: To explore sex differences regarding indication for atrio-ventricular junction ablation (AVJ), choice of pacing system, complications to pacemaker treatment, long-term outcome, and cause of death after AVJ ablation. DESIGN: 700 patients who had undergone AVJ ablation between January 1990 and December 2010 were included. Data were retrieved from the patients´ medical records and the Swedish Pacemaker and Implantable Cardioverter-Defibrillator Registry...
March 14, 2018: Scandinavian Cardiovascular Journal: SCJ
Veronica Restelli, Annemarie Taylor, Douglas Cochrane, Michael A Noble
BACKGROUND: This article reports on the findings of 12,278 laboratory related safety events that were reported through the British Columbia Patient Safety & Learning System Incident Reporting System. METHODS: The reports were collected from 75 hospital-based laboratories over a 33-month period and represent approximately 4.9% of all incidents reported. RESULTS: Consistent with previous studies 76% of reported incidents occurred during the pre-analytic phase of the laboratory cycle, with twice as many associated with collection problems as with clerical problems...
June 27, 2017: Diagnosis
Raquel Bernardelli Iamaguchi, Renan Lyuji Takemura, Gustavo Bersani Silva, Jairo Andre de Oliveira Alves, Luciano Ruiz Torres, Alvaro Baik Cho, Teng Hsiang Wei, Marcelo Rosa de Rezende, Rames Mattar
INTRODUCTION: Indication of free tissue transfer for limb reconstruction continues to grow, and despite the good results with this treatment option, complications can impair the functional results and cause a raise in health costs, with prolonged hospitalization. Therefore, peri-operative surgical information and comorbidities were described and analyzed, for identification of independent risk factors for complications of free flaps results for traumatic wounds. For our knowledge, intraoperative ischemia time of free flap was not previously studied for post-traumatic limb reconstruction, which could influence results, in these traumatic cases, with the highest rates of complications among microsurgical flap reconstructions...
March 13, 2018: International Orthopaedics
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Shannon M Fernando, Peter M Reardon, Sean M Bagshaw, Damon C Scales, Kyle Murphy, Jennifer Shen, Peter Tanuseputro, Daren K Heyland, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) are groups of healthcare providers that are used by many hospitals to respond to acutely deteriorating patients admitted to the wards. We sought to identify outcomes of patients assessed by RRTs outside standard working hours. METHODS: We used a prospectively collected registry from two hospitals within a single tertiary care-level hospital system between May 1, 2012, and May 31, 2016. Patient information, outcomes, and RRT activation information were stored in the hospital data warehouse...
March 14, 2018: Critical Care: the Official Journal of the Critical Care Forum
B Xing, J T Lin, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the treatment of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during Jan 2013 to Dec 2014. Information of the demographic features, the severity of the exacerbation, the medicine prescribed during the hospitalization and the use of mechanical ventilation were collected and analyzed. Results: During the study period, there were 3 240 patients hospitalized for asthma exacerbation, and 1 369(42...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Marzia Baldereschi, Daniela Balzi, Valeria Di Fabrizio, Lucia De Vito, Renzo Ricci, Paola D'Onofrio, Antonio Di Carlo, Maria Teresa Mechi, Francesco Bellomo, Domenico Inzitari
BACKGROUND: Informing health systems and monitoring hospital performances using administrative data sets, mainly hospital discharge data coded according to International-Classification-Diseases-9edition-Clinical-Modifiers (ICD9-CM), is now commonplace in several countries, but the reliability of diagnostic coding of acute ischemic stroke in the routine practice is uncertain. This study aimed at estimating accuracy of ICD9-CM codes for the identification of acute ischemic stroke and the use of thrombolysis treatment comparing hospital discharge data with medical record review in all the six hospitals of the Florence Area, Italy, through 2015...
2018: PloS One
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