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Healthcare risk assessment

Jason Suh, Amishi Desai, Anish Desai, Josephine Dela Cruz, Anusiyanthan Mariampillai, Alexander Hindenburg
Venous thromboembolism (VTE) remains the number one preventable cause of hospital acquired mortality and morbidity. Each year, more than 12 million patients are at risk for VTE. The delivery of appropriate and timely VTE prophylaxis is still suboptimal in many healthcare institutions and can lead to increased readmissions, morbidity, as well as costs. To clarify this issue further, we performed a retrospective case control study at our institution to determine if poor adherence to the VTE prophylaxis guidelines could lead to an increase in VTE events...
October 17, 2016: Journal of Thrombosis and Thrombolysis
Sue Patterson, Kathleen Freshwater, Nicole Goulter, Julie Ewing, Boyd Leamon, Anand Choudhary, Vikas Moudgil, Brett Emmerson
Aims and method To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice...
October 2016: BJPsych Bulletin
Amanda K Debes, Robert H Gilman, Carolyne Onyango-Makumbi, Andrea Ruff, Richard Oberhelman, David W Dowdy
BACKGROUND: The objective of this analysis was to assess the cost-effectiveness of TB diagnosis using Microscopic Observation Drug Susceptibility (MODS), Xpert MTB/RIF (Xpert), and empiric treatment for all patients, in addition to current clinical diagnostic practices in children less than 5 years of age in a national tuberculosis (TB) referral hospital in Uganda. METHODS: A decision analysis was conducted from the healthcare perspective, with a primary outcome of incremental cost effectiveness expressed as cost per year of life gained (YLG)...
October 3, 2016: Pediatric Infectious Disease Journal
Ahmed E Arafa, Amel A Mohamed, Manal M Anwar
BACKGROUND AND PURPOSE: Blood-borne pathogens (BBP) [hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV] pose a considerable infectious risk for nurses, resulting in unwanted health outcomes and psychological stress. AIM OF THE WORK: This study aimed to assess the knowledge and practices of nurses and define administrative roles regarding in BBP and infection control (IC) measures in selected Beni-Suef Hospitals. PARTICIPANTS AND METHODS: A cross-sectional study was carried out from December 2014 to January 2015 using a self-administered questionnaire...
September 2016: Journal of the Egyptian Public Health Association
Sofia Geralemou, Tong J Gan
PURPOSE OF REVIEW: Postoperative and postdischarge nausea and vomiting have profound impact on the efficient delivery of quality healthcare. In addition to patient dissatisfaction, physical morbidities as well as unplanned hospital admissions may result. It is important to risk stratify and intervene on patients at risk. The aim of this review is to explore the benefits and shortcomings of the scoring systems commonly used today. RECENT FINDINGS: Two widely-used risk stratification systems identify and score patient-, anesthesia-, and surgery-related risk factors for postoperative/postdischarge nausea and vomiting in the adult population...
September 29, 2016: Current Opinion in Anaesthesiology
David M Dror, Arpita Chakraborty, Atanu Majumdar, Pradeep Panda, Ruth Koren
BACKGROUND & OBJECTIVES: The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households' self-medication and financial position. METHODS: Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013...
June 2016: Indian Journal of Medical Research
Sara Andertun, Åsa Hörnsten, Senada Hajdarevic
AIM: The aim of this study was to describe Norwegian healthcare staffs' experiences of participating in care of patients with Ebola virus disease in Sierra Leone. BACKGROUND: Ebola is one of the most feared viruses known. Ebola virus disease is highly contagious with high mortality. The few qualitative studies made on experiences among healthcare professionals have highlighted problems as lack of protective resources, insufficient personnel and risk of societal stigmatization...
October 16, 2016: Journal of Advanced Nursing
Kourtney J Davis, David Hinds, Stephen P Motsko, Earl Goehring, Judith K Jones
PURPOSE: Our objective was to highlight the importance of database selection in observational research and to determine the incidence of corticosteroid-related events in patients exposed to fluticasone propionate intranasal spray (FPNS) compared with other intranasal steroids (INS). METHODS: After a feasibility study using an electronic medical record database in the UK (1990-2002), a retrospective cohort study was conducted using a large administrative claims database in the USA from 1994 to 2002 comparing the incidence and rate ratios of steroid-related events among intermittent, sub-chronic, and chronic FPNS use and other INS use episodes...
March 2016: Drugs—Real World Outcomes
Suliman Alghnam, Glen H Tinkoff, Renan Castillo
BACKGROUND: Repeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings. Therefore, identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. There has been limited research on factors associated with recidivism in the U.S. Using a population-based sample, we aim to: 1) identify the prevalence and risk factors for injury recidivism among non-institutionalized adults; 2) investigate the trend in nationwide recidivism rates over time...
December 2016: Injury Epidemiology
Rosemary Thackeray, Brianna M Magnusson
Congenital cytomegalovirus (CMV) infection causes severe disabilities and developmental delays. Women's awareness of CMV is low. Only about half of healthcare providers report counseling women about behaviors to reduce CMV risk and public health education is limited. Routine CMV counseling is not recommend. Providers may lack time to counsel women; other conditions may take priority for counseling; there may be a perception that women are reluctant to follow advice. This cross-sectional descriptive study examined women's attitudes toward CMV prevention behaviors...
December 2016: Preventive Medicine Reports
Marten N Basta, Liza C Wu, Suhail K Kanchwala, Joseph M Serletti, Julia C Tchou, Stephen J Kovach, Joshua Fosnot, John P Fischer
BACKGROUND: Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool. METHODS: An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome...
September 7, 2016: American Journal of Surgery
Ryan T Hurt, Stephen A McClave
Alterations in nutritional status are common and can be associated with increased morbidity and mortality. However, for healthcare providers, the definition of malnutrition is vague, insensitive, and poorly standardized. In contrast, nutrition risk is more easily defined, and recognizes that both poor nutritional status and disease severity contribute to increased morbidity and mortality. Clinicians need to identify patients who may already have evidence of nutrient deficiencies or have disease processes that affect nutrition risk...
November 2016: Medical Clinics of North America
Mikkel Faurschou, Magnus G Ahlström, Jesper Lindhardsen, Niels Obel, Bo Baslund
OBJECTIVE: Patients with organ- or life-threatening vasculitis receive high cumulative glucocorticoid (GC) doses during their disease course. GC have diabetogenic effects, but the risk of diabetes mellitus (DM) related to vasculitis therapy is not well characterized. We assessed the DM risk among patients diagnosed with giant cell arteritis (GCA) or granulomatosis with polyangiitis (GPA), i.e., patients with relatively common forms of systemic vasculitis. METHODS: We used Danish healthcare registries to identify 1682 patients diagnosed with GCA and 342 patients diagnosed with GPA from 1997 to 2015 and to obtain information regarding medication exposures...
October 15, 2016: Journal of Rheumatology
A Nolsøe, K Andresen, J Rosenberg
PURPOSE: The aim of this study was to assess the extent of reoperations after hernia repair in Denmark that are being performed at a different facility than the primary repair and thereby investigate whether or not reoperation is a reliable basis for assessment of personal- or facility recurrence rates. METHODS: On a national level, we included all groin hernia repairs that had been reoperated a least once from January 1, 1998, to August 19, 2015. RESULTS: A total of 14,264 hernia repairs were included comprising a total of 7371 reoperations...
October 14, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Kendall R Beck, Nicole Kim, Mandana Khalili
BACKGROUND: Vulnerable populations are disproportionately affected by hepatitis C virus (HCV) infection and experience high rates of health disparity. There are no data on real-world experience with highly efficacious direct-acting anti-HCV treatment in this population. AIMS: We aimed to evaluate the real-world experience with sofosbuvir-based regimens among a vulnerable HCV-infected population. METHODS: HCV treatment response was assessed among 204 patients who completed 12-24 weeks of sofosbuvir-based regimens (in combination with pegylated interferon and ribavirin, simeprevir, ledipasvir, or daclatasvir) at the San Francisco safety-net healthcare system liver specialty clinic between January 2014 and December 2015...
October 14, 2016: Digestive Diseases and Sciences
Caroline Anne Mitchell, Alice Pitt, Joe Hulin, Rod Lawson, Fleur Ashby, Ivan Appelqvist, Brigitte Delaney
OBJECTIVES: Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic. SETTING: Single-centre UK community substance misuse clinic. PARTICIPANTS: All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period...
October 14, 2016: BMJ Open
Giridhara R Babu, Gvs Murthy, R Deepa, Yamuna, Prafulla, H Kiran Kumar, Maithili Karthik, Keerti Deshpande, Sara E Benjamin Neelon, D Prabhakaran, Anura Kurpad, Sanjay Kinra
BACKGROUND: India is experiencing an epidemic of obesity-hyperglycaemia, which coincides with child bearing age for women. The epidemic can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, we developed the protocol for the proposed birth cohort of 5000 women, the recruitment for which will start in April 2016...
October 14, 2016: BMC Pregnancy and Childbirth
Tufa Kolola, Meseret Ekubay, Endalamaw Tesfa, Wogene Morka
In Ethiopia, neonatal mortality has been declined since the declaration of Millennium Developmental Goals, but the rate was slower since 2006. Thus, this study was designed to assess the determinants of neonatal mortality (NM) in North Shoa Zone. A community based case-control study was conducted on 84 cases and 252 controls. Cases were deceased new-borns within 28 days of birth while controls were infants survived beyond the first 28 days. Data were collected from mothers of the cases and controls using interviewer administered questionnaires...
2016: PloS One
Anita E Heywood, Hans Nothdurft, Dominique Tessier, Melissa Moodley, Lars Rombo, Cinzia Marano, Laurence De Moerlooze
BACKGROUND: Knowledge about the travel-associated risks of hepatitis A and B, and the extent of pre-travel health-advice being sought may vary between countries. METHODS: An online survey was undertaken to assess the awareness, advice-seeking behaviour, rates of vaccination against hepatitis A and B and adherence rates in Australia, Finland, Germany, Norway, Sweden, the UK and Canada between August and October 2014. Individuals aged 18-65 years were screened for eligibility based on: travel to hepatitis A and B endemic countries within the past 3 years, awareness of hepatitis A, and/or combined hepatitis A&B vaccines; awareness of their self-reported vaccination status and if vaccinated, vaccination within the last 3 years...
July 2016: Journal of Travel Medicine
Lars T Fadnes, Kathy Ainul Møen, Esperanza Diaz
OBJECTIVES: Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden. DESIGN: Population-based retrospective cohort study. SETTING: This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008...
October 13, 2016: BMJ Open
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