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Hospital caseload

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https://www.readbyqxmd.com/read/28343611/hospital-esophagectomy-volume-and-postoperative-length-of-stay-a-systematic-review-and-meta-analysis
#1
REVIEW
Femi Giwa, Aitua Salami, Ajibola I Abioye
BACKGROUND: Much attention in the volume-outcomes literature has focused on the empirical impact of surgical caseload on outcomes. However, relevant studies on the association between surgical volume and variables that potentially contribute to healthcare costs are limited. The objective of this study was to systematically elucidate a contemporary analysis of the empirical relationship between hospital esophagectomy volume and postoperative length of stay, a cost-related outcome. DATA SOURCES: OvidSP, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science and OpenGrey were searched for relevant articles published from 2000 to 2016...
March 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28281097/factors-in-maintaining-a-stable-patient-physician-relationship-among-individuals-with-schizophrenia
#2
Hsin-Hui Huang, Chuan-Yu Chen, Jen-Huoy Tsay, Yiing-Jenq Chou, Nicole Huang
This study aimed to determine whether adequate continuity of care (COC) existed among individuals with schizophrenia, and what the associated determinants were. The National Health Insurance Research Database of Taiwan was used to identify individuals with newly diagnosed schizophrenia from 2000 to 2009. Two outcome indicators were first derived to conduct the continuity assessment based on the usual provider continuity (UPC) index and the continuity of care index (COCI). The average scores of the UPC and COCI were 0...
March 9, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28274646/general-characteristics-and-activity-of-emergency-department-short-stay-units-in-spanish-hospitals
#3
Carles Ferré, Ferran Llopis, Francisco Javier Martín-Sánchez, Gonzalo Sempere, Pere Llorens, Carmen Navarro, Mikel Martínez-Ortiz, Antoni Juan
BACKGROUND: Emergency Department (ED) overcrowding mainly due to the lack of access to inpatient beds negatively affects safety and quality of care. Implementation of ED short-stay units (EDSSUs) may help to mitigate this situation. OBJECTIVES: To describe the general characteristics and evaluate the activity of EDSSUs in Spanish hospitals. METHODS: This is a cross-sectional study. A questionnaire was sent to coordinators responsible for the EDSSUs identified among Spanish hospitals appearing on the Ministry of Health Web page...
March 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28124200/operational-demands-on-pre-hospital-emergency-care-for-burn-injuries-in-a-middle-income-setting-a-study-in-the-western-cape-south-africa
#4
Rachel L Allgaier, Lucie Laflamme, Lee A Wallis
BACKGROUND: Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services. METHODS: A retrospective, cross-sectional study of administrative and patient records was conducted...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28122891/are-hospital-cancer-caseloads-related-to-the-validity-of-staging-data-reported-a-lesson-from-national-cancer-registry-in-taiwan
#5
Chin-Ying Cheng, Chun-Ju Chiang, Jong-Kai Hsiao, Mei-Shu Lai
OBJECTIVE: Data from the National Taiwan Cancer Registry have been widely used since 2002 to assess quality of health, but its quality of coding in cancer staging data has not been discussed. This study assessed the agreement rate for staging by site visit at medical institutes. METHODS: In this retrospective chart review study, 392 cancer patients in year 2013 were randomly selected from 14 hospitals; the senior cancer registrar reviewers had compared each original chart with data from the Taiwan Cancer Registry to assess agreement rate for staging...
January 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28067944/intensive-case-management-for-severe-mental-illness
#6
REVIEW
Marina Dieterich, Claire B Irving, Hanna Bergman, Mariam A Khokhar, Bert Park, Max Marshall
BACKGROUND: Intensive Case Management (ICM) is a community-based package of care aiming to provide long-term care for severely mentally ill people who do not require immediate admission. Intensive Case Management evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (fewer than 20) and high-intensity input. OBJECTIVES: To assess the effects of ICM as a means of caring for severely mentally ill people in the community in comparison with non-ICM (caseload greater than 20) and with standard community care...
January 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28031297/benefits-and-limitations-of-a-community-engaged-emergency-referral-system-in-a-remote-impoverished-setting-of-northern-ghana
#7
Sneha Patel, John Koku Awoonor-Williams, Rofina Asuru, Christopher B Boyer, Janet Awopole Yepakeh Tiah, Mallory C Sheff, Margaret L Schmitt, Robert Alirigia, Elizabeth F Jackson, James F Phillips
Although Ghana has a well-organized primary health care system, it lacks policies and guidelines for developing or providing emergency referral services. In 2012, an emergency referral pilot-the Sustainable Emergency Referral Care (SERC) initiative-was launched by the Ghana Health Service in collaboration with community stakeholders and health workers in one subdistrict of the Upper East Region where approximately 20,000 people reside. The pilot program was scaled up in 2013 to a 3-district (12-subdistrict) plausibility trial that served a population of approximately 184,000 over 2 years from 2013 to 2015...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28009637/novel-needle-guide-reduces-time-to-perform-ultrasound-guided-femoral-nerve-catheter-placement-a-randomised-controlled-trial
#8
Alparslan Turan, Rovnat Babazade, Hesham Elsharkawy, Wael Ali Sakr Esa, Kamal Maheshwari, Ehab Farag, Nicole M Zimmerman, Loran Mounir Soliman, Daniel I Sessler
BACKGROUND: Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. OBJECTIVES: We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus...
March 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27992551/affluence-and-private-health-insurance-influence-treatment-and-survival-in-non-hodgkin-s-lymphoma
#9
Harry Comber, Marianna De Camargo Cancela, Trutz Haase, Howard Johnson, Linda Sharp, Jonathan Pratschke
BACKGROUND: The aim of this study was to investigate inequalities in survival for non-Hodgkin's lymphoma (NHL), distinguishing between direct and indirect effects of patient, social and process-of-care factors. METHODS: All cases of NHL diagnosed in Ireland in 2004-2008 were included. Variables describing patient, cancer, stage and process of care were included in a discrete-time model of survival using Structural Equation Modelling software. RESULTS: Emergency admissions were more common in patients with co-morbid conditions or with more aggressive cancers, and less frequent for patients from more affluent areas...
2016: PloS One
https://www.readbyqxmd.com/read/27991813/therapist-effects-on-outcome-and-alliance-in-inpatient-psychotherapy-the-contribution-of-patients-symptom-severity
#10
Ulrike Dinger, Johannes Zimmermann, Oliver Masuhr, Carsten Spitzer
Therapists differ in their effectiveness regarding their patients' symptomatic improvement as well as their therapeutic alliances, but little is known about influencing factors. The current study aimed to investigate therapist effects on outcome and alliance in inpatient psychotherapy and to estimate the influence of patient severity on the magnitude of therapist effects in this specific setting. We examined differences between individual psychotherapists in their patients' early alliance and outcome at discharge in a psychotherapy setting of a psychiatric hospital...
December 19, 2016: Psychotherapy
https://www.readbyqxmd.com/read/27983505/modeling-tool-for-decision-support-during-early-days-of-an-anthrax-event
#11
Gabriel Rainisch, Martin I Meltzer, Sean Shadomy, William A Bower, Nathaniel Hupert
Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices...
January 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27979711/reliability-of-the-american-college-of-surgeons-commission-on-cancer-s-quality-of-care-measures-for-hospital-and-surgeon-profiling
#12
Jason B Liu, Kristopher M Huffman, Bryan E Palis, Lawrence N Shulman, David P Winchester, Clifford Y Ko, Bruce L Hall
BACKGROUND: Efforts to improve healthcare quality involve profiling hospitals and providers. Whether cancer-specific measures can be reliably employed for profiling purposes has not reported. STUDY DESIGN: Hospitals and surgeons were profiled with three measures assessing the adequacy of lymphadenectomy for colon (12RLN), gastric (G15RLN), and non-small cell lung (10RLN) cancers using hierarchical models. National Cancer Data Base (NCDB) cases spanning 2010-2013 were included if they met measure eligibility...
November 18, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27938728/-continuity-of-hospital-identifiers-in-hospital-discharge-data-analysis-of-the-nationwide-german-drg-statistics-from-2005-to-2013
#13
Ulrike Nimptsch, Annelene Wengler, Thomas Mansky
BACKGROUND: In Germany, nationwide hospital discharge data (DRG statistics provided by the research data centers of the Federal Statistical Office and the Statistical Offices of the 'Länder') are increasingly used as data source for health services research. Within this data hospitals can be separated via their hospital identifier ([Institutionskennzeichen] IK). However, this hospital identifier primarily designates the invoicing unit and is not necessarily equivalent to one hospital location...
November 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27933389/high-volume-is-the-key-for-improving-in-hospital-outcomes-after-radical-prostatectomy-a-total-population-analysis-in-germany-from-2006-to-2013
#14
Christer Groeben, Rainer Koch, Martin Baunacke, Manfred P Wirth, Johannes Huber
PURPOSE: Outcomes of radical prostatectomy are prone to publication bias, because most of the data originated from highly specialized centers. We assessed in-hospital outcomes of all radical prostatectomies in Germany from 2006 to 2013 focusing on caseload volume, surgical approach, and certification status. METHODS: We analyzed the nationwide German hospital billing data covering 221,331 radical prostatectomies from 2006 to 2013. Outcomes were in-hospital mortality, surgical revision, and transfusion rates and the length of stay...
December 8, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27912898/a-clinical-prediction-model-for-prolonged-air-leak-after-pulmonary-resection
#15
Adam Attaar, Daniel G Winger, James D Luketich, Matthew J Schuchert, Inderpal S Sarkaria, Neil A Christie, Katie S Nason
OBJECTIVE: Prolonged air leak increases costs and worsens outcomes after pulmonary resection. We aimed to develop a clinical prediction tool for prolonged air leak using pretreatment and intraoperative variables. METHODS: Patients who underwent pulmonary resection for lung cancer/nodules (from January 2009 to June 2014) were stratified by prolonged parenchymal air leak (>5 days). Using backward stepwise logistic regression with bootstrap resampling for internal validation, candidate variables were identified and a nomogram risk calculator was developed...
October 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905020/laparoscopic-versus-open-cholecystectomy-a-cost-effectiveness-analysis-at-rwanda-military-hospital
#16
Allison Silverstein, Ainhoa Costas-Chavarri, Mussa R Gakwaya, Joseph Lule, Swagoto Mukhopadhyay, John G Meara, Mark G Shrime
BACKGROUND: Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake in low- and middle-income countries. Thus, there is a need to evaluate laparoscopic cholecystectomy in comparison with an open approach in these settings. METHODS: A cost-effectiveness analysis was performed to evaluate laparoscopic and open cholecystectomies at Rwanda Military Hospital (RMH), a tertiary care referral hospital in Rwanda...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27903204/service-delivery-model-of-extracorporeal-membrane-oxygenation-in-an-australian-regional-hospital
#17
Joe McCaffrey, Neil R Orford, Nicholas Simpson, Jill Lamb Jenkins, Christopher Morley, Vin Pellegrino
BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) for adults in regional centres with low numbers of patients receiving ECMO is unclear. A robust service delivery model may assist in the quality provision of ECMO. OBJECTIVE: To describe a novel ECMO service delivery model in a regional Australian hospital, reporting on patient characteristics and outcomes before and after its implementation. METHODS: An observational cohort study of all patients receiving ECMO at the University Hospital Geelong intensive care unit before and after implementation of a new ECMO clinical service model...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27882394/-economic-aspects-of-oncological-esophageal-surgery-centralization-is-essential
#18
N von Dercks, I Gockel, M Mehdorn, D Lorenz
The incidence of esophageal carcinoma has increased in recent years in Germany. The aim of this article is a discussion of the economic aspects of oncological esophageal surgery within the German diagnosis-related groups (DRG) system focusing on the association between minimum caseload requirements and outcome quality as well as costs. The margins for the DRG classification G03A are low and quickly exhausted if complications determine the postoperative course. A current study using nationwide German hospital discharge data proved a significant difference in hospital mortality between clinics with and without achieving the minimum caseload requirements for esophagectomy...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27843841/temporal-variations-in-suicide-attempt-rates-a-hospital-based-study-from-india
#19
Shivanand Kattimani, Venkatalakshmi Penchilaiya, Siddharth Sarkar, V Muthukrishnan
BACKGROUND: Temporal variations of suicide attempts can help to better understand correlates of suicidal behavior. This study attempted to find the diurnal, weekly, and seasonal variations in suicide attempts at a tertiary care hospital in India. MATERIALS AND METHODS: This record-based study was conducted among patients evaluated at a crisis intervention clinic over a 4-year period at a tertiary care teaching hospital in Southern India. Patients who attempted suicide in recent past and had been medically stabilized were evaluated in this clinic...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27780643/robotic-intracorporeal-padua-ileal-bladder-surgical-technique-perioperative-oncologic-and-functional-outcomes
#20
Giuseppe Simone, Rocco Papalia, Leonardo Misuraca, Gabriele Tuderti, Francesco Minisola, Mariaconsiglia Ferriero, Giulio Vallati, Salvatore Guaglianone, Michele Gallucci
BACKGROUND: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder reconstruction is a challenging procedure. The need for surgical skills and the long operative times have led to concern about its reproducibility. OBJECTIVE: To illustrate our technique for RARC and totally intracorporeal orthotopic Padua ileal bladder. DESIGN, SETTING, AND PARTICIPANTS: From August 2012 to February 2014, 45 patients underwent this technique at a single tertiary referral centre...
October 22, 2016: European Urology
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