scholarly journals Impact of COVID-19 on gynaecological patient care: results of patient’s survey with 327 patients

2021 ◽  
Author(s):  
F. Recker ◽  
S. Dohmen ◽  
E. K. Egger ◽  
M. B. Stope ◽  
D. Dimitrova ◽  
...  
Keyword(s):  
Health Care Systems ◽  
Current Situation ◽  
University Hospital ◽  
Comprehensive Information ◽  
Patient Reported ◽  
Care Systems ◽  
The University ◽  
The Impact ◽  
Gynaecological Disease ◽  
Charité Berlin

Abstract Purpose The pandemic SARS-CoV-2 poses new and unprecedented challenges for health care systems on a national and global level. Although the current situation has been going on for more than 1 year, there is limited data on the impact of the pandemic on general hospital and medical practice care. This survey captures the perspective of patients with gynaecological diseases of this impact. Methods Using a paper-based questionnaire, 327 patients were asked about medical care and their experiences during the pandemic at the University Hospital Bonn and the University Hospital Charité Berlin. The study was performed from the 1st June to 30th September 2020. Results A total of 327 patients participated in the study: 156 stated to have been tested for coronavirus, and 1 patient reported a positive test. 41.3% of the patients felt insecure about the current situation, 30.4% were concerned about the risk of infection during the hospital stay. The pandemic-specific measures in hospitals and medical practices unsettled 6.8% of patients. 18.1% of patients feared that their gynaecological disease would not be treated adequately due to the pandemic. 55.7% of patients reported that their confidence in their physicians has increased during the pandemic. Conclusion The results show that patients’ confidence in the healthcare system and the physicians acting significantly increased during the COVID-19 crisis. Transparent and comprehensive information policy regarding actions and restrictions within the COVID-19 crisis eases patients concerns and improves patients’ confidence in their physicians, which is crucial for a successful treatment’s outcome.

scholarly journals Separating the wheat from the chaff – COVID-19 in a German emergency department: A Case-control study

2020 ◽  
Author(s):  
David Fistera ◽  
Dirk Pabst ◽  
Annalena Härtl ◽  
Benedikt Michael Schaarschmidt ◽  
Lale Umutlu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Systems ◽  
University Hospital ◽  
Nasopharyngeal Swab ◽  
Workflow Model ◽  
Manchester Triage System ◽  
Efficient Management ◽  
Care Systems ◽  
To Come ◽  
The University

Abstract Background: COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the Emergency Department. Especially the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?Methods: We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.Results: 43 of the 314 patients (13.7%) were tested positive for COVID-19 by SARS-Cov-2 nasopharyngeal swab. We did not find any laboratory parameter to distinguish safely between patients with COVID-19 and those with similar symptoms. Dysgeusia was the only clinical symptom that was significantly more frequent among COVID-19 patients. Conclusion: Dysgeusia seems to be a typical symptom for COVID-19, which occurred in 14% of our COVID-19 patients. However, no valid parameters could be found to distinguish clinically between COVID-19 and other diseases with similar symptoms. Therefore, early testing, a strict isolation policy and proper personal protection are crucial to maintain workflow and safety of patients and ED staff for the months to come.Trial registration: URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021675

scholarly journals P070 THE IMPACT OF THE COVID 19 PANDEMY ON HERNIA SURGERY IN UNIVERSITY HOSPITAL IN CZECH REPUBLIC

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Barbora Jíšová ◽  
Jakub Woleský ◽  
Barbora East
Keyword(s):  
Czech Republic ◽  
Health Care Systems ◽  
University Teaching ◽  
University Hospital ◽  
Hernia Surgery ◽  
Similar Time ◽  
Record System ◽  
Medical Record System ◽  
Care Systems ◽  
The Impact

Abstract Aim The SARS- CoV-2 pandemic has greatly affected health care systems worldwide, including the Czech Republic. However, the degree to which Covid-19 has impacted on hernia surgery is unknown. The aim of this study was to review the hernia surgery workload in a large university teaching hospital department. Material and Methods A computer based medical record system was used to identify all patients undergoing elective and emergency hernia repair of all types from March 1 to November 30, 2020 and for a similar time period in 2019 at the Motol University Hospital, Prague. Results 194 elective hernia operations were undertaken over the study period in 2020, a reduction from the 285 over a similar period in 2019. The number of emergency hernia operations in 2020 was 13 compared to 25 in 2019. Conclusions The SARS –CoV- 2 pandemic has reduced both the number of elective and emergency hernia operations in 2020 compared to 2019. Time will tell if the reduced elective workload will subsequently increase the emergency hernia workload during the recovery from the pandemic.

scholarly journals On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions

2011 ◽  
Vol 49 (4) ◽  
pp. 474-478
Author(s):  
M.B. Soyka ◽  
G. Nikolaou ◽  
K. Rufibach ◽  
D. Holzmann
Keyword(s):  
Retrospective Cohort ◽  
Health Care Systems ◽  
Financial Burden ◽  
Treatment Options ◽  
University Hospital ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The World ◽  
Care Systems ◽  
The University

Background: Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable. Study design: Retrospective cohort study. Level of evidence: 2b. Methods: Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other. Results: An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups. Conclusion: Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.

scholarly journals Separating the Wheat From the Chaff – Covid-19 in a German Emergency Department: A Case-control Study

2020 ◽  
Author(s):  
David Fistera ◽  
Dirk Pabst ◽  
Annalena Härtl ◽  
Benedikt Michael Schaarschmidt ◽  
Lale Umutlu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Systems ◽  
University Hospital ◽  
Nasopharyngeal Swab ◽  
Workflow Model ◽  
Manchester Triage System ◽  
Efficient Management ◽  
Care Systems ◽  
To Come ◽  
The University

Abstract Background: COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the Emergency Department. Especially the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?Methods: We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.Results: 43 of the 314 patients (13.7%) were tested positive for COVID-19 by SARS-Cov-2 nasopharyngeal swab. We did not find any laboratory parameter to distinguish safely between patients with COVID-19 and those with similar symptoms. Dysgeusia was the only clinical symptom that was significantly more frequent among COVID-19 patients. Conclusion: Dysgeusia seems to be a typical symptom for COVID-19, which occurred in 14% of our COVID-19 patients. However, no valid parameters could be found to distinguish clinically between COVID-19 and other diseases with similar symptoms. Therefore, early testing, a strict isolation policy and proper personal protection are crucial to maintain workflow and safety of patients and ED staff for the months to come.Trial registration: URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021675

scholarly journals The Impact and Implications of The COVID-19 Pandemic on Organ Procurement Outside of an Epicenter

2021 ◽  
pp. 152692482110028
Author(s):  
Janice Jene Hudgins ◽  
Allison Jo Boyer ◽  
Kristen Danielle Orr ◽  
Clint Allen Hostetler ◽  
Jeffrey Paul Orlowski ◽  
...  
Keyword(s):  
Health Care ◽  
Initial Phase ◽  
Organ Procurement ◽  
Health Care Systems ◽  
Health Data ◽  
Organ Procurement Organization ◽  
Care Systems ◽  
The Impact ◽  
Variable Impact ◽  
Single Organ

The COVID-19 pandemic has been well-documented to have a variable impact on individual communities and health care systems. We describe the experience of a single organ procurement organization (OPO), located in an area without a large cluster of cases during the initial phase of the COVID-19 pandemic. A review of community health data describing the impact of COVID-19 nationally and in Oklahoma was conducted. Additionally, a retrospective review of available OPO data from March 2019-May 2020 was performed. While the amount of donor referrals received and organs recovered by the OPO remained stable in the initial months of the pandemic, the observed organs transplanted vs. expected organs transplanted (O:E) decreased to the lowest number in the 15-month period and organs transplanted decreased as well. Fewer organs from Oklahoma donors were accepted for transplant despite staff spending more time allocating organs.

scholarly journals SARS-CoV-2 and Cytomegalovirus Co-Infections—A Case Series of Critically Ill Patients

2021 ◽  
Vol 10 (13) ◽  
pp. 2792
Author(s):  
Patrícia Moniz ◽  
Sérgio Brito ◽  
Pedro Póvoa
Keyword(s):  
Intensive Care Unit ◽  
Critically Ill ◽  
Immune Suppression ◽  
Clinical Course ◽  
Health Care Systems ◽  
Case Series ◽  
Confounding Factors ◽  
Care Systems ◽  
The Impact ◽  
Cmv Reactivation

The SARS-CoV-2 pandemic has placed great strain on the most developed of health care systems, especially in the context of critical care. Although co-infections with cytomegalovirus (CMV) are frequent in the critically ill due to underlying immune suppression of multiple causes, the impact on COVID-19 patients remains unclear. Furthermore, severe COVID-19 has recently been associated with significant immune suppression, and this may in turn impact CMV reactivation, possibly contributing to clinical course. Nevertheless, multiple confounding factors in these patients will certainly challenge upcoming research. The authors present a case series of five patients admitted to the intensive care unit (ICU) in the context of respiratory failure due to severe COVID-19. All patients evolved with CMV reactivation during ICU stay.

scholarly journals Impact of the COVID-19 pandemic and its related psychological effect on orthopedic surgeries conducted in different types of hospitals in Taiwan

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  
Keyword(s):  
Community Hospital ◽  
University Hospital ◽  
Total Knee Arthroplasties ◽  
Peak Period ◽  
Number Of Patients ◽  
Total Knee ◽  
Investigation Period ◽  
Orthopedic Diseases ◽  
The University ◽  
The Impact

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.

scholarly journals Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

2020 ◽  
Vol 13 (11) ◽  
pp. 400
Author(s):  
Arnold G. Vulto ◽  
Jackie Vanderpuye-Orgle ◽  
Martin van der Graaff ◽  
Steven R. A. Simoens ◽  
Lorenzo Dagna ◽  
...  
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Health Care Systems ◽  
Delphi Panel ◽  
The European Union ◽  
Modified Delphi ◽  
Care Systems ◽  
Supply Risks ◽  
The Impact

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

‘Untying the Knot’: Achieving Integrative and Collaborative Care within Trauma and Fear Saturated Systems – A Practice-Focused Discussion Paper

2017 ◽  
Vol 42 (2) ◽  
pp. 104-107 ◽  
Author(s):  
Dilip Balu
Keyword(s):  
Child Protection ◽  
Health Care Systems ◽  
Traumatic Experience ◽  
Ripple Effect ◽  
Discussion Paper ◽  
Care Systems ◽  
Trauma Informed ◽  
The Impact ◽  
The Brain ◽  
Mental Health Care Systems

The author's clinical experience with the Child Protection and Mental Health Care systems informs this brief practice-focused paper. The author posits that Secondary Traumatic Stress and Vicarious Trauma are central to understanding the impact of relationally traumatic material and the experience of individuals, families, team and the wider ecology of care systems. In particular, the author hypothesises that the tendency of systems to become fragmented in operation, with silos of sub-parts working parallel to each other, may be a natural adaptation to the ways in which traumatic experience ripples across system boundaries. This ‘ripple effect’ may lead to increasing emotional and relational reactivity, and survival-oriented inward focus of energies and efforts. The metaphor of the brain and nervous system is used to explore ideas of connection and integration in care systems. Trauma-informed leadership by individuals and teams is also touched upon in relation to reducing fear-driven clinical practice.

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