The geographics of patients transfers: the case of an Italian Regional Health System

GeoJournal ◽  
2015 ◽  
Vol 81 (5) ◽  
pp. 771-778 ◽  
Author(s):  
Valentina Evangelista
Keyword(s):  
Health System ◽  
Regional Health

Managing the effectiveness of the regional health system

2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko
Keyword(s):  
Public Health ◽  
Health System ◽  
System Analysis ◽  
Health Indicators ◽  
Krasnoyarsk Krai ◽  
Regional Health ◽  
Luenberger Observer ◽  
Efficiency Assessment ◽  
Public Health Indicators

Subject. This article studies the mechanism of State health regulation and methods of management of efficiency of regional healthcare institutions. Objectives. The article aims to analyze the territorial health system in the context of the urgent need to optimize budget expenditures and address public health problems, as well as develop directions to improve the effectiveness of the regional health system of the Krasnoyarsk Krai. Methods. For the study, we used the method of index numbers and calculation of dynamics indicators using official statistics data. Results. We have developed and now present a system of indicators of regional health efficiency assessment, focused mainly on public health indicators and quality of medical services. We also offer our own version of the Luenberger observer modification adapted to the objectives of the regional health system analysis. Conclusions and Relevance. The article concludes that it is necessary to optimize the regional health system using the parameters of medical and social efficiency of the system. The proposed approach to assessing the effectiveness of regional health system can be used as a mechanism to develop recommendations for the management of the network of medical and prophylactic institutions of the region.

scholarly journals 365. Characteristics and outcomes of COVID-19 patients admitted to a regional health system in the southeast

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S251-S253
Author(s):  
Charles Teixeira ◽  
Henry Shiflett ◽  
Deeksha Jandhyala ◽  
Jessica Lewis ◽  
Scott R Curry ◽  
...  
Keyword(s):  
Renal Failure ◽  
Health System ◽  
Patient Characteristics ◽  
Supplemental Oxygen ◽  
Regional Health ◽  
Cancer Symptoms ◽  
Presenting Symptoms ◽  
Global Pandemic ◽  
Male Sex ◽  
Previous Admission

Abstract Background COVID-19, first described in Wuhan, China, is now a global pandemic. We describe a cohort of patients (pts) admitted to our academic health system (HS) in the southeast, where demographics and comorbidities differ significantly from other regions in the U.S. Methods This was a retrospective review of 161 consecutive pts admitted with COVID-19 from 3/12/20 to 6/1/20. We assessed demographics, comorbidities, presenting symptoms, treatments and outcomes and compared pts who died during hospitalization to those who survived to discharge (EpiInfo 7.2, Atlanta, GA). Results Mean age was 60.5 years, 51.6% were female, 72% African American (AA) and 69.6% admitted from home. 54.5% had a BMI >30, 72% had HTN, 47.2% diabetes, and 33.6% COPD or asthma. The majority (68.8%) presented with fever (>38.0) and required supplemental oxygen within 8 hours of admission (63.4%). Cough (65.6%), dyspnea (57.5%), myalgias (30.6%) and diarrhea (23.8%) were also common. 40.4% received hydroxychloroquine, 23.6% steroids and 19.9% convalescent plasma. 42.9% required ICU care, 27.3% were intubated, and 19.3% died. Characteristics associated with death included older age, male sex, HTN, ESRD on HD, and cancer. Symptoms associated with death included absence of cough, absence of myalgias, previous admission for COVID-19, tachypnea, need for supplemental oxygen, elevated BUN and creatinine, and elevated ferritin. Interventions associated with death included use of steroids, receipt of ICU care, intubation, delay to intubation, and use of vasopressors or inotropes. Complications associated with death included development of a new arrhythmia, bacteremia, pneumonia, ARDS, thrombosis, and new renal failure requiring HD (Table). Table 1. Patient Characteristics by Death Table 2. Patient Characteristics by Death Table 3. Patient Characteristics by Death Conclusion COVID-19 pts admitted to our southeast U.S. HS had significant comorbidities, most commonly obesity, HTN, and diabetes. Additionally, AA comprised a disproportionate share (72%) of our cohort compared to the general population of our state (30%), those tested in our region (32.9%), and those found to be positive for COVID-19 (35.8%). In-hospital mortality was 19.3% and intubation, particularly if delayed, was associated with death as were several complications, most notably arrhythmia, ARDS, and renal failure with HD. Disclosures All Authors: No reported disclosures

scholarly journals Reducing hospital-acquired infections in a regional health system

2021 ◽  
pp. 1-2
Author(s):  
Keith L. Grant ◽  
Dora E. Wiskirchen ◽  
Ulysses Wu ◽  
Michael R. Grey ◽  
Pracha P. Eamranond
Keyword(s):  
Health System ◽  
Regional Health ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

2020 ◽  
Vol 144 (11) ◽  
pp. 1321-1324
Author(s):  
Tamera A. Paczos
Keyword(s):  
Health System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Testing ◽  
Turnaround Time ◽  
Test Method ◽  
Regional Health ◽  
The Core ◽  
Local Access ◽  
Average Turnaround Time

Context.— Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis. Objectives.— To demonstrate that investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the Coronavirus disease 2019 (COVID-19) pandemic. Design.— COVID-19 diagnostic testing data were analyzed. Volumes were evaluated by result date (March 16, 2020–May 6, 2020), and the average of received-to-verified turnaround time was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. Results.— Daily viral diagnostic testing capacity increased by greater than 3000% (from 21 tests per day to 658 tests per day). Total viral diagnostic testing reported by the core laboratory increased by 128 times during 22 days of test method validation and 826 times during the analysis period, while average turnaround time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average turnaround time was observed at the core laboratory (0.45 days) versus send-out testing (7.63 days) (P < .001). Conclusions.— Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment (PPE). In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.

The Length of Child Anxiety Treatment in a Regional Health System

2016 ◽  
Vol 47 (6) ◽  
pp. 985-992 ◽  
Author(s):  
Stephen P. H. Whiteside ◽  
Chelsea M. Ale ◽  
Brennan Young ◽  
Mark W. Olsen ◽  
Bridget K. Biggs ◽  
...  
Keyword(s):  
Health System ◽  
Child Anxiety ◽  
Regional Health ◽  
Anxiety Treatment

scholarly journals Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

2015 ◽  
Vol 30 (12) ◽  
pp. 1733-1740 ◽  
Author(s):  
Anna Lee D. Amarnath ◽  
Peter Franks ◽  
John A. Robbins ◽  
Guibo Xing ◽  
Joshua J. Fenton
Keyword(s):  
Cohort Study ◽  
Health System ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Regional Health ◽  
Osteoporosis Screening ◽  
System A

Regional Health System Response to the Virginia Tech Mass Casualty Incident

2007 ◽  
Vol 1 (S1) ◽  
pp. S9-S13 ◽  
Author(s):  
Lisa Kaplowitz ◽  
Morris Reece ◽  
Jody Henry Hershey ◽  
Carol M. Gilbert ◽  
Italo Subbarao
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Health System ◽  
Trauma Center ◽  
Virginia Tech ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
System Response ◽  
Regional Health ◽  
Severity Scores

ABSTRACTBackground: On April 16, 2007 a mass shooting occurred on the campus of Virginia Polytechnic Institute and State University (Virginia Tech). Due to both distance and weather, air transport of the injured directly to a level 1 trauma center was not possible. The injured received all of their care or were initially stabilized at 3 primary hospitals that either had a level 3 trauma center designation or no trauma center designation.Methods: This article is a retrospective analysis of the regional health system (prehospital, hospital, regional hospital emergency operations center, and public health local and state) response. Data records from all of the regional responding emergency medical services, hospitals, and coordinating services were reviewed and analyzed. Records for all 26 patients were reviewed and analyzed using triage designations, injury severity scores (ISS), and critical mortality.Results: Twenty-five of the 26 patients were triaged in the field. Excluding 1 patient (asthma), the average ISS for victims presenting was 8.2. Twelve patients had an ISS of ≥9, and 5 had an ISS score of ≥15. Ten of the 26 patients (38%) required urgent intervention and surgery in the first 24 hours. The overall regional health system mortality of victims received was 3.8% (1 death [excluding 1 dead on arrival {DOA}]/ 26 victims from scene). The regional health system critical mortality rate (excluding 1 victim who was DOA) was 20% (1/5).Discussion: The outcomes of the Virginia Tech mass casualty incident, as evidenced by the low overall regional health system mortality of victims received at 3.8% (1/26) and low critical mortality rate (excluding 1 victim who was DOA) of 20%, coupled with a need to treat a significant amount of moderately injured victims 46% (12/26 with ISS ≥9) gives credence to the successful response. The successful response occurred as a consequence of regional collaborative planning, training, and exercising, which resulted not only in increased expertise and improved communications but also in essential relationships and a sense of trust forged among all of the responders. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S9–S13)

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