scholarly journals Population trends in emergency cancer diagnoses: The role of changing patient case-mix

2019 ◽  
Vol 63 ◽  
pp. 101574
Author(s):  
A. Herbert ◽  
S. Winters ◽  
S. McPhail ◽  
L. Elliss-Brookes ◽  
G. Lyratzopoulos ◽  
...  
Keyword(s):  
Population Trends ◽  
Case Mix ◽  
Patient Case

scholarly journals The Effect of Adding Comorbidities to Current Centers for Disease Control and Prevention Central-Line–Associated Bloodstream Infection Risk-Adjustment Methodology

2017 ◽  
Vol 38 (9) ◽  
pp. 1019-1024 ◽  
Author(s):  
Sarah S. Jackson ◽  
Surbhi Leekha ◽  
Laurence S. Magder ◽  
Lisa Pineles ◽  
Deverick J. Anderson ◽  
...  
Keyword(s):  
Disease Control ◽  
Bloodstream Infection ◽  
Risk Adjustment ◽  
Central Line ◽  
Case Mix ◽  
Type Model ◽  
Patient Case ◽  
Icu Patients ◽  
Control And Prevention ◽  
Centers For Disease Control

BACKGROUNDRisk adjustment is needed to fairly compare central-line–associated bloodstream infection (CLABSI) rates between hospitals. Until 2017, the Centers for Disease Control and Prevention (CDC) methodology adjusted CLABSI rates only by type of intensive care unit (ICU). The 2017 CDC models also adjust for hospital size and medical school affiliation. We hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes.METHODSUsing a cohort design across 22 hospitals, we analyzed data from ICU patients admitted between January 2012 and December 2013. Demographics and International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) discharge codes were obtained for each patient, and CLABSIs were identified by trained infection preventionists. Models adjusting only for ICU type and for ICU type plus patient case mix were built and compared using discrimination and standardized infection ratio (SIR). Hospitals were ranked by SIR for each model to examine and compare the changes in rank.RESULTSOverall, 85,849 ICU patients were analyzed and 162 (0.2%) developed CLABSI. The significant variables added to the ICU model were coagulopathy, paralysis, renal failure, malnutrition, and age. The C statistics were 0.55 (95% CI, 0.51–0.59) for the ICU-type model and 0.64 (95% CI, 0.60–0.69) for the ICU-type plus patient case-mix model. When the hospitals were ranked by adjusted SIRs, 10 hospitals (45%) changed rank when comorbidity was added to the ICU-type model.CONCLUSIONSOur risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model. The CDC should strongly consider comorbidity-based risk adjustment to more accurately compare CLABSI rates across hospitals.Infect Control Hosp Epidemiol 2017;38:1019–1024

scholarly journals The Role of QuantiFERON-TB Gold Plus in Mycobacterium Tuberculosis Detection in a Severe HIV Immunocompromised Patient—Case Report

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1523
Author(s):  
Florentina Dumitrescu ◽  
Cătălina-Gabriela Pisoschi ◽  
Vlad Pădureanu ◽  
Andreea Cristina Stoian ◽  
Livia Dragonu ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Immunocompromised Patient ◽  
Symptomatic Treatment ◽  
Pneumocystis Pneumonia ◽  
Hiv Positive ◽  
Patient Case ◽  
Mycobacterium Tuberculosis Infection ◽  
Antituberculosis Therapy ◽  
Antituberculosis Treatment

Tuberculosis (TB) is an important opportunistic infection in HIV-positive people. We are reporting a case of a 31-year-old HIV-infected patient who was hospitalized in July 2021 for dyspnea, cough with mucopurulent sputum and asthenia. He was confirmed to have Serratia liquefaciens pneumonia and acute respiratory failure. The evolution was unfavorable despite the antibiotic, pathogenic and symptomatic treatment. Because the patient had severe immunosuppression (CD4 count = 37 cell/mm3), we used QuantiFERON-TB Gold Plus for the detection of the Mycobacterium tuberculosis infection. The antituberculosis therapy was initiated, which resulted in a significant improvement of the general condition and the patient was discharged with the recommendation to continue antiretroviral therapy, antituberculosis treatment and Trimethoprim/Sulfamethoxazole—single tablet daily for the prophylaxis of Pneumocystis pneumonia.

scholarly journals National Comparison of Hospital Performances in Lung Cancer Surgery: The Role of Case Mix Adjustment

2018 ◽  
Vol 106 (2) ◽  
pp. 412-420 ◽  
Author(s):  
Naomi Beck ◽  
Fieke Hoeijmakers ◽  
Esmee M. van der Willik ◽  
David J. Heineman ◽  
Jerry Braun ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Cancer Surgery ◽  
Cancer Surgery ◽  
Case Mix ◽  
National Comparison ◽  
Case Mix Adjustment

95 GOSH legacy and epic inpatient data show changing patient case mix and patient requirements since 2000

2021 ◽  
Author(s):  
William A Bryant ◽  
Richard W Issitt ◽  
Lydia Briggs ◽  
Daniel Key ◽  
John Booth ◽  
...  
Keyword(s):  
Case Mix ◽  
Patient Case

scholarly journals P063: Is triage score a valid measure of emergency department case mix?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S99-S100
Author(s):  
B.R. Holroyd ◽  
R.J. Rosychuk ◽  
S. Jelinski ◽  
M. Bullard ◽  
C. McCabe ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Reporting System ◽  
Decision Makers ◽  
Case Mix ◽  
Publicly Funded ◽  
Valid Measure ◽  
Patient Case ◽  
Canadian Province ◽  
Policy Makers

Introduction: In the Canadian province of Alberta, (pop. 4,227,879), the publicly-funded health care system uses the five level Canadian Triage and Acuity Scale (CTAS), to prioritize emergency department (ED) patients. Health system decision makers and policy makers currently use CTAS as an isolated metric to describe ED patient case-mix and to compare EDs. Methods: Using the National Ambulatory Care Reporting System dataset, we reviewed the distribution of patient CTAS scores and the proportion of inpatient admissions by CTAS level for the 16 highest volume Alberta hospital EDs during FY 2013/2014. Results: Collectively, the EDs received 1,027,976 patients, with 1%, 18%, 44%, 30% and 7% classified as CTAS 1-5, respectively. The proportions by CTAS level ranged from 0.2% to 2.8% in CTAS 1; 3.3% to 33.3% in CTAS 2; 29.1% to 54.1% in CTAS 3; 16.7% to 49.0% in CTAS 4; and 3.1% to 12.3% in CTAS 5. Admission proportions by CTAS level ranged from 43.9% to 75.2% in CTAS 1; 18.9% to 42.1% in CTAS 2; 5.4% to 24.7% in CTAS 3; 0.8% to 9.3% in CTAS 4; and 0.1% to 9.1% in CTAS 5. Conclusion: Inter-hospital differences in CTAS acuity distributions reflect triage variability and real differences in case-mix. Wide variation in admission proportions by CTAS level reflects differing admission thresholds between sites, but also suggest intra-level differences in patient severity, comorbidity and complexity. Triage levels cannot be used as an isolated metric to describe and compare ED case-mix. Further work is required to accurately characterize ED patient case-mix.

scholarly journals Patient case mix

1981 ◽  
Vol 56 (7) ◽  
pp. 610-1
Author(s):  
J S Gonnella
Keyword(s):  
Case Mix ◽  
Patient Case

scholarly journals Associations between resources and practices of ILD centers and outcomes in patients with idiopathic pulmonary fibrosis: data from the IPF-PRO Registry

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Joao A. de Andrade ◽  
Tejaswini Kulkarni ◽  
Megan L. Neely ◽  
Anne S. Hellkamp ◽  
Amy Hajari Case ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Transplant ◽  
Online Survey ◽  
Case Mix ◽  
P Value ◽  
Patient Case ◽  
Improvement Project ◽  
The Us ◽  
Event Rates

Abstract Background Performance benchmarks for the management of idiopathic pulmonary fibrosis (IPF) have not been established. We used data from the IPF-PRO Registry, an observational registry of patients with IPF managed at sites across the US, to examine associations between the characteristics of the enrolling sites and patient outcomes. Methods An online survey was used to collect information on the resources, operations, and self-assessment practices of IPF-PRO Registry sites that enrolled ≥ 10 patients. Site variability in 1-year event rates of clinically relevant outcomes, including death, death or lung transplant, and hospitalization, was assessed. Models were adjusted for differences in patient case mix by adjusting for known predictors of each outcome. We assessed whether site-level heterogeneity existed for each patient-level outcome, and if so, we investigated potential drivers of the heterogeneity. Results All 27 sites that enrolled ≥ 10 patients returned the questionnaire. Most sites were actively following > 100 patients with IPF (70.4%), had a lung transplant program (66.7%), and had a dedicated ILD nurse leader (77.8%). Substantial heterogeneity was observed in the event rates of clinically relevant outcomes across the sites. After controlling for patient case mix, there were no outcomes for which the site variance component was significantly different from 0, but the p-value for hospitalization was 0.052. Starting/completing an ILD-related quality improvement project in the previous 2 years was associated with a lower risk of hospitalization (HR 0.60 [95% CI 0.44, 0.82]; p = 0.001). Conclusions Analyses of data from patients with IPF managed at sites across the US found no site-specific characteristics or practices that were significantly associated with clinically relevant outcomes after adjusting for patient case mix. Trial registration ClinicalTrials.gov, NCT01915511. Registered 5 August 2013, https://clinicaltrials.gov/ct2/show/NCT01915511

scholarly journals Longitudinal interprofessional education in a graduate physiology course

2019 ◽  
Vol 43 (2) ◽  
pp. 241-245 ◽  
Author(s):  
Lisa M. Harrison-Bernard ◽  
Mihran V. Naljayan ◽  
Donald E. Mercante ◽  
Tina Patel Gunaldo ◽  
Scott Edwards
Keyword(s):  
Basic Science ◽  
Interprofessional Education ◽  
Physical Therapist ◽  
Physician Assistant ◽  
Kidney Injury ◽  
Health Science ◽  
Patient Case ◽  
First Case ◽  
Case Presentations

The primary purpose of conducting two interprofessional education (IPE) experiences during a multidisciplinary physiology graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students opportunities to work as a team in the diagnosis, treatment, and collaborative care when presented with a patient case focused on acute kidney injury (first case) and female athlete triad (second case). The secondary purpose was to apply basic physiology principles to patient case presentations of pathophysiology. The overall purpose was to assess the longitudinal effects and the value of IPE integrated within a basic science course. The following Interprofessional Education Collaborative subcompetencies were targeted: roles/responsibilities (RR1, RR4). Students were given a pre- and postsurvey to assess their IPE perceptions and knowledge of professional roles. There were statistically significant increases from the presurvey renal IPE experience to the presurvey endocrine IPE experience for two perception questions regarding the ability to explain the roles and responsibilities of a physical therapist (PT) and physician assistant using a Likert scale. In addition, student knowledge of the role of a PT increased significantly when comparing the renal IPE presurvey to the endocrine IPE presurvey results to open-ended questions. Students’ perceptions of their knowledge as well as their ability to express, in writing, their newly learned knowledge of the role of a PT was sustained over time. Incorporating multiple IPE experiences into multidisciplinary health science courses represents an appropriate venue to have students learn and apply interprofessional competencies.

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