Impact of primary care on hospital admission rates for diabetes patients: A systematic review

2017 ◽  
Vol 129 ◽  
pp. 182-196 ◽  
Author(s):  
R.J. Wolters ◽  
J.C.C. Braspenning ◽  
M. Wensing
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Hospital Admission ◽  
Admission Rates ◽  
Diabetes Patients

scholarly journals Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison

2021 ◽  
pp. 135581962110127
Author(s):  
Irina Lut ◽  
Kate Lewis ◽  
Linda Wijlaars ◽  
Ruth Gilbert ◽  
Tiffany Fitzpatrick ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Underlying Disease ◽  
Primary Diagnosis ◽  
Care Quality ◽  
Attendance Rates ◽  
Admission Rates ◽  
Primary Care Quality ◽  
Hospital Administrative

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.

scholarly journals What do hospital admission rates say about primary care?

BMJ ◽  
1999 ◽  
Vol 319 (7202) ◽  
pp. 67-68 ◽  
Author(s):  
R. Jankowski
Keyword(s):  
Primary Care ◽  
Hospital Admission ◽  
Admission Rates

BReATHE interventions (Beating Regional Asthma Through Health Education)—an innovative approach to children’s asthma care in the North East and North Cumbria, UK: an interventional study

2021 ◽  
pp. archdischild-2021-321644
Author(s):  
Jennifer Katherine Townshend ◽  
Sally Hails ◽  
Ruth Levey ◽  
Patty DeZwart ◽  
Michael McKean ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Education ◽  
Hospital Admission ◽  
Educational Interventions ◽  
Primary Outcome Measure ◽  
Admission Rates ◽  
North East ◽  
The North ◽  
Asthma Attack ◽  
Unplanned Admissions

To objective of this project was to reduce unplanned hospital admission rates in children related to asthma to the Newcastle upon Tyne Hospitals National Health Service Trust (NUTH).Multiple educational interventions were introduced both locally and regionally including: a collection of educational materials aimed at young people and families, schools, primary care and secondary care on the website www.beatasthma.co.uk; regional training days; a nurse-led one-stop clinic; a new pathway following an acute attendance to hospital with an asthma attack; a local asthma service and cascade training for schools.The primary outcome measure was reduction in unplanned hospital admission rates in children due to asthma to the NUTH.Results showed that admission rates had been increasing at a sustained rate of approximately 30% each year in the 3 years prior to our intervention. After the Beating Regional Asthma Through Health Education interventions, unplanned admissions to NUTH reduced by 29% and this reduction has been sustained for the last 3 years. This compares with a regional increase of 10% over the same time period.In conclusion, simple but effective educational interventions resulted in a significant and sustained reduction in unplanned asthma admissions to NUTH. Further work is underway to extend the reach of these interventions into primary care and schools.

Everyday J.

2020 ◽  
pp. 141-146
Author(s):  
Chadd K. Kraus
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Admission ◽  
Health Care Services ◽  
Medical Emergency ◽  
State Laws ◽  
Admission Rates ◽  
Care Services ◽  
Ed Visits

Commonly defined as having greater than four emergency department (ED) visits in a year, patients who are frequent users of the ED make up an estimated 3.5% to 10% of all ED visits and have been reported to account for nearly a third of all ED use. Frequent ED users have higher mortality, higher hospital admission rates, and higher use of all health care services, both specialty and primary care, compared to other patients using the ED. These patients should have the autonomy to access ED evaluation and care if he or she believes he or she has a medical emergency. This principle has been codified into both federal and many state laws protecting the “prudent layperson standard.” These patients should not be coerced to not seek ED care if the person believes he or she has an emergent condition.

scholarly journals PL04: Effectiveness of hospital avoidance interventions among elderly patients: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S6-S6
Author(s):  
A. Ness ◽  
N. Symonds ◽  
M. Siarkowski ◽  
M. Broadfoot ◽  
K. McBrien ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Home Visits ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Ed Visits

Introduction: Overuse of acute care services, particularly emergency department (ED) use, is an important topic for healthcare providers and policy makers within Canada and abroad. Prior work has shown that frail elderly patients with complex medical needs and limited personal and social resources are heavy users of ED services and are often admitted when they present to the ED. Updated information on the most effective strategies to avert ED presentation and hospital admission focused specifically on elderly patients is needed. Methods: This systematic review addressed the question: what interventions have demonstrated effectiveness in decreasing ED use and hospital admissions in elderly patients? Comprehensive literature searches were conducted in databases including Ovid Medline, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials with no language or date restrictions. Citations were limited to interventional studies. Grey literature and reference list searches, as well as communication with experts in the field were performed. Consensus or a third reviewer resolved any disagreements. Original research regarding interventions conducted in populations 65 years or older with acute illness, either living in community or facility-living were included. Primary outcomes were ED visits and hospital admissions. Secondary outcomes included: mortality, cost, and patient-reported outcomes such as health-related quality of life and functional status. Results: Forty-three relevant studies were identified including 22 randomized controlled trials (RCT), 2 cluster-RCT, 2 trials with non-random allocation, 4 before-after studies, 6 quasi-experimental studies, and 7 cohort studies. Intervention settings included: home visits (22), long-term care (7), outpatient or primary care clinics (8), and ED (3) or inpatient (3). Data characterization revealed that home-based, outpatient and/or primary care-based strategies reduced ED visits and hospitalizations, particularly those which included comprehensive geriatric assessments, home visits or regular face-to-face contact and interdisciplinary teams. Hospital-based models generally showed no difference in ED or inpatient service utilization. There was, however, considerable variability across individual studies with respect to reporting of outcomes, statistical analyses performed, and overall risk of bias. Conclusion: Various interventional strategies have been studied to avert ED presentation and hospital admission for frail elderly patients. More rigorous methodology and standardization of outcome measures is needed to quantitatively assess the effects of these programs.

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