scholarly journals 13.3 The Impact of Psychiatric Comorbidities in Transition of Care for Adolescents with Epilepsy

2021 ◽  
Vol 60 (10) ◽  
pp. S185-S186
Author(s):  
Yang Cai ◽  
Jane Timmons-Mitchell ◽  
Elia Pestana-Knight ◽  
Krystel Tossone ◽  
Carrie Cuomo ◽  
...  
Keyword(s):  
Transition Of Care ◽  
Psychiatric Comorbidities ◽  
The Impact

scholarly journals Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study

2021 ◽  
Author(s):  
Iman Alaie ◽  
Richard Ssegonja ◽  
Anna Philipson ◽  
Anne-Liis von Knorring ◽  
Margareta Möller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Life ◽  
Adolescent Depression ◽  
Longitudinal Cohort Study ◽  
Health Concern ◽  
Psychiatric Comorbidities ◽  
Longitudinal Cohort ◽  
Transfer Payments ◽  
Social Transfer ◽  
The Impact

Abstract Purpose Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations. Methods This is a longitudinal cohort study of 539 participants assessed at age 16–17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach. Results Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551–1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887–2620). Conclusion Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.

The association of psychiatric and neurological comorbidities with outcomes in traumatic injury patients

2021 ◽  
pp. 009121742198914
Author(s):  
Jennifer Brady ◽  
R David Hayward ◽  
Elango Edhayan
Keyword(s):  
Length Of Stay ◽  
Psychiatric Illness ◽  
Traumatic Injury ◽  
Lower Mortality ◽  
Linear Modeling ◽  
Psychiatric Comorbidities ◽  
Trauma Outcomes ◽  
Hospital Stays ◽  
The Impact ◽  
The Relationship

Introduction Mental illness is a well-known risk factor for injury and injury recidivism. The impact of pre-existing psychiatric illness on trauma outcomes, however, has received less attention. Our study examines the relationship of pre-existing psychiatric illness on trauma outcomes including length of stay, cost, and mortality. Methods Patient data were obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database. All patients admitted for trauma in the Detroit metropolitan area from 1/1/2006 to 12/31/2014 were included. The relationship between individual psychiatric comorbidities (depression, psychosis, and other neurological disorders) and outcomes were evaluated with logistic regression (mortality) and generalized linear modeling (length of stay and cost). Results Over 260,000 records were reviewed. Approximately one-third (29.9%) of patients had one or more psychiatric diagnoses. Patients with depression had longer hospital stays (RR = 1.12, p < 0.001) and higher costs (RR = 1.07, p < 0.001), but also lower mortality (OR = 0.69, p < 0.001). Patients with psychosis had longer stays (RR = 1.18, p < 0.001), higher costs (RR = 1.02, p = 0.002), and lower mortality (OR = 0.61, p < 0.001). Patients with other neurological comorbidities had higher mortality (OR = 1.23, p < 0.001), longer stays (RR = 1.29, p < 0.001), and higher costs (RR = 1.10, p < 0.001). Conclusion Patients with a psychiatric disorder required longer care and incurred greater costs, whereas mortality was higher for only those with a neurological disorder. Identifying patients’ psychiatric comorbidities at the time of admission for trauma may help optimize treatment. Addressing these conditions may help reduce the cost of trauma care.

scholarly journals 5 The Impact of Psychiatric Comorbidities on the Length of Hospital Stay in Patients with Heart Failure

Heart ◽  
2016 ◽  
Vol 102 (Suppl 6) ◽  
pp. A4-A5
Author(s):  
Paul Carter ◽  
Andrew Carter ◽  
Jennifer Reynolds ◽  
Hardeep Uppal ◽  
Suresh Chandran ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Psychiatric Comorbidities ◽  
Patients With Heart Failure ◽  
The Impact

scholarly journals Residents' Self-Perceived Errors in Transitions of Care in the Emergency Department

2011 ◽  
Vol 3 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Dustin Smith ◽  
J. Wayne Burris ◽  
Guisou Mahmoud ◽  
Gregory Guldner
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Resident Physician ◽  
Transitions Of Care ◽  
Transition Of Care ◽  
Standardized Protocol ◽  
The Mean ◽  
System Errors ◽  
The Impact ◽  
Research Assistants

Abstract Background The Accreditation Council for Graduate Medical Education requirements for systems-based practice state residents are expected to participate in identifying system errors and implementing potential systems solutions. The objective of this study was to determine the numbers of perceived errors occurring from patient pass offs between resident physicians in our emergency department. Methods Using a prospective observational study, we queried emergency medicine residents about perceived errors in the transition of care using trained research assistants and a standardized protocol. Transition of care was defined as the transfer of responsibility to evaluate and treat and disposition of a patient in the emergency department from 1 resident physician to a second oncoming emergency department resident physician. Mean resident-perceived errors per shift and per patient transfer of care were calculated. Additionally, the mean number of perceived errors impacting patients was calculated. Results Emergency medicine residents on 107 shifts reported receiving 713 patients in pass off with a mean of 7 patients per physician per shift, with 40% of patients passed off needing some intervention (mean of 2.8 patients per provider per shift). Nineteen of the 107 shifts (17.8%) during which a resident took patients from a prior provider had a perceived error in at least 1 patient signed off. Of the 713 patients transitioned, the receiving physician perceived an error related to the transition of care for 23. Two of the 23 errors were determined by reviewing emergency medicine attendings to not be errors, and for 9 the receiving physician perceived an impact on the patient. All were delays in care or disposition. Conclusion Our data suggest emergency medicine residents were able to perceive errors related to transitions of care, describe the types of pass-off errors, and, to a lesser degree, describe the impact these errors have on patients.

scholarly journals The Impact of Psychiatric Comorbidities on Readmissions for Diabetes in Youth

Diabetes Care ◽  
2005 ◽  
Vol 28 (9) ◽  
pp. 2150-2154 ◽  
Author(s):  
M. M. Garrison ◽  
W. J. Katon ◽  
L. P. Richardson
Keyword(s):  
Psychiatric Comorbidities ◽  
The Impact ◽  
Diabetes In Youth

scholarly journals Internal Medicine Residents’ Views About Care Transitions: Results of an Educational Intervention

2021 ◽  
Vol 8 ◽  
pp. 238212052098859
Author(s):  
Fatima Sheikh ◽  
Evelyn Gathecha ◽  
Alicia I Arbaje ◽  
Colleen Christmas
Keyword(s):  
Internal Medicine ◽  
Qualitative Analysis ◽  
Continuity Of Care ◽  
Transitional Care ◽  
Care Transitions ◽  
Reflective Writing ◽  
Patient Specific ◽  
Transition Of Care ◽  
Internal Medicine Residents ◽  
The Impact

Problem: Suboptimal care transitions can lead to re-hospitalizations. Intervention: We developed a 2-week “Transitions of Care Curriculum” to train first-year internal medicine residents to improve their knowledge and skills to deliver optimal transitional care. Our objective was to use reflective writing essays to evaluate the impact of the curriculum on the residents. Methods: The rotation included: Transition of Care Teaching modules, Transition Audit, Transitional Care Site Visits, and Transition of Care Conference. Residents performed the above elements of care transitions during the curriculum and wrote reflective essays about their experiences. These essays were analyzed to assess for the overall impact of the curriculum on the residents. Qualitative analysis of reflective essays was used to evaluate the impact of the curriculum. Of the 20 residents who completed the rotation, 18 reflective essays were available for qualitative analysis. Results: Five major themes identified in the reflective essays for improvement were: discharge planning, patient-centered care, continuity of care, goals of care discussions, and patient safety. The most discussed theme was continuity of care, with following subthemes: fragmentation of the healthcare system, disjointed care to the patients, patient specific factors contributing to lack of continuity of care, lack of primary care provider role as a coordinator of care, and challenges during discharge process. Residents also identified system-based gaps and suggested solutions to overcome these gaps. Conclusions: This experiential learning and use of reflective writing enhanced the residents’ self-identified awareness of gaps in care transitions and prompted them to generate ideas for systems improvement and personal actions to improve their practice during care transitions.

Suicidal/self-harm behaviors among cancer patients: a population-based competing risk analysis

2020 ◽  
pp. 1-10
Author(s):  
Vera Yu Men ◽  
Clifton Robert Emery ◽  
Tai-Chung Lam ◽  
Paul Siu Fai Yip
Keyword(s):  
Cancer Patients ◽  
Cumulative Incidence ◽  
Competing Risk ◽  
Contributing Factors ◽  
Age And Gender ◽  
Psychiatric Comorbidities ◽  
Risk Of Death ◽  
Self Harm ◽  
And Gender ◽  
The Impact

Abstract Background Cancer patients had elevated risk of suicidality. However, few researches studied the risk/protective factors of suicidal/self-harm behaviors considering the competing risk of death. The objective of this study is to systematically investigate the risk of suicidal/self-harm behaviors among Hong Kong cancer patients as well as the contributing factors. Methods Patients aged 10 or above who received their first cancer-related hospital admission (2002–2009) were identified and their inpatient medical records were retrieved. They were followed for 365 days for suicidal/self-harm behaviors or death. Cancer-related information and prior 2-year physical and psychiatric comorbidities were also identified. Competing risk models were performed to explore the cumulative incidence of suicidal/self-harm behavior within 1 year as well as its contributing factors. The analyses were also stratified by age and gender. Results In total, 152 061 cancer patients were included in the analyses. The cumulative incidence of suicidal/self-harm behaviors within 1 year was 717.48/100 000 person-years. Overall, cancer severity, a history of suicidal/self-harm behaviors, diabetes and hypertension were related to the risk of suicidal/self-harm behaviors. There was a U-shaped association between age and suicidal/self-harm behaviors with a turning point at 58. Previous psychiatric comorbidities were not related to the risk of suicidal/self-harm behaviors. The stratified analyses confirmed that the impact of contributing factors varied by age and gender. Conclusions Cancer patients were at risk of suicidal/self-harm behaviors, and the impacts of related factors varied by patients' characteristics. Effective suicide prevention for cancer patients should consider the influence of disease progress and the differences in age and gender.

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