scholarly journals IMPACT OF A LARGE-SCALE TELEMEDICINE NETWORK ON ALL-CAUSE AND CARDIOVASCULAR EMERGENCY AND HOSPITAL ADMISSIONS DURING THE COVID-19 PANDEMIC IN BRAZIL

2021 ◽  
Vol 77 (18) ◽  
pp. 3109
Author(s):  
Bruno Ramos Nascimento ◽  
Luiz Eduardo V. Fróes ◽  
Ana Cristina T. Castro ◽  
Eduardo T. Fróes ◽  
Cynthia B.M. Araújo ◽  
...  
Keyword(s):  
Large Scale ◽  
Hospital Admissions

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Effects of the Blair/Brown NHS Reforms on Socioeconomic Equity in Health Care

2012 ◽  
Vol 17 (1_suppl) ◽  
pp. 55-63 ◽  
Author(s):  
Richard Cookson ◽  
Mauro Laudicella ◽  
Paolo Li Donni ◽  
Mark Dusheiko
Keyword(s):  
Health Care ◽  
Hip Replacement ◽  
Large Scale ◽  
Hospital Admissions ◽  
Public Hospitals ◽  
Patient Choice ◽  
Socioeconomically Disadvantaged ◽  
Equity In Health ◽  
Socioeconomic Equity ◽  
Equity In Health Care

The central objectives of the ‘Blair/Brown’ reforms of the English NHS in the 2000s were to reduce hospital waiting times and improve the quality of care. However, critics raised concerns that the choice and competition elements of reform might undermine socioeconomic equity in health care. By contrast, the architects of reform predicted that accelerated growth in NHS spending combined with increased patient choice of hospital would enhance equity for poorer patients. This paper draws together and discusses the findings of three large-scale national studies designed to shed empirical light on this issue. Study one developed methods for monitoring change in neighbourhood level socioeconomic equity in the utilization of health care, and found no substantial change in equity between 2001-02 and 2008-09 for non-emergency hospital admissions, outpatient admissions (from 2004-05) and a basket of specific hospital procedures (hip replacement, senile cataract, gastroscopy and coronary revascularization). Study two found that increased competition between 2003-04 and 2008-09 had no substantial effect on socioeconomic equity in health care. Study three found that potential incentives for public hospitals to select against socioeconomically-disadvantaged hip replacement patients were small, compared with incentives to select against elderly and co-morbid patients. Taken together, these findings suggest that the Blair/Brown reforms had little effect on socioeconomic equity in health care. This may be because the ‘dose’ of competition was small and most hospital services continued to be provided by public hospitals which did not face strong incentives to select against socioeconomically-disadvantaged patients.

Seasonal Variation In the Occurrence of Venous Thromboembolism In Canada

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5120-5120
Author(s):  
Dimple Kondal ◽  
Vicky Tagalakis ◽  
Antonio Ciampi ◽  
Susan Kahn
Keyword(s):  
Seasonal Variation ◽  
Venous Thromboembolism ◽  
Research Funding ◽  
Large Scale ◽  
Hospital Admissions ◽  
Seasonal Pattern ◽  
Statistical Significance ◽  
Discharge Diagnosis ◽  
Discharge Data ◽  
Significant Difference

Abstract Abstract 5120 Background. The evidence in support of a seasonal variation in the occurrence of venous thromboembolism (VTE) is conflicting and based on studies of mostly small or moderate size, often single centered and moreover, have never included data from Canada which has clearly-defined seasons with wide temperature differences between winter and summer months. Objectives. We used discharge data from a population-level hospital registry to assess the occurrence of a seasonal pattern in hospital admissions with VTE (deep vein thrombosis (DVT) or pulmonary embolism (PE)), DVT alone and PE alone in the province of Quebec, Canada. Methods. Using data from the province of Quebec's hospital discharge database (Med-Echo) which systematically records information on all hospital admissions in Quebec since 1967, we constructed a retrospective cohort of all individuals who had a first-time discharge diagnosis of DVT or PE between January 1, 1996 and December 31, 2004 and no prior discharge diagnosis for DVT or PE back to 1983. DVT and PE were defined based on the International Classification of Diseases, 9th edition, Clinical Modification. VTE cases were grouped according to season and month of occurrence, and statistical significance of seasonal variation was determined using the Edwards' and Walter & Elwood test. Results. The cohort comprised of 45,588 (26,076 (57%) women and 19,512 (43%) men) admitted patients with incident VTE. The mean age was 62.5 years (SD 17.6) and 26,537 (58%) patients had DVT alone, 12,758 (28%) had PE alone and 6,239 (14%) had DVT with PE. Data by season showed a statistically significant difference with the lowest proportion of hospital VTE admissions in summer months (24.1%) and highest in winter (25.9%) months (p<0.0001). Seasonal variation in number of admissions by month was statistically significant for PE alone (p=0.0084; adjusted for total number of monthly hospital admissions for the Quebec province) with peak occurrence in November-December. There was no seasonal variation in monthly VTE (p=0.12) and DVT alone (p=0.87) admissions. Conclusion. Our large-scale population study provides evidence that in Quebec, Canada there is a seasonal variation in PE hospital admissions with an annual autumn peak. The underlying pathophysiologyic mechanisms are unknown and deserve further study. Disclosures: Tagalakis: Pfizer: Research Funding; Sanofi Aventis: Honoraria. Kahn:Sigvaris: Research Funding; sanofi-aventis: Advisory Board, Research Funding; Boehringer Ingelheim:.

scholarly journals Mobility Restrictions and Air Quality under COVID-19 Pandemic in São Paulo, Brazil

2020 ◽  
Author(s):  
Edmilson D. Freitas ◽  
Sergio A. Ibarra-Espinosa ◽  
Mario E. Gavidia-Calderón ◽  
Amanda Rehbein ◽  
Sameh A. Abou Rafee ◽  
...  
Keyword(s):  
Air Quality ◽  
Air Pollutants ◽  
Large Scale ◽  
Hospital Admissions ◽  
Air Pollutant ◽  
Government Officials ◽  
Social Unrest ◽  
The Public ◽  
Containment Measure ◽  
Mobility Reduction

Social distancing policies put in place during COVID-19 epidemic in addition to helping to limit the spread of the disease also contributed to improving urban air quality. Here we show a decrease in air pollutant concentration as a consequence of mobility reduction in S&atilde;o Paulo during the containment measure which began on 22nd March 2020. When comparing to foregoing weeks to equivalent periods of 2019, the concentration of most air pollutants sharply decreased in the first days of mobility restriction, to then increase again after government officials downplayed the threat of the disease. This trend is also followed by a decrease in hospital admissions by SARS-influenza. Therefore, despite the great economic and social unrest caused by the pandemic, this unique situation shows that large-scale mobility reduction policy had a significant impact on air quality, benefiting, directly and indirectly, the public health system.

scholarly journals Caring for adults with CHD in the era of coronavirus disease 2019 pandemic: early experience in an Italian tertiary centre

2020 ◽  
Vol 30 (10) ◽  
pp. 1405-1408
Author(s):  
Giancarlo Scognamiglio ◽  
Flavia Fusco ◽  
Assunta Merola ◽  
Michela Palma ◽  
Anna Correra ◽  
...  
Keyword(s):  
Hospital Care ◽  
Large Scale ◽  
Hospital Admissions ◽  
Early Experience ◽  
Medical Personnel ◽  
Western Country ◽  
Urgent Care ◽  
Tertiary Centre ◽  
Containment Policy ◽  
The Impact

AbstractBackground:Adults with CHD are known to greatly benefit from a prompt access to continuous expert care. On the other hand, coronavirus disease 2019 pandemic has determined a dramatic worldwide reconfiguration of the healthcare systems, with rapid redeployment of resources towards this emergency. Italy was the first Western country affected by a large-scale spread of coronavirus disease 2019. The aim of our study is to analyse the impact of the coronavirus disease 2019 outbreak on in-hospital care of patients with CHD in an Italian tertiary centre.Methods and results:We retrospectively reviewed data on CHD hospital admissions in our centre since 1 March, 2020, when the adoption of a strict infection containment policy throughout the country resulted in limited access of patients to routine hospital care and resources reallocation to the care of infected patients. Comparison with data from the previous year was performed in order to identify any relevant differences attributable to the outbreak. Despite cancellation of all elective procedures, the overall number of urgent hospital admission remained stable throughout the period of study. Patients admitted during the pandemic had greater disease complexity (p = 0.001) with longer length of in-hospital stay (p = 0.01). No adverse events or positive swabs were reported among CHD patients who were admitted to hospital or medical personnel caring for these patients.Conclusion:Data from our early experience suggest that coronavirus disease 2019 pandemic did not impact significantly on the provision of urgent care to adult patients with CHD.

Risk of Respiratory Hospital Admissions in the Vicinities of Large-Scale Composting Facilities in England

2018 ◽  
Vol 2018 (1) ◽  
Author(s):  
Aina Roca Barceló ◽  
Philippa Douglas ◽  
Daniela Fecht ◽  
Anna Freni Sterrantino ◽  
Marta Blangiardo ◽  
...  
Keyword(s):  
Large Scale ◽  
Hospital Admissions ◽  
Composting Facilities

scholarly journals A longitudinal analysis of loneliness, social isolation and falls amongst older people in England

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Feifei Bu ◽  
Jessica Abell ◽  
Paola Zaninotto ◽  
Daisy Fancourt
Keyword(s):  
Social Isolation ◽  
Life Style ◽  
Large Scale ◽  
Hospital Admissions ◽  
Social Contact ◽  
Total Sample ◽  
Point Increase ◽  
Longitudinal Association ◽  
Nationally Representative ◽  
Socio Demographic Factors

AbstractLoneliness and social isolation have been identified as important predictors of various health outcomes, but little research has investigated their influence on falls. This study aimed to investigate the longitudinal association between loneliness, social isolation and falls amongst older adults in England, looking at both self-reported falls and falls that require hospital admissions. This study drew on large scale, nationally representative data from the English Longitudinal Study of Ageing linked with Hospital Episode Statistics. Data were analysed using survival analysis, with self-reported falls (total sample = 4013) and falls require hospital admission being modelled separately (total sample = 9285). There was a 5% increase in the hazard of self-reported falls relative to one point increase in loneliness independent of socio-demographic factors (HR: 1.05, 95% CI: 1.02–1.08), but the association was explained away by individual differences in health and life-style measures (HR: 1.03, 95% CI: 1.00–1.07). Both living alone (HR: 1.18, 95% CI: 1.07–1.32) and low social contact (HR: 1.04, 95% CI: 1.01–1.07) were associated with a greater hazard of self-reported falls even after controlling for socio-demographic, health and life-style differences. Similar results were also found for hospital admissions following a fall. Our findings were robust to a variety of model specifications.

scholarly journals Research on mental disorders and their care in immigrant populations: a review of publications from Germany, Italy and the UK

2005 ◽  
Vol 20 (8) ◽  
pp. 540-549 ◽  
Author(s):  
Dirk Claassen ◽  
Micol Ascoli ◽  
Tzeggai Berhe ◽  
Stefan Priebe
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Large Scale ◽  
Hospital Admissions ◽  
Service Research ◽  
Future Research ◽  
Consistent Finding ◽  
Immigrant Populations ◽  
Research Questions ◽  
The Uk

AbstractObjectiveThe review aims to identify the extent and nature of research on mental disorders and their care in immigrant populations in three major European countries with high levels of immigration, i.e. Germany, Italy, United Kingdom (UK).MethodsPeer-reviewed publications on the subject from the three countries between 1996 and 2004 were analyzed. The research questions addressed, the methods used, and the results obtained were assessed.ResultsThirteen papers reporting empirical studies were found from Germany, four from Italy and 95 from the UK. Studies addressed a range of research questions and most frequently assessed rates of service utilization in different immigrant groups. The most consistent finding is a higher rate of hospital admissions for Afro-Caribbean patients in the UK. Many studies had serious methodological shortcomings with low sample sizes and unspecified inclusion criteria.DiscussionDespite large scale immigration in each of the three studied countries, the numbers of relevant research publications vary greatly with a relatively high level of empirical research in the UK. Possible reasons for this are a generally stronger culture of mental health service research and a higher number of researchers who are themselves from immigrant backgrounds in the UK.ConclusionOverall the evidence base to guide the development of mental health services for immigrant populations appears limited. Future research requires appropriate funding, should be of sufficient methodological quality and may benefit from collaboration across Europe.

scholarly journals Impact of a large-scale telemedicine network on emergency visits and hospital admissions during the coronavirus disease 2019 pandemic in Brazil: Data from the UNIMED-BH system

2020 ◽  
pp. 1357633X2096952
Author(s):  
Bruno R Nascimento ◽  
Luisa CC Brant ◽  
Ana Cristina T Castro ◽  
Luiz Eduardo V Froes ◽  
Antonio Luiz P Ribeiro ◽  
...  
Keyword(s):  
Large Scale ◽  
Hospital Admissions ◽  
Diagnosis Related Groups ◽  
Mobile App ◽  
Telemedicine System ◽  
Phone Calls ◽  
Emergency Ambulance ◽  
Surge Control ◽  
Ed Visits ◽  
The Impact

Introduction Triage by on-demand telemedicine is a strategy for healthcare surge control in the COVID-19 pandemic. We aimed to assess the impact of a large-scale COVID-19 telemedicine system on emergency department (ED) visits and all-cause and cardiovascular hospital admissions in Brazil. Methods From March 18-May 18, 2020 we evaluated the database of a cooperative private health insurance, with 1.28 million clients. The COVID-19 telemedicine system consisted of: a) mobile app, which redirects to teleconsultations if indicated; b) telemonitoring system, with regular phone calls to suspected/confirmed COVID-19 cases to monitor progression; c) emergency ambulance system (EAS), with internet phone triage and counselling. ED visits and hospital admissions were recorded, with diagnoses assessed by the Diagnosis Related Groups method. COVID-19 diagnosis and deaths were identified from the patients’ registries, and outcomes assessed until June 1st. Results In 60 days, 24,354 patients accessed one of the telemedicine systems. The most frequently utilized was telemonitoring (16,717, 69%), followed by teleconsultation (13,357, 55%) and EAS (687, 3%). The rates of ED and hospital admissions were: telemonitoring 19.7% (3,296) and 4.7% (782); teleconsultation 17.3% (2,313) and 2.4% (318) and EAS: 55.9% (384) and 56.5% (388) patients. At total 4.1% (1,010) had hospital admissions, 36% (363) with respiratory diseases (44 requiring mechanical ventilation) and 4.4% (44) with cardiovascular diagnoses. Overall, 277 (1.1%) patients had confirmed COVID-19 diagnosis, and 160 (0.7%) died, 9 with COVID-19. Conclusion Telemedicine resulted in low rates of ED visits and hospital admissions, suggesting positive impacts on healthcare utilization. Cardiovascular admissions were remarkably rare.

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