Revolving door syndrome: A new meaning for an old concept?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1114-1114
Author(s):  
P. Garrido ◽  
C. Saraiva
Keyword(s):  
Health Care ◽  
Hospital Admissions ◽  
Strong Predictor ◽  
Statistical Significance ◽  
Revolving Door ◽  
Full Time ◽  
University Hospitals ◽  
Short Term ◽  
Care Services ◽  
Psychiatric Units

Introduction“Revolving Door Syndrome” is usually defined as a cyclical pattern of short-term readmissions to the psychiatric units of health care centers, by young adults with chronic psychiatric disorders. Concerning the actual politics in health care sistems, with sucessive budget cuts and reduction of full-time hospital beds, the authors' aim has been to identify the patients that enter into a vicious circle of being admitted to hospital, discharged, and admitted again, as well as the underlying psychosocial reasons.ObjectivesThe purpose of this study was to identify factors associated with short-term readmissions to psychiatric acute care services, with statistical significance, and clinical interest, within a portuguese sample.Material and methodsRetrospective cohort study, in which the medical records of patients admitted to Coimbra University Hospitals two or more times (with short-term readmissions) between January and December of 2009, were analysed for socio-demographic characteristics, psychiatric diagnostic, presence of comorbidities, number of hospital admissions within that year, psychofarmacological treatments and presence of social and familiar support.Results and conclusionsThe authors found that lack of social and familiar support is a strong predictor for “Revolving Door Syndrome”, as well as the presence of a chronic psychiatric disorder.

scholarly journals Short-Term Association between Black Carbon Exposure and Cardiovascular Diseases in Pakistan’s Largest Megacity

Atmosphere ◽  
2018 ◽  
Vol 9 (11) ◽  
pp. 420 ◽  
Author(s):  
Daniel Malashock ◽  
Haider Khwaja ◽  
Zafar Fatmi ◽  
Azhar Siddique ◽  
Yi Lu ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Black Carbon ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Fine Particulate Matter ◽  
Tertiary Care ◽  
Short Term ◽  
Residential Site ◽  
Fine Particulate ◽  
Tertiary Care Hospitals

This study investigated the association between black carbon (BC) exposure and hospital admissions (HAs) and outpatient department/emergency room (OPD/ER) visits for cardiovascular diseases (CVD) among residents of Karachi, the largest city in Pakistan. We measured daily concentrations of BC in fine particulate matter (PM2.5) and collected records of HAs and OPD/ER visits for CVD from 2 major tertiary care hospitals serving Karachi for 6 weeks continuously during each quarter over 1 year (August 2008–August 2009). We subsequently analyzed daily counts of hospital and BC data over 0–3 lag days. Daily mean BC concentrations varied from 1 to 32 µg/m3. Results suggest that BC concentrations are associated with CVD HAs and OPD/ER visits. However, associations were generally only observed when modeled with BC from Tibet Center, the commercial-residential site, as compared to Korangi, the industrial-residential site. Overall, low statistical significance suggests that while BC may be a valuable indicator for CVD health risks from combustion-derived particles, further evaluation of the constituents of PM2.5 and their relative contributions to CVD health impacts is necessary.

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

scholarly journals Cost Savings and Reduced Health Care Utilization Associated with Participation in a Digital Diabetes Prevention Program in an Adult Workforce Population

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Cynthia Castro Sweet ◽  
Carolyn Bradner Jasik ◽  
Amy Diebold ◽  
Ashley DuPuis ◽  
Bryan Jendretzke
Keyword(s):  
Health Care ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Claims Data ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Cost Savings ◽  
Diabetes Prevention Program ◽  
Program Delivery ◽  
The Impact

Background: Though in-person delivery of the Diabetes Prevention Program (DPP) has demonstrated medical cost savings, the economic impact of digital programs is not as well understood. Objective: This study examines the impact of a digital DPP program on reducing all-cause health care costs and utilization among 2027 adult participants at 12 months. Methods: A longitudinal, observational analysis of health care claims data was conducted on a workforce population who participated in a digital diabetes prevention program. Differences in utilization and costs from the year prior to program delivery through 1 year after enrollment were calculated using medical claims data for digital DPP participants compared to a propensity matched cohort in a differences-in-differences model. Results: At 1 year, the digital DPP population had a reduction in all-cause health care spend of US$1169 per participant relative to the comparison group (P = 0.01), with US$699 of that savings coming from reduced inpatient spend (P = 0.001). Cost savings were driven by fewer hospital admissions and shorter length of stay (P < 0.001). No other significant results in cost differences were detected. There was a trend toward savings extending into the second year, but the savings did not reach statistical significance. Conclusions: These results demonstrated significant short-term health care cost savings at 1 year associated with digital DPP program delivery.

scholarly journals Physical therapy in avoidable hospitalizations for primary care-sensitive conditions

2016 ◽  
Vol 29 (1) ◽  
pp. 183-192
Author(s):  
Alessandra Bombarda Müller ◽  
Nadia Cristina Valentini ◽  
Maria Eugênia Bresolin Pinto
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Physical Therapy ◽  
Health Care Services ◽  
Hospital Admissions ◽  
Physical Therapists ◽  
The Public ◽  
Avoidable Hospitalizations ◽  
Care Services ◽  
Sensitive Conditions

Abstract Avoidable hospitalizations for primary care-sensitive conditions have been used as indicators of access to timely and appropriate care because hospital admissions for many conditions could be prevented by interventions in primary care. Physical therapists play an important role in health promotion, disease prevention, and the pursuit of fairness and improvements in the effectiveness of health care services, which are the goals of the public policies proposed by the Brazilian unified health care system. We used MEDLINE and SciELO to search the literature for articles concerning the association between physical therapy and the reduction of avoidable hospitalizations for primary care-sensitive conditions. The literature on the topic is still in its infancy and confined to relatively few studies. Although the available literature associates access to quality primary care with reduced hospitalizations for primary care-sensitive conditions, there is a need for original studies investigating whether there is an association between physical therapy and decreased hospital admissions for primary care-sensitive conditions.

Characterizing the health experience of Tuvaluan migrants in Auckland, New Zealand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jordan Paul Emont ◽  
Seipua O’Brien ◽  
Vili Nosa ◽  
Elizabeth Terry Toll ◽  
Roberta Goldman
Keyword(s):  
Climate Change ◽  
Health Care ◽  
New Zealand ◽  
Health Care Services ◽  
Participant Observation ◽  
Full Time ◽  
Structured Interviews ◽  
Content Type ◽  
Care Services ◽  
Full Time Employment

Purpose It is predicted that increasing numbers of citizens of the Pacific Island nation of Tuvalu will migrate to New Zealand in the coming decades due to the threat of climate change. Tuvaluans currently living in New Zealand face disparities in income, education and health. This study aims to understand the views of recent Tuvaluan immigrants to Auckland, New Zealand on health behaviors, health care and immigration. Design/methodology/approach The authors conducted semi-structured interviews, key informant interviews and participant observation using a focused ethnography methodology. Findings Participants explained that Tuvaluans in New Zealand do not fully use primary care services, have a poorer diet and physical activity compared to those living in Tuvalu, and struggle to maintain well-paying, full-time employment. Practical implications As Tuvaluan immigration to New Zealand continues, it will be important to educate the Tuvaluan community about the role of primary health-care services and healthy behaviors, facilitate the current process of immigration and provide job training to recent immigrants to improve their opportunities for full-time employment and ensure cultural survival in the face of the threat of climate change. Originality/value This paper contributes to a greater understanding of the challenges to be faced by Tuvaluan environmental migrants in the future and features a high proportion of study participants who migrated due to climate change.

Hospitals and Health Care

1987 ◽  
Author(s):  
William G. Rothstein
Keyword(s):  
Health Care ◽  
Speech Therapy ◽  
Heart Surgery ◽  
New Technologies ◽  
Hospital Admissions ◽  
Psychiatric Patients ◽  
Open Heart Surgery ◽  
Partial Hospitalization ◽  
Short Term ◽  
Hospital System

The use of hospitals for medical care became more varied after 1950. More patients were admitted for a wide variety of conditions and more different types of treatments were provided. Many new technologies were adopted that have raised costs considerably. Hospitals employed more residents, foreign medical graduates, and nurses. Between 1946 and 1983, hospitals grew both in size and importance in the health care system. The number of short-term nonfederal hospitals increased by only one-third, but the number of beds and the average daily census doubled and the number of admissions increased 2.6 times, while the U.S. population grew by only two-thirds. Much of the additional use was for nonsurgical care. During the 1928–1943 period, 74 percent of all hospital admissions were surgical. This declined to 60 percent between 1956 and 1968 and to 50 percent between 1975 and 1981. Outpatient care grew even more rapidly than inpatient care, with the number of hospital outpatients doubling between 1965 and 1983. The hospital system has become dominated by large hospitals, practically all of which have affiliated with medical schools. In 1983, the 18 percent of nonfederal short-term hospitals that had 300 or more beds admitted 50 percent of the patients, carried out 59 percent of the surgery, and had 55 percent of the outpatient visits and 61 percent of the births. They employed 72 percent of all physicians and dentists employed in hospitals and 90 percent of all medical and dental residents. At least 60 percent of them had nurseries for premature infants, hemodialysis units, radiation therapy or isotype facilities, computerized tomograhy (CT) scanners, and cardiac catheterization facilities, and almost one-half had open-heart surgery facilities. Most also offered types of care not traditionally associated with hospitals. Practically all of them provided social work services and physical therapy, at least 75 percent provided occupational and speech therapy, and 40 percent provided outpatient psychiatric care. On the other hand, fewer than one-third provided family planning, home care, or hospice services, or partial hospitalization for psychiatric patients. The expanding services of nonfederal short-term general hospitals has led to the employment of larger numbers of workers.

scholarly journals The Short-Term Impact of COVID-19 Pandemic on Spine Surgeons: A cross sectional global study

2020 ◽  
Author(s):  
Mohamed Fawzy Khattab ◽  
Tareq M.A. Kannan ◽  
Ahmed Morsi ◽  
Qussay Al-Sabbagh ◽  
Fadi Hadidi ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Cross Sectional Study ◽  
Care Providers ◽  
University Hospitals ◽  
Short Term ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
The Impact

Abstract Purpose: The outbreak of COVID-19 erupted in December 2019 in Wuhan-China. In a few weeks it progressed rapidly into a global pandemic which resulted in an overwhelming burden on health care systems, medical resources and staff.Spine surgeons as health care providers are no exception. In this study we try to highlight the impact of the crisis on spine surgeons in terms of knowledge, attitude, practice and socioeconomic BurdenMethods: This was global, multi-centric cross-sectional study on 781 spine surgeons that utilized an internet-based validated questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perceptions, effect of this crisis on practice and psychological distress. Univariate and multivariate ordinal logistic regression analyses were used to evaluate the predictors for the degree of COVID-19 effect on practice. Results: Overall, 20.2%, 52%, and 27.8% of the participants were affected minimally, intermediately, and hugely by COVID-19, respectively. Older ages (β= 0.33, 95% CI 0.11 to 0.56), orthopedic spine surgeons (β=0.30, 95% CI 0.01 to 0.61) and those who work in the private sector (β=0.05, 95% CI 0.19 to 0.61) were the most affected by COVID-19. Those who work in university hospitals (β=-0.36, 95% CI 0.00 to -0.71) were affected the least. The availability of N95 masks (47%) and disposable eye protectors or face shields (39.4%) was significantly associated with lower psychological stress (p=0.01). Only (6.9%), (3.7%), and (5%) had mild, moderate and severe mental distress, respectively.Conclusion: While it is important to recognize the short-term impact of COVID-19 pandemic on the practice of spine surgery, predicting where we will be standing in 6-12 months remains difficult and unknown. The COVID-19 crisis will probably have an unexpected long-term impact on lives and economies.

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