Ebola Preparedness Resources for Acute-Care Hospitals in the United States: A Cross-Sectional Study of Costs, Benefits, and Challenges

2017 ◽  
Vol 38 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Michael A. Smit ◽  
Kenneth A. Rasinski ◽  
Barbara I. Braun ◽  
Linda L. Kusek ◽  
Aaron M. Milstone ◽  
...  
Keyword(s):  
United States ◽  
Acute Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Acute Care Hospitals ◽  
The United States ◽  
Labor Costs ◽  
Cross Sectional ◽  
American Hospital ◽  
American Hospital Association

OBJECTIVETo assess resource allocation and costs associated with US hospitals preparing for the possible spread of the 2014–2015 Ebola virus disease (EVD) epidemic in the United States.METHODSA survey was sent to a stratified national probability sample (n=750) of US general medical/surgical hospitals selected from the American Hospital Association (AHA) list of hospitals. The survey was also sent to all children’s general hospitals listed by the AHA (n=60). The survey assessed EVD preparation supply costs and overtime staff hours. The average national wage was multiplied by labor hours to calculate overtime labor costs. Additional information collected included challenges, benefits, and perceived value of EVD preparedness activities.RESULTSThe average amount spent by hospitals on combined supply and overtime labor costs was $80,461 (n=133; 95% confidence interval [CI], $56,502–$104,419). Multivariate analysis indicated that small hospitals (mean, $76,167) spent more on staff overtime costs per 100 beds than large hospitals (mean, $15,737; P<.0001). The overall cost for acute-care hospitals in the United States to prepare for possible EVD cases was estimated to be $361,108,968. The leading challenge was difficulty obtaining supplies from vendors due to shortages (83%; 95% CI, 78%–88%) and the greatest benefit was improved knowledge about personal protective equipment (89%; 95% CI, 85%–93%).CONCLUSIONSThe financial impact of EVD preparedness activities was substantial. Overtime cost in smaller hospitals was >3 times that in larger hospitals. Planning for emerging infectious disease identification, triage, and management should be conducted at regional and national levels in the United States to facilitate efficient and appropriate allocation of resources in acute-care facilities.Infect Control Hosp Epidemiol 2017;38:405–410

Infection prevention practices in the United States, the Netherlands, Switzerland, and Japan: Results from national surveys

2021 ◽  
pp. 1-9
Author(s):  
M. Todd Greene ◽  
Sarah L. Krein ◽  
Anita Huis ◽  
Marlies Hulscher ◽  
Hugo Sax ◽  
...  
Keyword(s):  
United States ◽  
The Netherlands ◽  
Acute Care ◽  
Infection Prevention ◽  
Acute Care Hospitals ◽  
The United States ◽  
Survey Study ◽  
Surveillance Systems ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Objective: To assess the extent to which evidence-based practices are regularly used in acute care hospitals in different countries. Design: Cross-sectional survey study. Participants and setting: Infection preventionists in acute care hospitals in the United States (US), the Netherlands, Switzerland, and Japan. Methods: Data collected from hospital surveys distributed between 2015 and 2017 were evaluated to determine the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central-line–associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). Descriptive statistics were used to examine hospital characteristics and the percentage of hospitals reporting regular use of each infection prevention practice. Results: Survey response rates were 59% in the United States, 65% in the Netherlands, 77% in Switzerland, and 65% in Japan. Several recommended practices were used in the majority of hospitals: aseptic catheter insertion and maintenance (CAUTI), maximum sterile barrier precautions (CLABSI), semirecumbent patient positioning (VAP), and contact precautions and routine daily cleaning (CDI). Other prevention practices for CAUTI and VAP were used less frequently, particularly in Swiss and Japanese hospitals. Established surveillance systems were also lacking in Dutch, Swiss and Japanese hospitals. Conclusions: Most hospitals in the United States, the Netherlands, Switzerland, and Japan have adopted certain infection prevention practices. Clear opportunities for reducing HAI risk in hospitals exist across all 4 countries surveyed.

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

Preparation of Children for Hospitalization in Acute Care Hospitals in the United States

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 361-368
Author(s):  
Pat Azarnoff ◽  
Patricia D. Woody
Keyword(s):  
United States ◽  
Acute Care ◽  
Group Discussion ◽  
Acute Care Hospitals ◽  
The United States ◽  
Pediatric Care ◽  
Children's Hospitals ◽  
General Hospitals ◽  
Psychological Preparation ◽  
Children’S Hospitals

To study the prevalence and nature of psychological preparation for pediatric care, children's hospitals and acute care general hospitals were surveyed, and 24 hospitals were visited. Of 1,427 hospitals responding, 468 (33%) provided regular, planned preparation services. Prior to hospitalization, group tours and group discussion were the two most frequently used methods. During hospitalization, children learned informally as events occurred, usually through conversations.

Pressure Ulcers and Prevention Among Acute Care Hospitals in the United States

2013 ◽  
Vol 39 (9) ◽  
pp. 404-414 ◽  
Author(s):  
Sandra Bergquist-Beringer ◽  
Lei Dong ◽  
Jianghua He ◽  
Nancy Dunton
Keyword(s):  
United States ◽  
Acute Care ◽  
Pressure Ulcers ◽  
Acute Care Hospitals ◽  
The United States

Abstract 23: Incidence of Adult In-Hospital Cardiac Arrest in the United States

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Mathias J Holmberg ◽  
Catherine Ross ◽  
Paul S Chan ◽  
Jordan Duval-Arnould ◽  
Anne V Grossestreuer ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Arrest ◽  
The United States ◽  
Annual Incidence ◽  
Adult Patients ◽  
Negative Binomial Regression Model ◽  
American Hospital ◽  
American Hospital Association ◽  
Average Annual Incidence ◽  
Hospital Cardiac Arrest

Introduction: Current incidence estimates of in-hospital cardiac arrest in the United States are based on data from more than a decade ago, with an estimated 200,000 adult cases per year. The aim of this study was to estimate the contemporary incidence of in-hospital cardiac arrest in adult patients, which may better inform the public health impact of in-hospital cardiac arrest in the United States. Methods: Using the Get With The Guidelines®-Resuscitation (GWTG-R) registry, we developed a negative binomial regression model to estimate the incidence of index in-hospital cardiac arrests in adult patients (>18 years) between 2008 and 2016 based on hospital-level characteristics. The model coefficients were then applied to all United States hospitals, using data from the American Hospital Association Annual Survey, to obtain national incidence estimates. Hospitals only providing care to pediatric patients were excluded from the analysis. Additional analyses were performed including both index and recurrent events. Results: There were 154,421 index cardiac arrests from 388 hospitals registered in the GWTG-R registry. A total of 6,808 hospitals were available in the American Hospital Association database, of which 6,285 hospitals provided care to adult patients. The average annual incidence was estimated to be 283,700 in-hospital cardiac arrests. When including both index and recurrent cardiac arrests, the average annual incidence was estimated to 344,800 cases. Conclusions: Our analysis indicates that there are approximately 280,000 adult patients with in-hospital cardiac arrests per year in the United States. This estimate provides the contemporary annual incidence of the burden from in-hospital cardiac arrest in the United States.

Simulation Use in Acute Care Hospitals in the United States

2018 ◽  
Vol 34 (5) ◽  
pp. 242-249 ◽  
Author(s):  
Mary G. Harper ◽  
Gregory E. Gilbert ◽  
Marie Gilbert ◽  
Linda Markey ◽  
Krista Anderson
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
The United States

scholarly journals 545. Incidence of Carbapenem Non-Susceptible Acinetobacter spp. and Carbapenem-Resistant Pseudomonas aeruginosa Clinical Cultures among Patients in US Acute Care Hospitals, 2012–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S260-S260
Author(s):  
Sophia Kazakova ◽  
James Baggs ◽  
Hannah Wolford ◽  
Babatunde Olubajo ◽  
Kelly M Hatfield ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acute Care ◽  
Statistical Significance ◽  
Acute Care Hospitals ◽  
Healthcare Database ◽  
American Hospital ◽  
American Hospital Association ◽  
Carbapenem Resistant ◽  
Effective Interventions ◽  
Acinetobacter Spp

Abstract Background Carbapenem-nonsusceptible Acinetobacter spp. (CNAB) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) are recognized causes of severe and difficult to treat healthcare-associated infections. This study estimated and compared the incidence of CNAB and CRPA among patients admitted to US acute care hospitals in 2012–2017. Methods We measured the incidence of positive clinical cultures from inpatient encounters in a cohort of over 300 hospitals submitting data to the Premier Healthcare Database and Cerner Health Facts in 2012–2017. We included clinical cultures from any body site yielding Acinetobacter spp./P. aeruginosa non-susceptible/resistant to imipenem, meropenem, or doripenem. Cultures collected on days 1–3 of hospitalization were considered community-onset (CO) and cultures from later were hospital-onset (HO). Duplicate isolates identified within 14 days of an incident culture and surveillance cultures were excluded. For each year, a raking procedure generated weights to extrapolate the sample estimate to match the American Hospital Association distributions based on US census division, hospital bed capacity, teaching status, and urban designation. We compared estimated rates in 2017 vs. 2012 using weighted multivariable logistic regression adjusting for hospital characteristics and hospital-level clustering. Results In 2017, the estimated rates of HO and CO CNAB rates were 0.77 and 1.39/10,000 discharges, and HO and CO CRPA rates were 3.14 and 6.57, respectively. Compared with 2017, rates of HO CNAB decreased 49% (Odds Ratio (OR) 0.51; 95% CI: 0.34–0.75) and rates of CO CNAB decreased 29% (OR 0.71; 95% CI: 0.54–0.92). For CRPA, the incidence of HO decreased (OR 0.66; CI: 0.49–0.88) with no change in CO rates (OR 0.93; CI: 0.79–1.11). Assessment of cultures from sterile sites alone showed similar results, but they did not reach statistical significance, Figure 1. Conclusion We estimate significant national decreases in the rates of HO and CO CNAB, and HO CRPA. Risk factors and effective interventions to reduce CO CRPA might differ from CNAB and HO CRPA. Additional prevention strategies are needed to address CO CRPA. Disclosures All authors: No reported disclosures.

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