scholarly journals Quantifying Psychopathology in Rapid Readmissions

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 165-166
Author(s):  
Sam K. Suhail ◽  
Harpinder Sandhu ◽  
Sandeep Mellacheruvu
Keyword(s):  
Social History ◽  
Low Socioeconomic Status ◽  
Medical Records ◽  
City Hospital ◽  
Readmission Rates ◽  
Systematic Analysis ◽  
Low Socioeconomic ◽  
Psychiatric Readmission ◽  
Psychiatric Illnesses ◽  
Risk Patients

AbstractPsychiatric readmissions contribute to a significant cost and healthcare burden to physicians, hospitals, and the healthcare system as an entity. Furthermore, as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) began to reduce financial coverage to hospitals with overwhelming rehospitalization rates. The purpose of this study was to do a systematic analysis on inpatient psychiatric readmission data and identify co-morbidities and risk factors that lead to high readmission rates. The data collection includes 163 patients with a total of 348 readmissions over the span of 90 days at one inner-city hospital in the Chicagoland area. Study findings suggest that higher rates of readmission are linked to cocaine abuse in both male and female populations. Diagnosis of bipolar in females and schizoaffective disorder in male populations were the among the highest for readmission. Key social factors such as homelessness and low socioeconomic status were identified to contribute to a large proportion of psychiatric readmission burden. However, an overwhelming amount of information was missing due to unobtained labs and lack of current patient social history. By using this data as well as data from electronic medical records (EMRs) to further investigate and identify other features of at-risk patients, hospitals can potentially address these markers to lower readmission rates. Ultimately, a higher understanding of the patients’ needs can be understood and can help develop standardized plans of care for prevalent psychiatric illnesses in these populations.

Safety of Etanercept in Patients at High Risk for Mycobacterial Tuberculosis Infections

2009 ◽  
Vol 36 (5) ◽  
pp. 914-917 ◽  
Author(s):  
ROHIT AGGARWAL ◽  
AUGUSTINE M. MANADAN ◽  
ANUPAMA POLIYEDATH ◽  
WINSTON SEQUEIRA ◽  
JOEL A. BLOCK
Keyword(s):  
High Risk ◽  
Low Socioeconomic Status ◽  
Cook County ◽  
Cook County Hospital ◽  
Etanercept Therapy ◽  
Systematic Analysis ◽  
Low Socioeconomic ◽  
Purified Protein Derivative ◽  
Latent Tb ◽  
Latent Tb Infection

Objective.The magnitude of the risk of reactivation of tuberculosis (TB) on use of etanercept, especially in patients with positive purified protein derivative (PPD) test, has not been assessed. We evaluated the risk of developing active TB among PPD-positive patients treated with etanercept.Methods.All patients with a positive PPD test, as defined by American Thoracic Society guidelines, who received etanercept at Cook County Hospital from 2001 to 2008 were retrospectively reviewed. The primary endpoint was the development of active TB either while receiving or after completing etanercept therapy.Results.Four hundred eighty-seven patients received etanercept, of whom 84 were PPD-positive and constituted the primary cohort. The cohort was composed largely of patients who were at high risk for development of active TB: born in endemic area (80%), ethnic/racial minorities (51 Hispanic, 16 African American, and 8 Asian), and low socioeconomic status (66, 78.57%). Overall etanercept exposure was a mean of 24.6 months (range 3 to 60 mo), with 196 patient-years of etanercept exposure in PPD-positive individuals. Indications for etanercept use included rheumatoid arthritis 58 (69%), ankylosing spondylitis 11 (13%), psoriatic arthritis 13 (15.5%), juvenile inflammatory arthritis 1 (1.2%), and vasculitis 1 (1.2%). Of the 80 subjects, 74 received treatment for latent TB infection (LTBI) prior to initiating etanercept. A comprehensive review of these patients’ medical records failed to reveal any active TB infection.Conclusion.This systematic analysis suggests that the risk of reactivation of LTBI during etanercept therapy is low in appropriately treated individuals.

Social determinants of health affect unplanned readmissions following acute myocardial infarction

2021 ◽  
Vol 10 (1) ◽  
pp. 39-54
Author(s):  
Marguerite M Hoyler ◽  
Mark D Abramovitz ◽  
Xiaoyue Ma ◽  
Diana Khatib ◽  
Richard Thalappillil ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
New York ◽  
Low Socioeconomic Status ◽  
Safety Net ◽  
Insurance Status ◽  
Readmission Rates ◽  
Low Socioeconomic ◽  
Hospital Safety ◽  
Increases In Risk

Background: Low socioeconomic status predicts inferior clinical outcomes in many patient populations. The effects of patient insurance status and hospital safety-net status on readmission rates following acute myocardial infarction are unclear. Materials & methods: A retrospective review of State Inpatient Databases for New York, California, Florida and Maryland, 2007–2014. Results: A total of 1,055,162 patients were included. Medicaid status was associated with 37.7 and 44.0% increases in risk-adjusted readmission odds at 30 and 90 days (p < 0.0001). Uninsured status was associated with reduced odds of readmission at both time points. High-burden safety-net status was associated with 9.6 and 9.5% increased odds of readmission at 30 and 90 days (p < 0.0003). Conclusion: Insurance status and hospital safety-net burden affect readmission odds following acute myocardial infarction.

Utilization of hepatocellular carcinoma surveillance in the United States.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 174-174 ◽  
Author(s):  
Samar Harris ◽  
Adam C. Yopp ◽  
Jasmin A Tiro ◽  
Muhammad Shaalan Beg ◽  
Celette Sugg Skinner ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Low Socioeconomic Status ◽  
The United States ◽  
Inclusion Criteria ◽  
National Meeting ◽  
Low Socioeconomic ◽  
Primary Care Clinics ◽  
Risk Patients ◽  
Hepatocellular Carcinoma Surveillance

174 Background: Surveillance for hepatocellular carcinoma is recommended in high-risk patients, but several studies have suggested it is being underutilized.The aim of this study is to quantify utilization rates for HCC surveillance among patients with cirrhosis and summarize patterns of association between utilization rates and patient and clinic characteristics. Methods: A systematic literature review using the Medline database and national meeting abstracts identified all cohort studies that described HCC surveillance rates among at-risk patients in the United States. Two investigators independently extracted data on patient populations, study methods, and results. A pooled surveillance rate with 95% confidence intervals was calculated. Pre-specified subgroup analysis was performed to find correlates of surveillance utilization. Results: We identified 9 studies that met all inclusion criteria. There were a variety of definitions for surveillance among the studies, with only 4 assessing surveillance every 6-12 months as recommended by the AASLD guidelines. The pooled surveillance rate was 18.4% (95% CI 17.8% - 19.0%). Surveillance rates were significantly higher among patients followed in gastroenterology clinics compared to those followed in primary care clinics (51.7% vs. 16.9%, p< 0.001). Elderly, non-Caucasians, and people of low socioeconomic status had lower surveillance rates than their counterparts. Current studies fail to identify specific reasons for the underutilization of HCC surveillance. Conclusions: Utilization rates for HCC surveillance are low, although they are significantly higher among patients followed in subspecialty clinics. Appropriate intervention targets to increase surveillance rates and reduce socio-demographic disparities have not been identified to date, and this should be a primary goal for future studies.

Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽  
2011 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Eugene Kinyanda ◽  
Ruth Kizza ◽  
Jonathan Levin ◽  
Sheila Ndyanabangi ◽  
Catherine Abbo
Keyword(s):  
Low Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Psychosocial Risk ◽  
Psychiatric Nurses ◽  
Health Concern ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Low Socioeconomic ◽  
Dsm Iv ◽  
Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

Audio Stories as Incidental Language Teachers

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ute Ritterfeld ◽  
Timo Lüke
Keyword(s):  
Language Learning ◽  
Low Socioeconomic Status ◽  
Language Teachers ◽  
Control Group ◽  
Low Socioeconomic ◽  
Migrant Families ◽  
Populations At Risk ◽  
Grammatical Skills ◽  
Entertainment Value

Abstract. Audio stories offer a unique blend of narrative entertainment with language learning opportunities as a user’s enjoyment is dependent on their processing of the linguistic content. A total of 138 third- and fourth-graders from low socioeconomic status and migrant families recruited from a metropolitan area in Germany participated in a randomized pre–post follow-up intervention study with a control group. Children listened to a tailored crime story of approximately 90 min over a period of 3 days within the classroom setting. Entertainment value for the age group was established in a pilot study. Outcome variables included semantic and grammatical skills in German and were administered before (pretest), shortly after intervention (posttest), and 2 weeks later (follow-up). We used nonverbal intelligence, reading, comprehension skills, age and sex as control variables. Results indicate a strong positive effect of media reception on language skills. The effectiveness of the intervention is discussed with reference to different linguistic domains, entertainment value, and compensatory effects in populations at risk of language learning deficits.

Tomorrow never knows: Paradoxical effects of a future prime on performance among low socioeconomic status college students

2014 ◽  
Author(s):  
Sarah Dayle Herrmann ◽  
Jessica Bodford ◽  
Robert Adelman ◽  
Oliver Graudejus ◽  
Morris Okun ◽  
...  
Keyword(s):  
College Students ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Low Socioeconomic ◽  
Paradoxical Effects
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