Elementi per una valutazione epidemiologica dell'attività di un Servizio Psichiatrico di Diagnosi e Cura

1992 ◽  
Vol 1 (3) ◽  
pp. 165-175 ◽  
Author(s):  
Marco Piccinelli ◽  
Pierluigi Politi

RiassuntoScopo - Analizzare l'attività del Servizio Psichiatrico di Diagnosi e Cura di Pavia nel periodo compreso tra il 1978 (anno dell'apertura del servizio) ed il 1990. Disegno - Analisi retrospettiva dei dati contenuti in un archivio computerizzato, nel quale, a partire dal 1978, sono state raccolte informazioni relative alle caratteristiche socio-demografiche e nosologiche dei pazienti ricoverati, nonché alia modalità ed all'andamento dei ricoveri. Setting - Il Servizio Psichiatrico di Diagnosi e Cura di Pavia, il cui bacino di utenza è costituito dall'ULSS 77, comprendente la città di Pavia e 61 comuni limitrofi. Principali indici utilizzati - Per ciascun anno considerato sono stati ricavati: indicatori d'uso (primi ricoveri, ricoveri complessivi, giornate di degenza, pazienti ricoverati); presenza media giornaliera e media annuale dei massimi mensili di pazienti ricoverati; indicatori d'intensita d'uso o di flusso (degenza media, indice di occupazione media dei posti-letto, indice di turnover, indice di rotazione dei posti-letto). La produttivita del servizio è stata indagata utilizzando il monogramma di Barber. Risultati - Tra il 1978 ed il 1983 si è verificato un progressivo incremento nel numero dei pazienti ricoverati, dei ricoveri complessivi e delle giornate di degenza; è seguito un periodo stazionario protrattosi fino al 1987; infine, durante gli ultimi tre anni il numero dei ricoveri complessivi e quello dei pazienti ricoverati sono leggermente diminuiti, mentre le giornate di degenza sono rimaste sostanzialmente stabili. Il numero annuale dei pazienti entrati in contatto per la prima volta con il servizio ha segnato due picchi negli anni 1979 e 1983 (N = 250), diminuendo poi progressivamente fino ai valori di 139 nel 1989 e di 152 nel 1990. Le frazione percentuali dei primi ricoveri rispetto ai ricoveri complessivi e rispetto ai pazienti ricoverati si sono ridotte nel corso del periodo considerato: nel 1990 esse erano pari a 30% e 50% rispettivamente. Presenza media giornaliera e media annuale dei massimi mensili di pazienti ricoverati sono aumentate tra il 1979 ed il 1983, passando da 12 a 21 pazienti/die, e da 14 a 25 pazienti/die, rispettivamente; negli ultimi otto anni i due parametri si sono stabilizzati su valori di 20-21 e 24-25 pazienti/die rispettivamente. II nomogramma di Barber, costruito sulla base dei valori assunti dagli indicatori d'intensita d'uso nel corso di ciascun anno considerato, ha mostrato che tutti gli anni in esame si sono distribuiti entro la zona di produttivita accettabile, ad eccezione del 1980 e del 1981. Conclusioni - Dopo una fase iniziale di progressiva espansione, il servizio sembra aver raggiunto una fase di equilibrio dinamico con il suo bacino di utenza, fornendo per la maggior parte del periodo considerato un livello di produttività accettabile.Parole chiaveservizi psichiatrici, utilizzazione, dei servizi, produttività.SummaryObjective – To analyze the activity of a General Hospital Psychiatric Inpatient Service in Pavia between 1978 (when the service was set up) and 1990. Design - Retrospective analysis of data stored in a computerized database, in which, since 1978, information has been collected on sociodemographic and nosological characteristics of patients admitted to the service, as well as on clinical aspects of all admissions. Setting – A General Hospital Psychiatric Inpatient Service in Pavia, whose catchmentarea (ULSS 77) includes the town of Pavia and 61 close municipalities. Main outcome measures -For each yearover the period considered we reported on: the indices of service utilization (first admissions, total admissions, days of stay, number of admitted patients); the mean daily number of inpatients, and the mean of the largest daily numbers of inpatients by month; the indices of intensity of service utilization (mean lenght of stay, index of bed occupation, index of turnover, index of bed rotation). The service productivity was determined according to the Barber's nomogram. Results – Between 1978 and 1983 patients admitted to the service, total admissions, and days of stay gradually increased; a steady period then followed until 1987; over the last three years, total admissions and the number of admitted patients slightly decreased, while daysof stay remained substantially stable. The annual number of patients admitted for the first time to the service marked two peaks in 1979 and 1983 (N = 250), and then gradually decreased to 139 in 1989 and 152 in 1990. The percent ratio of first admissions by total admissions and that of first admissions by the number of admitted patients showed a reduction over the period considered: in 1990 they were 30% and 50% respectively. The mean daily number of inpatients and the mean of the largest daily numbers of inpatients by month increased between 1979 and 1983, from 12 to 21 and from 14 to 25 patients/day respectively; over the last eight years the values remained rather constant, around 20-21 and 24-25 patients/day respectively. The Barber's nomogram, obtained on the basis of the indices of intensity of service utilization over the period considered, showed that each year fell within the area of acceptable productivity, with the exception of 1980 and 1981. Conclusions – After an initial phase of gradual expansion, the service then reached asteadystate, providing an acceptable productivity over most of the period considered.

2020 ◽  
Vol 12 (1) ◽  
pp. 1-6
Author(s):  
Selma Uzunović ◽  
Muhamed Skomorac ◽  
Fatima Bašić ◽  
Farah Kamberović ◽  
Amir Ibrahimagić ◽  
...  

Background: Brucellosis is associated with people living in close proximity to their animals, where conditions for disease onset and spread exist. An epidemic of brucellosis in Bosnia and Herzegovina (B&H) has persisted since 2004. Zenica-Doboj Canton is one of the most affected areas. Objective: To investigate the epidemiological characteristics of human brucellosis from the year 2008 to2018. Methods: Data collected from paper-based patients/cases reported to the Epidemiology Department were analyzed. Results: After 2008, the annual number of patients diagnosed with brucellosis was decreasing, except in 2017 and 2018 with 20 and 35 cases, respectively. Within the 2008-2018 period, a total of 263 human brucellosis cases were recorded, decreasing from 102 (incidence of 44.7/100,000) cases in 2008 to three cases in 2012, but increased to 35 cases in 2018. Males were predominant, with a total of 205 (77.9%) cases. The mean age of the affected patients was 39.2 years; but the most affected age group was the 25-49 years age group with 117 (44.5%) cases. Most cases (151 cases, 66%) were reported during the period of March-July, and 242 (92%) cases were from the rural areas. Conclusion: With the implementation of the small ruminant vaccination program in 2009, the number of infected humans had declined, while brucellosis still remains.


1998 ◽  
Vol 15 (3) ◽  
pp. 84-87
Author(s):  
Miriam O'Doherty

AbstractObjectives: To investigate effects on one psychiatric inpatient service of a 40% reduction in the number of acute beds and the establishment of an acute day hospital.Method: A retrospective review of all public admissions to the acute inpatient unit during two three-month study periods; before and almost three years after the changes. Review of attendance at the acute day hospital during the second study period.Results: The number of admissions actually increased by 3% from 169-174; the mean duration of stay fell from 27-17 days; and the number of brief admissions of three days duration or less almost tripled from 15-43. Although fewer patients suffering from schizophrenia were admitted in the second study period than in the first, their mean duration of stay and the frequency of re-admission within 28 days of discharge changed little, while patients with diagnoses of mild/moderate depression and substance misuse experienced significantly shorter admissions and higher readmission rates. The use of temporary orders under the Mental Treatment Act (1945) doubled, and the readmission rates within 28 days increased by over 60%.The acute day hospital treated 98 patients who had a diagnostic profile similar to that of the inpatients; 53% of them required admission before and/or after attendance at the day hospital.Conclusions: The major reduction in the number of acute inpatient beds and the opening of an acute day hospital resulted in greater concentration of inpatient resources on the more severely ill patients. The increase in re-admissions and the failure to effect a reduction in admissions and may have a complex aetiology and merits further investigation.


1986 ◽  
Vol 31 (9) ◽  
pp. 834-837 ◽  
Author(s):  
L. Warneke

A twelve month period of the functioning of a psychiatric intensive care unit in a general hospital is reviewed. The unit has actually been functioning for about three and a half years. Although there were growing pains initially, the unit has become an integral part of the psychiatric inpatient service. It serves to provide intensive care to acutely inpatients and provides a safe, secure environment. It also reduces the number of disturbed patients on the two general units. Very disturbed patients are expertly managed by the staff and a surprisingly low percentage of patients have to be transferred to the local mental hospital under certification. The experience demonstrates that a psychiatric intensive care unit based on a general medical intensive care unit model can function well with benefit both to patients and staff.


Author(s):  
Pantouvaki Anna ◽  
Kastanis Grigorios

Objectives: The purpose of this study is to evaluate the frequency of unstable distal radius fractures in adult population and the management performed in orthopaedic and physiotherapy department of the General Hospital” Venizeleio” in Heraklion-Crete re-organised due to pandemic period. In pandemic period, due to urgent needs of covid-19 patients, a lot of orthopaedic associations suggested some restrictions concerning the treatment of DRF. The aim of this study is to answer in two hypothetical questions. First, did patients with unstable DRF receive a conservative instead of surgical treatment and second is the protocol of rehabilitation program still the same or do the patients receive a modified rehabilitation program? Methods: Patients admitted in the emergency department of the hospital during pandemic period of 2020 with distal radius fracture surgically treated, were evaluated and data compared with those of pre-pandemic period. (2018-2019). Results: A number of 32, 35 and 42 patients with DRF were treated and hospitalized in 2018, 2019 (pre-pandemic period) and 2020 (pandemic period) respectively. The mean age of patients did not appear with any statistical difference. (p= .93) between periods and causes of DRF did not change dramatically. Additionally, there was a remarkable variation in number of patients between the 1st and 2nd semesters of quarantine period. (p=.68). Conclusion: Adaptations in management of distal radius fracture during lockdown did not affect patient’s surgical and rehabilitation treatment and functional outcomes. The mean age of patients treated, did not vary during pandemic period while the causes of DRF. But it was obligatory to adopt the rehabilitation treatment plan and the number of hospital visits due to Covid-19 precautions.


Author(s):  
R.E Field ◽  
I. Afzal ◽  
J. Dixon ◽  
V.R Patel ◽  
P Sarkar ◽  
...  

AbstractThis retrospective cohort analysis, reports the demographic data and early outcome of the first 500 patients who were admitted to a District General Hospital in South West London, UK and tested positive to COVID-19. The patients were admitted between 10 January and 10 April 2020; with the first COVID-19 positive diagnosis on 6 March. A surge in admissions started around the 15 March and peaked at the beginning of April.56.8% of the admissions were male and 43.2% were female. The average age of the 500 admissions was 69.32 years (SD 19.23 years, range 1 week to 99.21 years). By the morning of 14 April 2020, 199 patients had been discharged (Female 89, Male 111), 163 patients had died (female 61, male 102) and 131 remained as in-patients (female 66, male 71).Fewer than one in twenty deaths occurred in patients below the age of 50 years, in either gender. Mortality rose dramatically, for both genders, after the age of sixty with males being almost twice as vulnerable to dying, as females, during the 7th decade. Males older than their mid-fifties were more likely to die than leave hospital. The same applied to females beyond their mid seventies. We did not see any evidence of a poorer outcome associated with a lower decile for Index of Multiple Deprivation or convincing evidence that any Ethnic minority groups were more likely to die than the White subgroups. When compared to the equivalent medical conditions, normally treated in the early spring, COVID-19 has an increased mortality, adversely affecting more men and an older population.The mean duration from admission to discharge was 11.29 days (SD 11.50 days). For admission to death, the mean interval was 11.72 days (SD 11.05 days). 62 of the 500 admissions required ventilator support. Of this subgroup, 71% were male and 29% were female. By the morning of the 14 April, no female over the age of 60 had left the intensive care unit alive and no male over the age of 50 had left the intensive care unit alive. At this time-point, 1.2% of the 500 admitted patients had returned alive from the intensive care units, following a period of ventilator support. This figure will rise if prolonged ventilator and renal support proves effective.While only providing a snapshot of a relatively small number of patients, reviewed over a short time period, from a small geographic area, the data supports the view that the younger members of society are less vulnerable to the adverse sequelae of COVID-19 infection and that any return to normal work and social activities should be considered initially for the individuals who are less than 40-50 years of age. There is an ongoing need for analyses on larger patient cohorts using both demographic and detailed clinical data.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1759-1759
Author(s):  
J. Teixeira ◽  
P. Casquinha

IntroductionPatients with psychiatric disorders are admitted to psychiatric units for evaluation and treatment in the acute phase of illness.AimsTo perform a descriptive analysis of psychiatric hospitalization characteristics before (phase1) and after (phase2) the inclusion of the Rehabilitation Unit for Alcoholic Patients (RUAP).MethodsA retrospective study with clinical and statistical data analysis of patients admitted to a general Psychiatric Hospital twelve months before and after the inclusion of RUAP.ResultsThe sample had 741 patients (376 males, 365 females). Hospitalization characteristics data is presented in table1.[Hospitalization characteristics of phase 1 and 2]ConclusionSample demographic characteristics were similar in both phases. Although mood disorders were the more prevalent diagnosis, after inclusion of RUAP, Alcoholic Dependence Syndrome became the most frequently assigned diagnosis. It is also relevant the higher mean occupancy rate and the higher number of patients admitted to the service. Patients social characteristics in phase 1 and 2 need further investigation.


2020 ◽  
Author(s):  
Feng Geng ◽  
Feng Jiang ◽  
Jeffrey Rakofsky ◽  
Tingfang Liu ◽  
Yuanli Liu ◽  
...  

Abstract Background The development of child psychiatry in China is slow and very limited resources have been allocated to it. To investigate the current resources of inpatient psychiatric facilities for youth in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized in an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric bed was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients hospitalized in adult units. Conclusion Our findings highlight a dire situation of youth inpatient service in China, especially in less developed regions. There is an urgent need to change the policy and develop mental health services, including inpatient services for child and adolescent patients.


2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  


2013 ◽  
pp. 50-56
Author(s):  
Quoc Tinh Nguyen ◽  
Thi Cu Nguyen

Background: Diarrhea is a leading cause of morbidity and mortality in children in developing countries. Rotavirus is the most important factor cause of severe diarrhea and mortality in children, especially under 2 years. Objective: To study Clinical and paraclinical characteristitics of rotavirus diarrhea in children less than 5 years old in the Pediatric Department of Binh Dinh General Hospital. Methods: Cross observational study, 417 children from 2 months to 5 years old who were hospitalized for acute diarrhea without blood in stool in Pediatric Department of Binh Dinh general hospital, from 15/3/2012 to 14/3/2013. There were 228 patients with rotavirus - positive stool specimens and 189 patients with rotavirus - negative stool specimens. Tested for rotavirus A classification by agglutination techniques. Results: Percentage of Rotavirus diarrhea in children <5 years was 54.7%. The mean age of rotavirus diarrhea was 14.83 ± 9.08 tháng months. Ages with the highest cases of rotavirus diarrhea are 2 - 12 months: 48.2%. Rotavirrus diarrhea is experienced in every month but, the highest prevalence is experienced in the spring - summer) with 71,5%. Clinical characteristitics of rotavirus diarrhea: Vomit presents in 91,7% of cases. 32.9% of the initial symptoms of the disease is vomiting. Mean number of vomiting episodes per day: 7 ± 3.57 times, significantly higher compared with non-rotavirus acute diarrhea (p <0,01). Mean number of bowel movement per day: 10.61±4.18 times, mean duration of diarrhea: 6.66 ± 2.52 days. Younger children have higher frequency and duration of diarrhea compared to older children. Paraclinical characteristitics of rotavirus diarrhea: the mean number leukocyte: 9.74 ±3.61 (x 109/l). 2.2% with low blood sodium status; 8.8% with reduction in serum potassium concentration. 26.3% with low blood calcium and glucose status. Laboratory characteristics of stool: 8.8% with white blood cells in stool, 41.7% with carbohydrate in stool. Conclusion: Rotavirus accounting for 54.7% of the causes of diarrhea in children. Rotavirus diarrhea is experienced throughout the year but the highest prevalence is in the spring-summer. Prominent symptoms of the disease are vomiting and watery stool. Children <24 months experience higher frequency and duration of diarrhea compared to older age groups. Key words: Diarrhea, Rotavirus.


2018 ◽  
Vol 69 (8) ◽  
pp. 2236-2239
Author(s):  
Marius Moga ◽  
Mark Edward Pogarasteanu ◽  
Dumitru Ferechide ◽  
Antoine Edu ◽  
Chen Feng Ifrim

Gout is a metabolic disease involving the impregnation of joints and other tissues with urate crystals. The onset is often brutal, and it manifests itself with pain and inflammation in the affected joint. The treatment usually involves rest, ice, NSAIDs and anti-gout medication. The long-term treatment involves medication and dietary changes. In the joint, urate crystals are deposited in the synovial, in the cartilage and in the menisci. In the arthroscopic practice, the gouty knee is a rare occurrence. We present a relevant case, that of a 57 years old patient without a prior gout diagnosis where we found urate crystal deposits covering the synovium, cartilage and meniscus, and we discuss the current and recent year Pub Med indexed literature in order to evaluate the possibilities for arthroscopic treatment of this pathology. We looked at the number of patients involved, their characteristics, and the surgical techniques used. We also looked at the temporal relation of the arthroscopic intervention to the recent gout attacks, and at the described lesions that were found. Also, we evaluated the papers for joint liquid analysis, gout drug treatment, and description of clinical aspects involved and associated lesions. Finally, we looked at the follow-up, at the functional scores used to monitor the patient�s evolution, at the associated medication and at the long-term outcomes, if described. We have found opinions to vary. In the end, we draw conclusions pertaining to the practical short-term and long-term use of knee arthroscopy in the treatment of gout.


Sign in / Sign up

Export Citation Format

Share Document