scholarly journals Factors affecting disability in patients attending the internal medicine departments of general hospitals

1999 ◽  
Vol 53 (6) ◽  
pp. 611-620 ◽  
Author(s):  
Misako Sata ◽  
Kazuyasu Yoshitake ◽  
Hiroshi Utsunomiya ◽  
Keiko Hatada ◽  
Toshihiro Ohtsuka ◽  
...  
Keyword(s):  
Internal Medicine ◽  
General Hospitals ◽  
Factors Affecting

scholarly journals Responsiveness of Inpatient Services at the Public General Hospitals in Gaza

2021 ◽  
Author(s):  
Iyad Ibrahim Shaqura ◽  
Ebrahim Jaafaripooyan ◽  
Mostafa Hosseini ◽  
Abed El Raheem Shagora ◽  
Ali Akbarisari
Keyword(s):  
Internal Medicine ◽  
Influential Factors ◽  
Public Hospitals ◽  
Medical Department ◽  
Cross Sectional ◽  
General Hospitals ◽  
Factors Affecting ◽  
The Public ◽  
Inpatient Services ◽  
Post Hoc

Abstract BackgroundThis study aimed at measuring the responsiveness level of inpatient services according to patients’ perspectives, and identifying the factors affecting its performance at the Gazan public general hospitals, particularly in internal medicine and surgical departments, in 2020.MethodsIt was a cross-sectional descriptive study, conducted in 5 public general hospitals in Gaza. Data were collected between October 2019 and June 2020 in a survey included 675 inpatients using an interviewed questionnaire. Data were analyzed using software SPSS 22.0 and by applying descriptive statistics, independent t-test and analysis of variance (ANOVA), and post hoc Scheffé test. ResultsThe overall responsiveness was “above moderate”, 80.15% and 80.9%, for both internal medicine and surgical departments, respectively. Access to social support, confidentiality and dignity were the highest-performing domains, while, choice of provider and quality of basic amenities were the lowest. Dignity and confidentiality were the most important domains based on patients’ viewpoints. Hospital type, medical department, and hospital stay in addition to the educational level, marital status, employment status, income, and insurance status were the most influential factors on the level of responsiveness and its domains. ConclusionThe assessment of the responsiveness of inpatient services at public hospitals is useful in integrating the health system goals. Inpatient care responsiveness was satisfactory in the Gazan public hospitals, however, there is a room for further improvements. Reform strategies should be directed toward the domains of weak performance and the important ones as well. Attention should be given to the supply-side such as hospital characteristics as they significantly affect the level of responsiveness and its domains. Further research is required to carry out mixed-method studies, moreover, the non-public hospitals need to be covered.

scholarly journals Use of the Flugelman index for identifying patients who are difficult to discharge from the hospital

2013 ◽  
pp. 103-108
Author(s):  
Chiara Bozzano ◽  
Ilario Lancini ◽  
Elena Mei ◽  
Maida Lucarini ◽  
Roberta Mastriforti ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Hospital Stay ◽  
Discharge Planning ◽  
District General Hospital ◽  
Feeding Problems ◽  
Care Needs ◽  
Socioeconomic Condition ◽  
Factors Affecting ◽  
Effective Discharge ◽  
Medical Wards

Introduction: To evaluate the use of multidimensional assessment based on the Fluegelman Index (FI) to identify internal medicine patients who are likely to be difficult to discharge from the hospital. Materials and methods: Have been evaluated all patients admitted to the medical wards of the District General Hospital of Arezzo from September 1 to October 31, 2007. We collected data on age, sex, socioeconomic condition, cause of admission, comorbidity score preadmission functional status (Barthel Index), incontinence, feeding problems, length of hospitalization, condition at discharge, and type of discharge. The FI cut off for difficult discharge was > 17. Results: Of the 413 patients (mean age 80 + 11.37 years; percentage of women, 56.1%) included in the study, 109 (26.39%) had Flugelman Index > 17. These patients were significantly older than the patients with lower FIs (85 + 9.35 vs 78 + 11.58 years, p < 0.001), more likely to be admitted for pneumonia (22% vs. 4.9% of those with lower FIs; p < 0,001). They also had more comorbidity, loss of autonomy, cognitive impairment, social frailty, and nursing care needs. The subgroup with FIs>17 had significantly higher in-hospital mortality (30.28% vs 6.25%, p < 0.001), longer hospital stay (13 vs. 10 days, p < 0.05), and higher rates of discharge to nursing homes. Conclusions: Evaluation of internal medicine patients with the Flugelman Index may be helpful for identifying more critical patients likely to require longer hospitalization and to detect factors affecting the hospital stay. This information can be useful for more effective discharge planning.

scholarly journals A Study on Factors Affecting Profitability of General Hospitals by bed-size

2012 ◽  
Vol null (41) ◽  
pp. 265-292
Author(s):  
정명진 ◽  
임정수 ◽  
Dae Kyu Oh ◽  
서창진
Keyword(s):  
General Hospitals ◽  
Factors Affecting

scholarly journals Strengthening the Ability of General Hospital Neurology Departments to Treat Neuropsychiatric Diseases and Mental Disorders

2018 ◽  
Vol 4 (3-4) ◽  
pp. 208-214
Author(s):  
Wei Zhu ◽  
Weidong Pan
Keyword(s):  
Internal Medicine ◽  
Mental Disorders ◽  
Integrative Medicine ◽  
Health Centers ◽  
Diagnosis And Treatment ◽  
Current Status ◽  
General Hospitals ◽  
Neuropsychiatric Diseases ◽  
Mental Diseases ◽  
Mental Health Centers

Due to the “stigma” of neuropsychological and psychogenic disorders in China, patients with psychological and affective disorders mostly prefer to go to general hospitals or integrative medicine hospitals, while the majority of patients with mental disorders in the department of internal medicine are treated in the department of neurology. At present, there are few physicians with the ability to diagnose and treat neuropsychiatric diseases properly in the neurological department of general hospitals in China, and the diagnosis and treatment experience of mental diseases is insufficient. At the same time, the diagnosis and treatment of comorbid patients with internal diseases and mental disorders are more complicated. The psychology departments in general hospitals or mental health centers also have a limited ability to diagnose and treat comorbid diseases relating to internal medicine and mental disorders together. Therefore, this article reviews the current status of diagnosis and treatment of neuropsychiatric and mental disorders in general hospitals or integrative medicine hospitals.

Abstract 112: Statin Utilization in the Outpatient Clinic of a University Based Residency Training Program

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Eric Chang ◽  
Demilade Adedinsewo ◽  
Camille Calcano ◽  
Obiora Egbuche ◽  
Aneese Chaudhry ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Outpatient Clinic ◽  
Patient Population ◽  
Private Insurance ◽  
Safety Net ◽  
Atherosclerotic Cardiovascular Disease ◽  
Specific Patient ◽  
Factors Affecting ◽  
Safety Net Hospital ◽  
National Estimates

Background: Current guidelines released in 2013 recommend statins for five specific patient groups including persons with clinical atherosclerotic cardiovascular disease (ASCVD) and diabetes. National estimates of statin utilization in 2012 report statin use in persons with ASCVD at 58.8% and 63.5% among persons with diabetes. A recent review also showed suboptimal statin prescription rates prior to 2013, with only 23% being prescribed a statin at goal dose. Our goal was to assess statin prescriptions in a large resident run outpatient clinic and identify factors affecting statin prescriptions as potential targets for intervention to improve compliance with the guidelines. Methods: We obtained data from the medical record data warehouse of a primary care outpatient clinic within a large safety-net hospital from Jan–Dec 2015. The clinic is predominantly run by internal medicine residents and supervised by general internal medicine attending physicians. Patients with a diagnosis of ASCVD and diabetes were identified and electronic medical records abstraction was done to identify persons who were prescribed a statin (regardless of dose). Bivariate analyses were conducted to identify potential factors affecting statin prescriptions. Results: Our patient population was predominantly African American, representing more than 70% of our clinic patients. We found 87% of persons with ASCVD and 70% of persons with diabetes were on statin. We found no differences in statin prescriptions by demographic characteristics among persons with ASCVD. Among patients with diabetes, younger age (p<0.01), female sex (p<0.05), non-black race (p<0.05) and private insurance/lack of insurance (p<0.01) were associated with a lower likelihood of being prescribed a statin. Conclusion: Statin prescriptions among patients with ASCVD and diabetes appear to be higher in our patient population compared to prior national estimates, however statin prevalence remains suboptimal. Our next steps are to begin a targeted educational intervention for residents in the continuity clinic and ultimately demonstrate that resident driven intervention is an effective way to increase compliance with the guidelines.

Occupational Аccidents and Near-Miss Events in the Internal Medicine Services: Turkey Sample in University Hospital

2021 ◽  
Vol 17 (6) ◽  
pp. 520-529
Author(s):  
Pelin Uymaz ◽  
Sinem Ozpınar
Keyword(s):  
Internal Medicine ◽  
Health And Safety ◽  
Near Miss ◽  
University Hospital ◽  
Occupational Accidents ◽  
Protective Measures ◽  
Factors Affecting ◽  
Workplace Accidents ◽  
Health Institutions ◽  
Moderate Positive Correlation

Background. Health institutions are considered occupational areas with high risk due to the need for human resources, including numerous specialists with distinct characteristics, use of intensive technology, and complex occupational processes. The importance of occupational health and safety, which aims to eliminate or minimize all these negativities, is increasing rapidly. The purpose of this study is to examine the frequency of exposure to occupational accidents and near-miss events of the nurses and physicians working in the internal ­medicine units of a university hospital, and their reporting status and factors affecting these characteristics. Materials and methods. This research is a descriptive study, and the data of the recent year have been evaluated. The research was carried out in internal medicine units of a university hospital in Istanbul. The data in this study were collected by using the “Evaluation Form for Occupational Accidents and Near-Miss Events” which was created by the researchers. Results. A total of 117 individuals, 83 women (70.94 %), and 34 men (29.06 %) participated in this study. Of the participants, 59 were nurses (50.43 %), and 58 were physicians (49.57 %). There was a significant moderate positive correlation (r = 0.305) between age and the number of occupational accidents (p = 0.039). The average number of occupational accidents experienced by nurses (1.31 ± 0.74) was found to be lower than physicians (2.80 ± 2.53) (p = 0.006). The number of near-miss incidents experienced by physicians (2.79 ± 4.30) was higher than the nurses (1.29 ± 83.00) (p = 0.032). Conclusions. Every workplace accident or near-miss event experienced by healthcare professionals should be reported and analyzed carefully to prevent future workplace accidents. Training of health professionals on health risks they may encounter and protective measures against occupational accidents have vital importance.

Liasion psychiatry–1 year review in psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro, Portugal

2016 ◽  
Vol 33 (S1) ◽  
pp. S388-S389
Author(s):  
A.R. Figueiredo ◽  
M. Silva ◽  
A. Fornelos ◽  
P. Macedo ◽  
S. Nunes ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Mental Health ◽  
Health Services ◽  
Psychiatric Service ◽  
Psychiatric History ◽  
Clinical Area ◽  
General Hospitals ◽  
Psychiatry Department ◽  
Medicine Service ◽  
Competing Interest

IntroductionLiasion psychiatry is a clinical area of psychiatry that includes psychiatric assistant activities in other medical and surgical areas of a general hospital. In Portugal, it has developed as a result of psychiatry integration in general hospitals. Historically, it started at the beginning of 1930s in USA. In Portugal, the law 413 of 1971 definned the articulation of mental health services with other health services–liasion psychiatry.ObjectiveWe aim to define patients evaluated in the context of liasion psychiatry, as well as other medical and surgical areas needs of psychiatry collaboration.MethodsRetrospective analyses of collaboration requests realized to psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro–Vila Real, between October 2014 and October 2015.DiscussionMost of collaboration requests came from Internal Medicine Service. Authors systematize the reasons for the requests, the time of response to those, the existence of psychiatric history, the type of intervention, the number of observations in the same patient, the most frequent diagnosis and treatment. This psychiatric service consists of four specialists and activity evaluated in this article is one of the clinical areas where these professionals intervene. Depending on the results, it is interesting then to assess needs and optimize available resources.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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