Development of Hospital Data Warehouse for Cost Analysis of DPC Based on Medical Costs

2007 ◽  
Vol 46 (06) ◽  
pp. 679-685 ◽  
Author(s):  
I. Kumamoto ◽  
Y. Uto ◽  
F. Muranaga
Keyword(s):  
Cost Analysis ◽  
Data Warehouse ◽  
Evaluation System ◽  
Malignant Tumors ◽  
Intrahepatic Bile Duct ◽  
Medical Costs ◽  
University Hospital ◽  
Medical Procedure ◽  
Hospital Data ◽  
Medical Expenses

Summary Objectives : To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. Methods : We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignanttumors andwhose DPC category was reevaluated in 2004. Results : The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. Conclusions : These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.

scholarly journals First Steps to Evaluate an NLP Tool’s Medication Extraction Accuracy from Discharge Letters

2021 ◽  
Author(s):  
Deniz Caliskan ◽  
Jakob Zierk ◽  
Detlef Kraska ◽  
Stefan Schulz ◽  
Philipp Daumke ◽  
...  
Keyword(s):  
Natural Language Processing ◽  
Data Warehouse ◽  
Language Processing ◽  
Gold Standard ◽  
Evaluation System ◽  
University Hospital ◽  
Industry Partner ◽  
Standard Medication ◽  
The University ◽  
F Measure

Introduction: The aim of this study is to evaluate the use of a natural language processing (NLP) software to extract medication statements from unstructured medical discharge letters. Methods: Ten randomly selected discharge letters were extracted from the data warehouse of the University Hospital Erlangen (UHE) and manually annotated to create a gold standard. The AHD NLP tool, provided by MIRACUM’s industry partner was used to annotate these discharge letters. Annotations by the NLP tool where then compared to the gold standard on two levels: phrase precision (whether or not the whole medication statement has been identified correctly) and token precision (whether or not the medication name has been identified correctly within correctly discovered medication phrases). Results: The NLP tool detected medication related phrases with an overall F-measure of 0.852. The medication name has been identified correctly with an overall F-measure of 0.936. Discussion: This proof-of-concept study is a first step towards an automated scalable evaluation system for MIRACUM’s industry partner’s NLP tool by using a gold standard. Medication phrases and names have been correctly identified in most cases by the NLP system. Future effort needs to be put into extending and validating the gold standard.

scholarly journals Aligning an interface terminology to the Logical Observation Identifiers Names and Codes (LOINC®)

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jean Noël Nikiema ◽  
Romain Griffier ◽  
Vianney Jouhet ◽  
Fleur Mougin
Keyword(s):  
Data Warehouse ◽  
Health Information Systems ◽  
Poor Quality ◽  
University Hospital ◽  
Hospital Data ◽  
System A ◽  
The Poor ◽  
Laboratory Results ◽  
Small Overlap

Abstract Objective Our study consists in aligning the interface terminology of the Bordeaux university hospital (TLAB) to the Logical Observation Identifiers Names and Codes (LOINC). The objective was to facilitate the shared and integrated use of biological results with other health information systems. Materials and Methods We used an innovative approach based on a decomposition and re-composition of LOINC concepts according to the transversal relations that may be described between LOINC concepts and their definitional attributes. TLAB entities were first anchored to LOINC attributes and then aligned to LOINC concepts through the appropriate combination of definitional attributes. Finally, using laboratory results of the Bordeaux data-warehouse, an instance-based filtering process has been applied. Results We found a small overlap between the tokens constituting the labels of TLAB and LOINC. However, the TLAB entities have been easily aligned to LOINC attributes. Thus, 99.8% of TLAB entities have been related to a LOINC analyte and 61.0% to a LOINC system. A total of 55.4% of used TLAB entities in the hospital data-warehouse have been mapped to LOINC concepts. We performed a manual evaluation of all 1-1 mappings between TLAB entities and LOINC concepts and obtained a precision of 0.59. Conclusion We aligned TLAB and LOINC with reasonable performances, given the poor quality of TLAB labels. In terms of interoperability, the alignment of interface terminologies with LOINC could be improved through a more formal LOINC structure. This would allow queries on LOINC attributes rather than on LOINC concepts only.

The use of bedside chest radiography at a university hospital. Data on a two-week period

2012 ◽  
Vol 81 (3) ◽  
pp. e260-e263 ◽  
Author(s):  
Alessandra Delnevo ◽  
Stefania Tritella ◽  
Luca Alessandro Carbonaro ◽  
Oxana Bobrechova ◽  
Giovanni Di Leo ◽  
...  
Keyword(s):  
Chest Radiography ◽  
University Hospital ◽  
Hospital Data

scholarly journals How Prevalent Are Symptoms and Risk Factors of Pelvic Inflammatory Disease in a Sexually Conservative Population.

2020 ◽  
Author(s):  
Oqba Al-Kuran ◽  
Al-Mehaisen Lama ◽  
Alduraidi Hamza ◽  
Naser Alhusban ◽  
Balqees Attarakih ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Inflammatory Disease ◽  
Symptom Score ◽  
Pelvic Pain ◽  
Inflammatory Disease ◽  
Chronic Pelvic Pain ◽  
University Hospital ◽  
Medical Procedure ◽  
Adult Women ◽  
Jordanian Population

Abstract Background: Pelvic Inflammatory Disease (PID) is the inflammation of the adnexa of the uterus, that mainly manifests in a subclinical/chronic context and goes largely underreported. However, it poses a major threat to women’s health, as it is responsible for infertility and ectopic pregnancies, as well as chronic pelvic pain. Previous studies in Jordan have not reported PID, attributed mainly to the social structure of the country which largely represent a sexually conservative population. Our study aims to report the clinical symptoms that point towards PID and investigate the major risk determinants in a Jordanian population, in a cross-sectional study. Methods: One hundred sixty-eight consecutive adult women that came in the Outpatient Clinics of Gynaecological Department of the Jordan University Hospital were interviewed and their medical history and symptoms were registered and analysed. A Score for PID symptoms, we developed, was given to each woman. Results and correlations were then statistically tested.Results: Our study population consisted of relatively young women (37.7±11) that had their first child at an average age of 24.1 (±4.8) and a mean parity of 3.1 (±2.2). Fifty-eight women (34.5%) reported having undergone at least one CS, while the mean PID Symptom Score was 3.3 (±2.3). The women in our study exhibited 8 symptoms of PID, namely dysmenorrhea and vaginal discharge; being the commonest (45.2% and 44.6% respectively), in addition to chronic pelvic pain, pelvic heaviness, , menorrhagia, dyspareunia, , urinary symptoms, and smelly urine, and reported history of 3 conditions that can be attributed to PID, that is infertility, preterm labour, and miscarriages.Conclusions: Our PID Scoring System seems to identify the risk factors of PID and predict well the PID likelihood. This score predicts that women with higher parity, who used contraceptives and underwent any invasive medical procedure are expected to score higher in the PID Symptom Score. Our data also suggest that PID should not be ruled out in the Jordanian population when symptoms are compatible to this diagnosis.

scholarly journals Violência contra a mulher: compreendendo a atuação interdisciplinar

2017 ◽  
Vol 11 (12) ◽  
pp. 5245
Author(s):  
Maria Cíntia Gomes ◽  
Margaret Olinda de Souza Carvalho e Lira ◽  
Michelle Christini Araújo Vieira ◽  
Sued Sheila Sarmento ◽  
Israel De Lima Florentino
Keyword(s):  
Violence Against Women ◽  
Practical Knowledge ◽  
Structured Interview ◽  
Physical Structure ◽  
University Hospital ◽  
Hospital Data ◽  
Categorical Analysis ◽  
Emergency Team ◽  
Analysis Technique ◽  
Violencia Domestica

RESUMOObjetivo: compreender as estratégias de atuação interdisciplinar em situações de violência contra a mulher. Método: estudo qualitativo, descritivo, com nove profissionais da equipe de emergência de um hospital universitário. Os dados foram coletados a partir de entrevista semiestruturada e interpretados pela técnica de Análise de Conteúdo, na modalidade Análise Categorial. Resultados: do total de participantes, sete referem saber identificar sinais suspeitos de violência à mulher, mas descrevem limitações e inseguranças que interferem no desempenho satisfatório durante o atendimento atribuídas ao pouco conhecimento teórico sobre a temática, à superlotação e a deficiências na segurança externa e na estrutura física do local de trabalho. Conclusão: a insuficiência de conhecimento teórico e prático e as deficiências nas condições de trabalho foram limitações que afetaram a atuação da equipe de emergência no atendimento à mulher em situação de violência. Os resultados contribuirão para reflexões de equipes interprofissionais sobre a atuação e cuidado à mulher agredida em emergências hospitalares. Descritores: Violência contra a Mulher; Violência Doméstica; Violência Sexual; Emergências; Assistência Hospitalar. ABSTRACTObjective: to understand the strategies of interdisciplinary action in situations of violence against women. Method: qualitative, descriptive study with nine professionals from the emergency team of a university hospital. Data were collected from a semi-structured interview and interpreted by the Content Analysis technique, in the Categorical Analysis modality. Results: seven of the participants reported knowing how to identify suspicious signs of violence against women, but they describe limitations and insecurities that interfere with the satisfactory performance during the service attributed to the lack of theoretical knowledge about the subject, overcrowding and deficiencies in external security and physical structure of the workplace. Conclusion: the lack of theoretical and practical knowledge and the deficiencies in working conditions were limitations that affected the emergency team's role in providing care to women in situations of violence. The results will contribute to reflections of interprofessional teams on the performance and care of women attacked in hospital emergencies. Descriptors: Violence Against Women; Domestic Violence; Sexual Violence; Emergencies; Hospital Care.RESUMENObjetivo: comprender las estrategias de actuación interdisciplinaria en situaciones de violencia contra la mujer. Método: estudio cualitativo, descriptivo, con nueve profesionales del equipo de emergencia de un hospital universitario. Los datos fueron recolectados a partir de entrevista semiestructurada y interpretados por la técnica de Análisis de Contenido, en la modalidad Análisis Categorial. Resultados: del total de participantes, siete se refieren saber identificar signos sospechosos de violencia a la mujer, pero describen limitaciones e inseguridades que interfieren en el desempeño satisfactorio durante la atención, atribuidas al poco conocimiento teórico sobre la temática, el hacinamiento y las deficiencias en la seguridad externa y en la estructura física del lugar de trabajo. Conclusión: la insuficiencia de conocimiento teórico y práctico y las deficiencias en las condiciones de trabajo fueron limitaciones que afectaron la actuación del equipo de emergencia en la atención a la mujer en situación de violencia. Los resultados contribuirán a reflexiones de equipos inter profesionales sobre la actuación y cuidado a la mujer agredida en emergencias hospitalarias. Descriptores: Violencia contra la Mujer; Violencia Doméstica; Violencia Sexual; Urgencias Médicas; Atención Hospitalaria.

scholarly journals Gender Comparisons of Asymmetric Lateralization in Neurodegenerative Disorder Patients via E-Pen Based Cognitive Assessment System

2019 ◽  
Author(s):  
Haemi JEE ◽  
Jaehyun PARK
Keyword(s):  
Cognitive Assessment ◽  
Evaluation System ◽  
Neurodegenerative Disorder ◽  
Assessment System ◽  
University Hospital ◽  
Horizontal Line ◽  
Cognitive Assessment System ◽  
Directional Bias ◽  
Visuospatial Neglect ◽  
Male Patients

Background: The clinical gender-dependent characteristics of visuospatial neglect between men and women have not been elucidated in Korean patients with cognitive impairment. The goal of this study was to observe the asymmetric lateralization in patients using a novel e-pen based cognitive assessment system. Methods: A total of 31 patients, 16 men and 15 women, with early stage hemispheric cerebral dysfunction were recruited for the assessment of unilateral neglect suing a novice paper-and-pencil based electronic evaluation system from a rehabilitation center of Inha University hospital in 2016. Results were assessed for degrees of deviations, and numbers of neglected lines. Degree of deviation was assessed using the positions and distances from the horizontal line centers. Effect sizes were calculated to assess proximities between the assessed results. Results: Comparatively greater left and rightward biasness for the right-sided and left-sided horizontal lines were observed for the male patients, respectively. Moreover, greater degree of left to rightward biasness was observed as the horizontal lines shortened in both groups. However, the magnitude of biasness in female patients showed comparatively less directional bias, indicating greater prevalence for the center of mass effect in male patients. Conclusion: Gender difference in visuospatial neglect seems to exist with less accuracy in recognition for the bisecting center for the female and asymmetrical lateralization and magnitude of deviation for the male patients.

scholarly journals Position of lips and tongue in rest in newborns with and without ankyloglossia

CoDAS ◽  
2021 ◽  
Vol 33 (6) ◽  
Author(s):  
Silvia Márcia Andrade Campanha ◽  
Roberta Lopes de Castro Martinelli ◽  
Durval Batista Palhares
Keyword(s):  
Visual Inspection ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Hospital Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Square Test

ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.

scholarly journals Nursing Students and Nurses’ Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

2021 ◽  
pp. 084456212110489
Author(s):  
Dimitri Létourneau ◽  
Johanne Goudreau ◽  
Chantal Cara
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Methodological Approach ◽  
University Hospital ◽  
Hospital Data ◽  
Interpretive Phenomenology ◽  
Pedagogical Strategies ◽  
Individual Interviews ◽  
Progressive Development ◽  
Regulatory Bodies

Background Most nursing education programs prepare their students to embody humanism and caring as it is expected by several regulatory bodies. Ensuring this embodiment in students and nurses remains a challenge because there is a lack of evidence about its progressive development through education and practice. Purpose This manuscript provides a description of nursing students’ and nurses’ recommendations that can foster the development of humanistic caring. Methods Interpretive phenomenology was selected as the study's methodological approach. Participants (n = 26) were recruited from a French-Canadian university and an affiliated university hospital. Data was collected through individual interviews. Data analysis consisted of an adaptation of Benner’s (1994) phenomenological principles that resulted in a five-stage interpretative process. Results The following five themes emerged from the phenomenological analysis of participants’ recommendations: 1) pedagogical strategies, 2) educators’ approach, 3) considerations in teaching humanistic caring, 4) work overload, and 5) volunteerism and externship. Conclusion The findings suggest the existence of a challenge when using mannikins in high-fidelity simulations with the intention of developing humanistic caring. The findings also reaffirm the importance of giving concrete and realistic exemplars of humanistic caring to students in order to prevent them from making “communication” synonymous to “humanization of care”.

scholarly journals How Can a Multidisciplinary Approach Improve Prognosis of Soft-Tissue Sarcomas of Extremities?

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Asmae Mazti ◽  
Mohamed El Idrissi ◽  
Abdelhalim El Ibrahimi ◽  
Mustapha El Maaroufi ◽  
Ghizlane El Koubaiti ◽  
...  
Keyword(s):  
Survival Rate ◽  
Soft Tissue ◽  
Malignant Tumors ◽  
Research Work ◽  
Soft Tissue Sarcomas ◽  
University Hospital ◽  
R0 Resection ◽  
Magnetic Resonance Imaging Scan ◽  
Tumor Type ◽  
Multidisciplinary Meeting

Soft-tissue sarcomas are malignant tumors that require good management within specialized centers. Our study aims to assess the benefit of handling these kinds of tumors using the Multidisciplinary Meeting (MDM) approach. The current paper details this approach through a prospective study that has lasted for 42 months in the HASSAN II University Hospital Center, Fez, Morocco. During this research work, 116 cases were selected with an average age of 53 years. In 95.7% of the cases, it was found that the lower limb was the most frequent tumor type (78.4%). Also, ninety-two (92) patients (79.3%) have had a prior biopsy. Ninety-nine (99) patients (85.3%) have received a magnetic resonance imaging scan (MRI) before surgery. Sixty-three (63) patients were operated on, including R0 resection used for 37 patients, R1 used for 21 patients, and R2 used for five patients. As a result, liposarcomas were the most frequent type (30.1%), followed by synovial sarcomas (14.6%), leiomyosarcomas (9.5%), ewing sarcoma (8.6), and undifferentiated pleomorphic sarcomas (7.7%). In addition, neoadjuvant chemotherapy was used for 36 patients. The other 22 patients received adjuvant chemotherapy and/or radiotherapy. The overall survival rate was 60.56 months, which proves a significant improvement, thanks to the multidisciplinary meeting approach. Conclusion. The conducted investigation has shown that using MDM for managing soft-tissue sarcomas of extremities improves the patients’ survival rate. Moreover, results have proven MDM might allow optimal treatment regarding less local recurrence and metastasis.

scholarly journals Adesão à identificação correta do paciente pelo uso da pulseira

2018 ◽  
Vol 12 (10) ◽  
pp. 2621
Author(s):  
Tamyris Garcia De Assis ◽  
Luana Ferreira De Almeida ◽  
Luciana Guimarães Assad ◽  
Ronilson Gonçalves Rocha ◽  
Cíntia Silva Fassarella ◽  
...  
Keyword(s):  
Patient Safety ◽  
Descriptive Statistics ◽  
University Hospital ◽  
Patient Identification ◽  
Hospital Data ◽  
Health Team ◽  
Systems Quality ◽  
Quantitative Descriptive ◽  
And Training

RESUMO Objetivo: analisar a adesão à identificação do paciente por pulseira pela equipe de saúde e pelos pacientes. Método: trata-se de estudo quantitativo, descritivo e documental. Constituiu-se a amostra por 137 pacientes internados em uma unidade cardiointensiva de um hospital universitário. Coletaram-se os dados, mediante o preenchimento de um formulário estruturado, em seguida, organizados e analisados utilizando-se a estatística descritiva simples. Resultados: observou-se a presença da pulseira de identificação em 100% dos pacientes. Destes, 26% apresentavam não conformidades. Ansalisou-se, a partir dos relatos dos pacientes, que 61% dos profissionais não utilizaram a pulseira para identificá-los no momento dos procedimentos e 90% dos pacientes não foram orientados quanto ao motivo e importância da utilização da pulseira. Conclusão: observou-se de forma unânime a identificação dos pacientes, no entanto, necessita-se, na prática, de maior sensibilização e treinamento da equipe multiprofissional para a adequação conforme se preconiza na Meta 1 de Segurança do Paciente. Descritores: Segurança do Paciente; Sistemas de Identificação de Pacientes; Qualidade da Assistência à Saúde; Gestão de Risco; Hospitalização; Hospitais Universitários.ABSTRACT Objective: to analyze the adherence to the identification of the patient by hospital wristband by the health team and by the patients. Method: this is a quantitative, descriptive and documentary study. The sample consisted of 137 patients hospitalized in a cardio-intensive unit of a university hospital. Data was collected by completing a structured form, then organized and analyzed using simple descriptive statistics. Results: the presence of the identification wristband was observed in 100% of the patients. Of these, 26% had nonconformities. From the patients' reports, 61% of the professionals did not use the wristband to identify them at the time of the procedures and 90% of the patients were not guided as to the reason and importance of the use of the wristband. Conclusion: the identification of patients was unanimously observed, however, it is necessary, in practice, to increase awareness and training of the multi-professional team for the adequacy as recommended in Goal 1 of Patient Safety. Descriptors: Patient Safety; Patient Identification Systems; Quality of Health Care; Risk Management; Hospitalization; Hospitals, University.RESUMENObjetivo: analizar la adhesión a la identificación del paciente por pulsera por el equipo de salud y por los pacientes. Método: se trata de un estudio cuantitativo, descriptivo y documental. Se constituyó la muestra por 137 pacientes internados en una unidad cardiointensiva de un hospital universitario. Se recogen los datos, mediante el llenado de un formulario estructurado, a continuación, organizado y analizado utilizando la estadística descriptiva simple. Resultados: se observó la presencia de la pulsera de identificación en el 100% de los pacientes. De ellos, el 26% presentaba no conformidades. Se analizó, a partir de los relatos de los pacientes, que el 61% de los profesionales no utilizaron la pulsera para identificarlos en el momento de los procedimientos y el 90% de los pacientes no fueron orientados en cuanto al motivo e importancia del uso de la pulsera. Conclusión: se observó de forma unánime la identificación de los pacientes, sin embargo, se necesita, en la práctica, de mayor sensibilización y entrenamiento del equipo multiprofesional para la adecuación conforme se preconiza en la Meta 1 de Seguridad del Paciente. Descriptores: Seguridad del Paciente; Sistemas de Identificación de Pacientes; Calidad de la Atención de Salud; Gestión de Riesgos; Hospitalización; Hospitales Universitarios.

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