scholarly journals A Computer Analysis of Patient Activity and Blood Product Usage in Community Hospital Hemophilia Program

1977 ◽  
Author(s):  
R.A. Lipton ◽  
J. Chin

This program evaluation assessed utilization of blood products and hospital services in 1975. One hundred eight hemophiliacs, 10 (0-4 years), 37 (5-12 years), 21 (13-18 years), 24 (19-30 years), 16 (30 years and over); 73 (Factor VIII), 20 (Factor IX), 12 (Von Willebrand’s Disease), and 3 (Factor XI) were categorized as to their severity and their primary treatment mode: Home Care Prophylactic, Home Care Episodic, Hospital-based Prophylactic, and Hospital-based Episodic Care. The results showed that the major user of hospital services was the child, 5-12 years. Hospital-based patients used more hospital based services, i.e., emergency room, comprehensive clinic, and dental non-surgery than did home based patients. In terms of factor unit consumption per kilogram body weight, prophylactic patients used the greatest amount of blood product. Children on prophylaxis missed less school but adults on prophylaxis did not miss less work. Children on hospital modes of care utilized this medical service less in the summer than did their peers on home based care. These results provided direction for planning future programs and staffing. They suggest a need for increasing surveillance of Home Care patients to maximize their participation in certain hospital based services. The unexpected finding of decreased hospital based care during the summer warrants further study. The results suggest considering prophylactic modes of care in school aged children.

Blood ◽  
1987 ◽  
Vol 70 (4) ◽  
pp. 1208-1210 ◽  

A 1986 survey of seven hemophilia treatment centers in Pennsylvania (PA) has revealed that 22 hemophiliacs residing in PA have developed the acquired immunodeficiency syndrome (AIDS), representing 9.2% of the total 238 United States hemophiliac AIDS cases. These 22 included ten (45.5%) from western PA (W-PA), eleven (50.0%) from central PA (C-PA), and one (0.5%) from eastern PA (E-PA). The HIV antibody prevalence for these three geographic groups is comparable, with 84 of 178 (47.2%) of hemophiliacs in W-PA seropositive, 102 of 182 (56.0%) in C-PA seropositive, and 105 of 177 (59.3%) in E-PA seropositive. Blood product usage for these three areas is comparable: 47.8 X 10(3) (W-PA) v 43.9 (C-PA) v 53.3 (E-PA) units factor VIII concentrate per patient per year; 36.5 v 24.5 v 33.7 for factor IX concentrate; 8.4 v 4.7 v 7.7 for cryoprecipitate; and 1.3 v 2.7 v 1.0 for fresh frozen plasma, respectively. These data demonstrate a geographic variation in hemophilia AIDS incidence in PA, with a tenfold higher incidence in W- PA and C-PA than E-PA, which is unrelated to differences in HIV antibody prevalence, patient blood product usage, or inaccuracies in AIDS case reporting. Because of the greater than or equal to 5 year median latency between HIV infection and development of AIDS, the AIDS incidence will continue to change, but other factors appear to be operative in the development of AIDS in hemophiliacs.


2019 ◽  
Vol 38 (6) ◽  
pp. 973-980 ◽  
Author(s):  
Lisa I. Iezzoni ◽  
Naomi Gallopyn ◽  
Kezia Scales

Blood ◽  
1987 ◽  
Vol 70 (4) ◽  
pp. 1208-1210 ◽  

Abstract A 1986 survey of seven hemophilia treatment centers in Pennsylvania (PA) has revealed that 22 hemophiliacs residing in PA have developed the acquired immunodeficiency syndrome (AIDS), representing 9.2% of the total 238 United States hemophiliac AIDS cases. These 22 included ten (45.5%) from western PA (W-PA), eleven (50.0%) from central PA (C-PA), and one (0.5%) from eastern PA (E-PA). The HIV antibody prevalence for these three geographic groups is comparable, with 84 of 178 (47.2%) of hemophiliacs in W-PA seropositive, 102 of 182 (56.0%) in C-PA seropositive, and 105 of 177 (59.3%) in E-PA seropositive. Blood product usage for these three areas is comparable: 47.8 X 10(3) (W-PA) v 43.9 (C-PA) v 53.3 (E-PA) units factor VIII concentrate per patient per year; 36.5 v 24.5 v 33.7 for factor IX concentrate; 8.4 v 4.7 v 7.7 for cryoprecipitate; and 1.3 v 2.7 v 1.0 for fresh frozen plasma, respectively. These data demonstrate a geographic variation in hemophilia AIDS incidence in PA, with a tenfold higher incidence in W- PA and C-PA than E-PA, which is unrelated to differences in HIV antibody prevalence, patient blood product usage, or inaccuracies in AIDS case reporting. Because of the greater than or equal to 5 year median latency between HIV infection and development of AIDS, the AIDS incidence will continue to change, but other factors appear to be operative in the development of AIDS in hemophiliacs.


2021 ◽  
Vol 9 (T4) ◽  
pp. 236-239
Author(s):  
Anggi Stiexs ◽  
Nur Chayati

BACKGROUND: Family support during stroke treatment at home is crucial. However, post-stroke patients’ long-term care will be a problem for families, reducing the level of life satisfaction and physical burden for caregivers. Furthermore, families may experience depression. AIM: Analyzing family conditions related to physical, psychological, and spiritual conditions that receive home-based health worker interventions. METHODS: Study implemented systematic review design with Prisma guidelines, initially with the identification of article sources, following by article screening, checking the eligibility of studies then appraised the selected articles. Three databases were used, Ebsco, PubMed, and PROQUEST. Only studies using quasi-experimental, pre-experimental, and RCT designs were included in this study. Furthermore, those articles were published between 2014 until 2019, full type article and conducted anykind of home intervention for stroke patients and/or family member. Keywords that were employed “Stroke, Apoplexy, Cerebrovascular Accident, Vascular Accident, Home Care Services, home care, Home Health Care, Domiciliary Care, Physical, Physics, Psychological Factors, Psychological Side Effects, Psychosocial Factors, Spirituality.” Totally, 19,528 articles were obtained. Finally, only six eligible articles met review requirements. RESULTS: Implementation of home-based care lowered the physical fatigue of the family. In psychological responses showed that home-based care could reduce the incidence of depression and anxiety levels. Another impact was that the family felt helped because patients could more independently do their activities. Furthermore, the family always supported to motivate the patients to do their daily tasks. CONCLUSION: Home-based interventions for stroke patients can reduce depression, anxiety, and fatigue for the family caregiver.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 218-218
Author(s):  
Robyn Stone ◽  
Alex Hennessa ◽  
Natasha Bryant

Abstract Home-based care is a rapidly growing sector becoming more important to individuals, families, providers, and payers. The ways in which agencies create the work environment for home care aides who are essentially in their clients’ homes is not adequately documented and may be changing rapidly with labor market innovations. This qualitative study describes how different home care business models (e.g., non-profit VNAs, for-profit franchises, uber-style matching, worker-owned coops) address job design and the overall work environment for home care aides. Interviews with employers and focus groups with home care aides examine workplace practices, how work is organized and supported when the workforce is virtual and the workplace is a client’s home, and the perceived attributes of a positive workplace environment across business models. This study fills significant knowledge gaps about home care workplace design and the role of agencies in creating a supportive environment.


2014 ◽  
Vol 39 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Lynne McPherson ◽  
Noel MacNamara

Kinship-care placements in Australia are now more prevalent than foster care and are the fastest growing form of out-of-home care in this country (AIHW, 2014). On 30 June 2013, 93% of Australian children in out-of-home care were in home-based care, with 43% of these in foster care and 48% in relative/kinship care (AIHW, 2014). The past decade has seen a greater understanding of children's needs in out-of-home care, with models of therapeutic care showing promise in Australia and internationally. These models, however, are designed almost exclusively for children placed in foster care or residential care, and as such do not consider the unique features of kinship care. This paper will identify the needs of children in out-of-home care, before briefly examining the concepts of therapeutic foster care as a response to children who have experienced trauma. Key distinctions between foster care and kinship care will be highlighted and implications for a conceptual model of therapeutic kinship care discussed.


1993 ◽  
Vol 162 (2) ◽  
pp. 239-243 ◽  
Author(s):  
C. J. Simpson ◽  
C. P. Seager ◽  
J. A. Robertson

ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S216-S216
Author(s):  
Robyn Stone ◽  
Natasha Bryant

Abstract Despite home heath/home care aides being the informal “eyes and ears” of the health system, team-based home care initiatives have not incorporated this workforce into their programs. This presentation summarizes barriers to their inclusion: a basic lack of understanding on the part of clinical team members of the complex tasks these caregivers perform, inadequate investments in competency-based aide training and education, and variation in state nurse delegation laws that limit aides’ scope of practice and their ability to work effectively in teams. This is followed by a review of several programs that have successfully included aides as key members of home care teams. The presentation concludes with recommendations on how federal and state policymakers, educators and health systems and providers can support inclusion of aides in team-based care through standardization of competency-based training programs, expansion of nurse delegation nationwide, and support for piloting, evaluation, dissemination and replication of promising models.


2017 ◽  
Vol 38 (11) ◽  
pp. 1615-1634 ◽  
Author(s):  
Elizabeth Nisbet ◽  
Jennifer Craft Morgan

In a context of growing demand for home-based direct care services, the need to retain direct care workers (DCWs) is clear. The Patient Protection and Affordable Care Act, changes to the Fair Labor Standards Act, and state-level changes in Medicaid support for home-based care together have affected agencies that hire DCWs, with implications for an issue that affects worker satisfaction: scheduling. Many home-based aides employed by agencies cannot count on consistent or sufficient hours. Hours shortfall and instability have been recognized as important issues for retail and restaurant workers, but focused on less for care aides. This study uses semistructured interviews with agency representatives to examine these issues from an employer perspective, with a focus on how the competing influences of health care, labor, and employment policy shape scheduling and a review of how recommendations for changes in policy and practice in other sectors might apply to home care.


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