Impact of hospitalist care on hospital malpractice premiums using California hospital data

Summary: Objective: Studies of completed and attempted suicide in Turkey are based on data of State Institute of Statistics (SIS) and emergency clinics of the large hospitals. This study seeks (1) to find, independent of the SIS and hospital data, the annual incidences of completed and attempted suicide in Trabzon, Turkey; (2) to examine the associated factors between the incidence of completed and attempted suicide. Method: The data are derived by using a method specially designed for this study. Data sources include emergency clinics in all hospitals, village clinics, the Forensic Medical Center of Trabzon, the Governorship of Trabzon, “mukhtars” (local village representatives) of neighborhoods, the Office of the Public Prosecutor of Trabzon, the Police Headquarters and Gendarmerie, and the local press organs. Results: The incidences of completed and attempted suicide per 100,000 inhabitants turned out to be 2.60 and 31.5, respectively, whereas the SIS reported the incidence of completed suicide to be 1.11 per 100,000 inhabitants in Trabzon in 1995. Conclusion: Our results demonstrate that SIS data are inadequate for suicide research in Turkey. Our findings show that the risk of completed and attempted suicide is high in young, unmarried, and unemployed persons, and that these groups must be carefully evaluated for suicide risk. The study highlights the need for culture-specific research on suicidal behavior in Turkey.

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Quality Measures Up in JCAHO Study of Hospital Data

Family Practice News ◽

10.1016/s0300-7073(05)71925-3 ◽

2005 ◽

Vol 35 (19) ◽

pp. 96

Author(s):

ALICIA AULT

Keyword(s):

Quality Measures ◽

Hospital Data

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Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

Current Drug Therapy ◽

10.2174/1574885515999200819092717 ◽

2020 ◽

Vol 15 ◽

Author(s):

Solomon Hambisa ◽

Rediet Feleke ◽

Ameha Zewudie ◽

Mohammed Yimam

Keyword(s):

Drug Use ◽

World Health Organization ◽

Teaching Hospital ◽

Cross Sectional Study ◽

University Teaching ◽

World Health ◽

Sectional Study ◽

Hospital Data ◽

Cross Sectional ◽

Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

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Dynamics of the COVID-19 epidemic in Ireland under mitigation

BMC Infectious Diseases ◽

10.1186/s12879-021-06433-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bernard Cazelles ◽

Benjamin Nguyen-Van-Yen ◽

Clara Champagne ◽

Catherine Comiskey

Keyword(s):

Transmission Rate ◽

Vaccination Campaign ◽

Virus Transmission ◽

Reporting Rate ◽

Mitigation Measures ◽

Third Wave ◽

The European Union ◽

Hospital Data ◽

Prevalence Survey ◽

Epidemic Curve

Abstract Background In Ireland and across the European Union the COVID-19 epidemic waves, driven mainly by the emergence of new variants of the SARS-CoV-2 have continued their course, despite various interventions from governments. Public health interventions continue in their attempts to control the spread as they wait for the planned significant effect of vaccination. Methods To tackle this challenge and the observed non-stationary aspect of the epidemic we used a modified SEIR stochastic model with time-varying parameters, following Brownian process. This enabled us to reconstruct the temporal evolution of the transmission rate of COVID-19 with the non-specific hypothesis that it follows a basic stochastic process constrained by the available data. This model is coupled with Bayesian inference (particle Markov Chain Monte Carlo method) for parameter estimation and utilized mainly well-documented Irish hospital data. Results In Ireland, mitigation measures provided a 78–86% reduction in transmission during the first wave between March and May 2020. For the second wave in October 2020, our reduction estimation was around 20% while it was 70% for the third wave in January 2021. This third wave was partly due to the UK variant appearing in Ireland. In June 2020 we estimated that sero-prevalence was 2.0% (95% CI: 1.2–3.5%) in complete accordance with a sero-prevalence survey. By the end of April 2021, the sero-prevalence was greater than 17% due in part to the vaccination campaign. Finally we demonstrate that the available observed confirmed cases are not reliable for analysis owing to the fact that their reporting rate has as expected greatly evolved. Conclusion We provide the first estimations of the dynamics of the COVID-19 epidemic in Ireland and its key parameters. We also quantify the effects of mitigation measures on the virus transmission during and after mitigation for the three waves. Our results demonstrate that Ireland has significantly reduced transmission by employing mitigation measures, physical distancing and lockdown. This has to date avoided the saturation of healthcare infrastructures, flattened the epidemic curve and likely reduced mortality. However, as we await for a full roll out of a vaccination programme and as new variants potentially more transmissible and/or more infectious could continue to emerge and mitigation measures change silent transmission, challenges remain.

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Description of multimorbidity clusters of admitted patients in medical departments of a general hospital

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139361 ◽

2021 ◽

pp. postgradmedj-2020-139361

Author(s):

María Matesanz-Fernández ◽

Teresa Seoane-Pillado ◽

Iria Iñiguez-Vázquez ◽

Roi Suárez-Gil ◽

Sonia Pértega-Díaz ◽

...

Keyword(s):

General Hospital ◽

Multiple Correspondence Analysis ◽

Hypertensive Heart Disease ◽

Chronic Kidney Failure ◽

Hospital Environment ◽

Heart Valve Disease ◽

Malignant Neoplasms ◽

Hospital Data ◽

Data Set ◽

And Gender

ObjectiveWe aim to identify patterns of disease clusters among inpatients of a general hospital and to describe the characteristics and evolution of each group.MethodsWe used two data sets from the CMBD (Conjunto mínimo básico de datos - Minimum Basic Hospital Data Set (MBDS)) of the Lucus Augusti Hospital (Spain), hospitalisations and patients, realising a retrospective cohort study among the 74 220 patients discharged from the Medic Area between 01 January 2000 and 31 December 2015. We created multimorbidity clusters using multiple correspondence analysis.ResultsWe identified five clusters for both gender and age. Cluster 1: alcoholic liver disease, alcoholic dependency syndrome, lung and digestive tract malignant neoplasms (age under 50 years). Cluster 2: large intestine, prostate, breast and other malignant neoplasms, lymphoma and myeloma (age over 70, mostly males). Cluster 3: malnutrition, Parkinson disease and other mobility disorders, dementia and other mental health conditions (age over 80 years and mostly women). Cluster 4: atrial fibrillation/flutter, cardiac failure, chronic kidney failure and heart valve disease (age between 70–80 and mostly women). Cluster 5: hypertension/hypertensive heart disease, type 2 diabetes mellitus, ischaemic cardiomyopathy, dyslipidaemia, obesity and sleep apnea, including mostly men (age range 60–80). We assessed significant differences among the clusters when gender, age, number of chronic pathologies, number of rehospitalisations and mortality during the hospitalisation were assessed (p<0001 in all cases).ConclusionsWe identify for the first time in a hospital environment five clusters of disease combinations among the inpatients. These clusters contain several high-incidence diseases related to both age and gender that express their own evolution and clinical characteristics over time.

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Perioperative anaphylaxis: A five-year review in a tertiary paediatric hospital

Anaesthesia and Intensive Care ◽

10.1177/0310057x20964470 ◽

2021 ◽

Vol 49 (1) ◽

pp. 44-51

Author(s):

Theresa SW Toh ◽

Sze Y Foo ◽

Wenyin Loh ◽

Kok W Chong ◽

Anne EN Goh ◽

...

Keyword(s):

New Zealand ◽

Skin Tests ◽

Hospital Data ◽

Paediatric Hospital ◽

Male Predominance ◽

Severity Grade ◽

Culprit Drug ◽

Respiratory Change ◽

Ige Mediated ◽

Grade 3

Making a diagnosis of perioperative anaphylaxis and identifying culprit drugs are diagnostic challenges. The aim of this study is to describe the perioperative presentation of anaphylaxis and results of patients who underwent allergy evaluation. This is a retrospective review of perioperative anaphylaxis of severity Grade 2 and above based on the Australian and New Zealand Anaesthetic Allergy Group criteria from 2015 to 2019 in a tertiary paediatric hospital. Data collected were demographics, clinical features, investigations and management. Of the 35,361 cases of paediatric anaesthesia, there were 15 cases of perioperative anaphylaxis, giving an incidence of four in 10,000. The median age was seven years (interquartile range four–15 years) with a male predominance of 86.7% (13/15). The severity of anaphylaxis was Grade 2 in 33.3% (5/15) and Grade 3 in 66.7% (10/15). The commonest presenting feature was hypotension (13/15, 86.7%) while the earliest symptom was respiratory change (9/15, 60.0%). Dynamic tryptase was raised in 75% (6/8) of the patients with adequate tryptase samples. Eight patients (53.3%) completed allergy testing, of whom five patients (62.5%) had IgE-mediated anaphylaxis with skin test positive to cefazolin ( n = 3), atracurium ( n = 1) and rocuronium ( n = 1). Three patients (25.0%) had non–IgE-mediated reactions with negative skin tests. Although only half the patients completed allergy evaluation, a culprit drug could be identified in 62.5%, with antibiotics being the commonest. This emphasises the need for appropriate evaluation in cases of suspected perioperative anaphylaxis.

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Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study

BMJ Open ◽

10.1136/bmjopen-2020-044884 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044884

Author(s):

Melanie Rae Bish ◽

Fiona Faulks ◽

Lisa Helen Amir ◽

Rachel R Huxley ◽

Harold David McIntyre ◽

...

Keyword(s):

Breast Feeding ◽

Mode Of Delivery ◽

Panel Study ◽

Multivariable Analysis ◽

Morbidly Obese ◽

Hospital Data ◽

Targeted Interventions ◽

Live Births ◽

Breast Feed ◽

Over Time

ObjectivesUsing routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that adjusted for sociodemographics, antenatal, intrapartum and postpartum conditions, mode of delivery and infant’s-related covariates.DesignPopulation-based retrospective panel.SettingA regional hospital that serves 26% of Victoria’s 6.5 million population in Australia.ParticipantsAll women experiencing live births between 2010 and 2017 were included. Women with missing body mass index (BMI) were excluded.ResultsA total of 7491 women contributed to 10 234 live births. At baseline, 57.2% of the women were overweight or obese, with obesity increasing over 8 years by 12.8%, p=0.001. Although, breast feeding increased over time, observed in all socioeconomic status (SES) and BMI categories, the lowest proportions were consistently found among the obese and morbidly obese (78.9% vs 87.1% in non-obese mothers, p<0.001). In the multivariable analysis, risk of not breast feeding was associated with higher BMI, teenage motherhood, smoking, belonging to the lowest SES class, gravidity >4 and undergoing an assisted vaginal or caesarean delivery. Compared with women with a normal weight, the obese and morbidly obese were 66% (OR 1.66, 95% CI 1.40 to 1.96, p<0.001) to 2.6 times (OR 2.61, 95% CI 2.07 to 3.29, p<0.001) less likely to breast feed, respectively. The detected dose–response effect between higher BMI and lower breast feeding was not explained by any of the study covariates.ConclusionThis study provides evidence of increasing breast feeding proportions in regional Victoria over the past decade. However, these proportions were lowest among the obese and morbidly obese and those coming from the most disadvantaged backgrounds suggesting the need for targeted interventions to support breast feeding among these groups. The psychosocial and physiological associations between obesity and breast feeding should further be investigated.

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Integrating data from multiple Finnish biobanks and national health-care registers for retrospective studies: Practical experiences

Scandinavian Journal of Public Health ◽

10.1177/14034948211004421 ◽

2021 ◽

pp. 140349482110044

Author(s):

Jaakko Lähteenmäki ◽

Anna-Leena Vuorinen ◽

Juha Pajula ◽

Kari Harno ◽

Mika Lehto ◽

...

Keyword(s):

Health Care ◽

Statistical Power ◽

Data Exchange ◽

Genotype Data ◽

Multiple Sources ◽

Hospital Data ◽

National Register ◽

National Register Data ◽

Health Care Encounters

Aim: This case study aimed to investigate the process of integrating resources of multiple biobanks and health-care registers, especially addressing data permit application, time schedules, co-operation of stakeholders, data exchange and data quality. Methods: We investigated the process in the context of a retrospective study: Pharmacogenomics of antithrombotic drugs (PreMed study). The study involved linking the genotype data of three Finnish biobanks (Auria Biobank, Helsinki Biobank and THL Biobank) with register data on medicine dispensations, health-care encounters and laboratory results. Results: We managed to collect a cohort of 7005 genotyped individuals, thereby achieving the statistical power requirements of the study. The data collection process took 16 months, exceeding our original estimate by seven months. The main delays were caused by the congested data permit approval service to access national register data on health-care encounters. Comparison of hospital data lakes and national registers revealed differences, especially concerning medication data. Genetic variant frequencies were in line with earlier data reported for the European population. The yearly number of international normalised ratio (INR) tests showed stable behaviour over time. Conclusions: A large cohort, consisting of versatile individual-level phenotype and genotype data, can be constructed by integrating data from several biobanks and health data registers in Finland. Co-operation with biobanks is straightforward. However, long time periods need to be reserved when biobank resources are linked with national register data. There is a need for efforts to define general, harmonised co-operation practices and data exchange methods for enabling efficient collection of data from multiple sources.

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Perceived Stigma as a Contextual Barrier to Early Uptake of HIV Testing, Treatment Initiation, and Disclosure; The Case of Patients Admitted with AIDS-Related Illness in a Rural Hospital in South Africa

Healthcare ◽

10.3390/healthcare9080962 ◽

2021 ◽

Vol 9 (8) ◽

pp. 962

Author(s):

Sphiwe Madiba ◽

Evelyn Ralebona ◽

Mygirl Lowane

Keyword(s):

Adult Patients ◽

Hiv Status ◽

Perceived Stigma ◽

Hospital Data ◽

Hiv Diagnosis ◽

Related Stigma ◽

Enacted Stigma ◽

Delayed Disclosure ◽

Selective Disclosure ◽

Close Family

We explored the extent to which perceived HIV-related stigma influences the disclosure and concealment of HIV status to family among adult patients hospitalised for AIDS-related illness, and described reports of negative responses and enacted stigma following disclosure. We conducted interviews with a purposeful sample of 28 adult patients in a rural South African hospital. Data analysis was deductive and inductive and followed the thematic approach. We found evidence of delayed HIV diagnosis and initiation of treatment. There was delayed and selective disclosure as well as concealment of the HIV-positive status. The disclosure was delayed for months or even years. During that time, there was active concealment of the HIV status to avoid stigma from family, friends, and community. When disclosure occurred, there was selective disclosure to close family members who would keep the secret and respond favorably. Although the participants disclosed mostly to close family, some of their post-disclosure experiences included incidents of enacted stigma and discrimination. The fear of perceived stigma and self-stigma influenced the active concealment of their HIV status from others. Continuous concealment of one’s HIV status and delayed disclosure limit the opportunities for support and care. There is a need to take into consideration the interaction between HIV-related stigma and disclosure to develop disclosure-counselling strategies in primary health care settings.

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Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

Nordic Journal of Nursing Research ◽

10.1177/2057158521994451 ◽

2021 ◽

pp. 205715852199445

Author(s):

Kristina Sundt Eriksen ◽

Sissel Iren Eikeland Husebø ◽

Hartwig Kørner ◽

Kirsten Lode

Keyword(s):

Colorectal Cancer ◽

Thematic Analysis ◽

Oldest Old ◽

Healthcare Services ◽

Hospital Data ◽

Colorectal Cancer Surgery ◽

Discharge From Hospital ◽

Depth Interviews ◽

Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

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