1117 Managing Cosmetic Surgery Complications: A Retrospective Service Evaluation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Luck ◽  
E Strachan ◽  
B Piggott ◽  
S Saour
Keyword(s):  
Cosmetic Surgery ◽  
Average Length ◽  
Service Evaluation ◽  
Surgery Complications ◽  
Surgical Interventions ◽  
Financial Costs ◽  
Service Activity ◽  
Patient Level Costing ◽  
The Uk ◽  
The Impact

Abstract Aim The cosmetic surgery industry continues to grow, both within the UK and internationally. There is a perception that the NHS is often left to deal with the complications of these procedures, particularly those performed abroad. This study aimed to evaluate the burden of cosmetic surgery complications on a tertiary London plastics service with an appraisal of the financial costs incurred. Method This one-year retrospective service evaluation included all emergent referrals following cosmetic surgical interventions in the UK private sector and abroad. Outpatient referrals and planned revisional procedures were excluded. Financial costs were based upon current Clinical Commissioning Group tariffs. Results In total, 14 patients were included (seven from the UK and seven from Europe or North Africa). Remote telemedicine advice was provided for six patients; eight patients required admission. All eight admissions were female with an average age of 42.6 years. The most common complication was infection (75%) with an average length of stay of 2.3 nights. These eight patients required six trips to theatre, two CT scans and 37 outpatient visits. The median tariff per patient was £1,510 (range £242 to £5,196), leading to an overall reimbursement of £16,471. The majority of these costs were generated during inpatient admissions (£12,855) with a lesser contribution from outpatient episodes (£3,616). Conclusions This project provides an overview of the impact of managing emergent complications following cosmetic surgery, both in terms of service activity and financial cost. A long-term, prospective service evaluation of both elective and emergency referrals based upon patient-level costing data is now underway.

scholarly journals Understanding the impact of the COVID-19 pandemic on a socially deprived UK coastal town: a preliminary exploratory analysis of health and socioeconomic data

2021 ◽  
Author(s):  
Maddy French ◽  
Mark Spencer ◽  
Mike Walker ◽  
Afzal Patel ◽  
Neil Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admissions ◽  
Exploratory Analysis ◽  
Social Outcomes ◽  
Socioeconomic Outcomes ◽  
Chi Squared ◽  
Service Activity ◽  
Indirect Impacts ◽  
The Uk ◽  
The Impact

Introduction In addition to the direct impact of COVID-19 infections on health and mortality, a growing body of literature indicates there are wide-ranging indirect impacts of the COVID-19 pandemic and associated public health measures on population health and wellbeing. Exploring these indirect impacts in the context of a socially deprived UK coastal town will help identify priority areas to focus COVID-19 recovery efforts on. Methods Data on primary care diagnosis, hospital admissions, and several socioeconomic outcomes between 2016 and Spring 2021 in the UK town of Fleetwood were collected and analysed in an exploratory analysis looking at pre- and post- COVID-19 patterns in health and social outcomes. Weekly and monthly trends were plotted by time and differences between periods examined using Chi-squared and t-tests. Results Initial falls in hospital admissions and diagnoses of conditions in primary care in March 2020 were followed by sustained changes to health service activity for specific diagnostic and demographic groups, including for chronic kidney disease and young people. Increases in the number of people receiving Universal Credit and children eligible for free school meals appear to be greater for those in the least deprived areas of the town. Discussion These exploratory findings provide initial evidence of the sustained impact of the pandemic across several health and social outcomes. Examining these trends in multivariate analyses will further test these associations and establish the strength of the medium term impact of the pandemic on the population of this coastal town. Advanced modelling of this data is ongoing and will be published shortly.

scholarly journals The Impact of Cosmetic Surgery Advertising on Swiss Women’s Body Image and Attitudes Toward Cosmetic Surgery

2017 ◽  
Vol 76 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Eleni-Marina Ashikali ◽  
Helga Dittmar ◽  
Susan Ayers
Keyword(s):  
Body Image ◽  
Cosmetic Surgery ◽  
Risk Information ◽  
British Association ◽  
Negative Body Image ◽  
Additional Information ◽  
Women's Body Image ◽  
The Uk ◽  
The Impact

Abstract. International concern has been expressed about advertising for cosmetic surgery (British Association of Aesthetic Plastic Surgeons [BAAPS], 2005, 2008 ). A recent study showed that exposure to such advertising resulted in a more negative body image and attitudes toward surgery among women living in the UK ( Ashikali, Dittmar, & Ayers, 2015 ). This study investigates the impact of cosmetic surgery advertising on women living in Switzerland, a country with relatively little advertising for cosmetic surgery. A group of 145 women (mean age 23.07) were exposed to advertising for cosmetic surgery containing either discount incentives, risk information, no additional information, or to the control condition. Exposure to advertising for cosmetic surgery resulted in increased dissatisfaction with both bodyweight and appearance. Highly materialistic women perceived such surgery as being less beneficial to their image when exposed to advertising for cosmetic surgery as well as when exposed to risk information rather than discount incentives. Moreover, appearance-dissatisfied women considered surgery to a lesser extent when exposed to risk information compared to discount incentives. Our findings highlight the need for research examining the impact of cosmetic surgery media, the content of advertising for cosmetic surgery as well as cultural variability.

scholarly journals Impact of COVID-19 Pandemic on a Regional Stroke Thrombectomy Service in the United Kingdom

2020 ◽  
pp. 1-7
Author(s):  
Joseph Kwan ◽  
Madison Brown ◽  
Paul Bentley ◽  
Zoe Brown ◽  
Lucio D’Anna ◽  
...  
Keyword(s):  
Negative Impact ◽  
Service Evaluation ◽  
Outcome Data ◽  
Term Outcome ◽  
Neurological Outcomes ◽  
Neurological Improvement ◽  
Patient Demographics ◽  
The United Kingdom ◽  
The Uk ◽  
The Impact

<b><i>Introduction:</i></b> We examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on our regional stroke thrombectomy service in the UK. <b><i>Methods:</i></b> This was a single-center health service evaluation. We began testing for COVID-19 on 3 March and introduced a modified “COVID Stroke Thrombectomy Pathway” on 18 March. We analyzed the clinical, procedural and outcome data for 61 consecutive stroke thrombectomy patients between 1 January and 30 April. We compared the data for January and February (“pre-COVID,” <i>n</i> = 33) versus March and April (“during COVID,” <i>n</i> = 28). <b><i>Results:</i></b> Patient demographics were similar between the 2 groups (mean age 71 ± 12.8 years, 39% female). During the COVID-19 pandemic, (a) total stroke admissions fell by 17% but the thrombectomy rate was maintained at 20% of ischemic strokes; (b) successful recanalization rate was maintained at 81%; (c) early neurological outcomes (neurological improvement following thrombectomy and inpatient mortality) were not significantly different; (d) use of general anesthesia fell significantly from 85 to 32% as intended; and (e) time intervals from onset to arrival, groin puncture, and recanalization were not significantly different, whereas internal delays for external referrals significantly improved for door-to-groin puncture (48 [interquartile range (IQR) 39–57] vs. 33 [IQR 27–44] minutes, <i>p</i> = 0.013) and door-to-recanalization (82.5 [IQR 61–110] vs. 60 [IQR 55–70] minutes, <i>p</i> = 0.018). <b><i>Conclusion:</i></b> The COVID-19 pandemic has had a negative impact on the stroke admission numbers but not stroke thrombectomy rate, successful recanalization rate, or early neurological outcome. Internal delays actually improved during the COVID-19 pandemic. Further studies should examine the effects of the COVID-19 pandemic on longer term outcome.

scholarly journals A multi-centre service evaluation of the impact of the COVID-19 pandemic on presentation of newly diagnosed cancers and type 1 diabetes in children in the UK

2021 ◽  
Author(s):  
◽  
Gemma Williams ◽  
Ross McLean ◽  
Jo-Fen Liu ◽  
Timothy Ritzmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Disease Severity ◽  
Delayed Diagnosis ◽  
Service Evaluation ◽  
Newly Diagnosed ◽  
Children And Families ◽  
The Uk ◽  
The Impact ◽  
Diagnostic Intervals

AbstractBackgroundThe COVID-19 pandemic led to changes in patterns of presentation to Emergency Departments (ED). Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions.MethodsWe collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres, and T1DM in four centres between 1stJanuary – 31st July 2020 and the corresponding period in 2019. We assessed the impact of lockdown on total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity.FindingsFor CCs and T1DM, the route to diagnosis and severity of illness at presentation were unchanged across all time periods. Diagnostic intervals for CCs during lockdown were comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI in Jan-Mar 2020 (median 2.7 weeks). Diagnostic intervals for T1DM during lockdown were similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in Jan-Mar 2020 (median 21 days).InterpretationThere is no evidence of diagnostic delay or increased illness severity for CC or T1DM, during the first phase of the pandemic across the participating centres. This provides reassuring data for children and families with these life-changing conditions.Research in ContextEvidence before this studyThis project was initiated after the first national lockdown in March 2020 during COVID-19 pandemic in the UK. At the design stage, Medline was searched (with no language limit), using the keywords ((Cancer) OR (neoplasm) OR (Type 1 diabetes mellitus)) AND ((Covid-19) OR (SARS-CoV-2) OR (Pandemics)) AND ((Emergency department attendances) OR (diabetes ketoacidosis) OR (Delayed diagnosis) OR (interval) OR (wait)) to identify publications reporting the impact of the pandemic and public health measures on both overall and paediatric healthcare services. Significant changes in service utilisation in the UK were reported following the commencement of the first lockdown, including a 49% reduction in emergency department attendances in the week following the lockdown; and two adult studies reported that referral via the urgent two-week wait cancer referral diagnoses decreased by 84% from Mar-May and 60% in June 2020. As for Type 1 diabetes (T1DM), a 30 patient UK-study reported an increase in newly diagnosed T1DM during the first six weeks of lockdown. Increased proportions of severe diabetic ketoacidosis (DKA) at presentation were also reported in an Italian survey involving 53 paediatric diabetes centres. Through the search we identified a need for multi-centre, more thorough assessment on referral pathways, time taken from symptom onset to diagnosis, and its association with severity at presentation for children diagnosed with life-changing conditions during the national lockdown.Added value of this studyOur findings suggest that the first national lockdown in the UK were not associated with delayed diagnosis of childhood cancer or type 1 diabetes at participating centres. This provides reassuring information for children and families with these life-changing conditions.ImplicationWe believe that our study can play a key role in allaying parental and professional concern. it is important to establish whether subsequent public health measures have impacted the diagnostic interval in the context of an evolving backlog of patient referrals across the UK.

scholarly journals EP.WE.268Impact of COVID-19 on surgical services in a District General Hospital in the UK: benefits versus drawbacks

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Islam El-Abbassy ◽  
Hesham El-Hakim ◽  
Mei Kei Wong ◽  
Robert McIntyre
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Surgical Service ◽  
Remote Consultation ◽  
Face To Face ◽  
Surgical Services ◽  
Number Of Patients ◽  
Service Activity ◽  
The Uk ◽  
The Impact

Abstract Background COVID-19 outbreak led to significant changes in health services worldwide. This study aims to assess the impact of this outbreak on the surgical services in a small District General Hospital and to highlight any benefits that we can take forward. Methods Data were collected retrospectively comparing the surgical service activity during the two months (April and May 2020) around the peak of COVID-19 first wave in the UK and the similar two-month period the year before when activity was at its usual pre-COVID level. A short questionnaire on the use and satisfaction of remote consultation was circulated to all hospital consultants. Results The total number of patients presenting to the emergency department in all specialities almost halved during the COVID-19 crisis. The number of emergency surgical admissions decreased. All elective lists were cancelled and more patients were managed conservatively. In April and May 2020, 156 patients had outpatient surgical consultations. Only 14 of them were face-to-face, whereas the rest were done either by telephone or video calls. This is compared to 472 patients who had face-to-face consultations in April and May 2019. The results of the questionnaire showed that over 90% of the consultants felt telemedicine consultations were satisfactory and that they would have an important role in the future. Conclusion COVID-19 had serious impacts on surgical services regarding cancellation of elective lists and prolongation of waiting time. Despite these drawbacks, the increased confidence with telemedicine services was a significant benefit.

Review of postural orthostatic tachycardia syndrome: a predominantly female condition

2019 ◽  
Vol 14 (12) ◽  
pp. 1-10
Author(s):  
Helen Eftekhari ◽  
Sajad Hayat
Keyword(s):  
Online Survey ◽  
Average Length ◽  
The United States ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Childbearing Age ◽  
Predominantly Female ◽  
The Uk ◽  
The Impact ◽  
Underlying Pathophysiology

Postural orthostatic tachycardia syndrome is a debilitating and underdiagnosed condition, affecting five times as many women of childbearing age as it does men. The true prevalence is difficult to estimate, with charities reporting up to potentially 3 million people with the condition in the United States. There is a lack of awareness and knowledge regarding how to manage people with postural orthostatic tachycardia syndrome. This results in a difficult journey to diagnosis. The average length of time to diagnosis from symptom onset is 4 years in the UK with dismissals of symptoms and misdiagnosis being common experiences. The largest online survey by an American charity found that 75% of women were misdiagnosed with anxiety compared with 25% of men. This article aims to raise awareness of postural orthostatic tachycardia syndrome, its underlying pathophysiology, diagnosis and the impact on quality of life, as well as the management and socioeconomic impact of the condition. Cardiac nurses who meet people with postural orthostatic tachycardia syndrome can improve the patient experience. Being aware of the condition, validating the experiences of these young, predominantly female, patients to rebuild trust, and providing support can make a huge difference.

The fundamentals of health economics and its application in the provision of vascular surgery in the UK

2021 ◽  
pp. 021849232098846
Author(s):  
Fatima Osman ◽  
Andrew Ravendren ◽  
Idhrees Mohammed ◽  
Mohamad Bashir
Keyword(s):  
Health Economics ◽  
Supply And Demand ◽  
Healthcare Delivery ◽  
Clinical Decision ◽  
Holistic Health ◽  
Patient Centered ◽  
Surgical Interventions ◽  
Life Years ◽  
The Uk ◽  
The Impact

Health economics offers a lifeline to policymakers as a way of improving health outcomes in the face of increased monetary constraints. Doctors are uniquely placed in healthcare delivery where they have a pertinent influence on both supply and demand for healthcare provisions. Every clinical decision made by doctors is also an economic decision, and the true cost of offering a scarce healthcare resource includes not being able to fund alternative therapies and hence, foregoing its benefit. Technology and innovation in medicine is seeing an increase in potential therapies; however, how well do they perform against the current gold standard and are they worth the additional cost? A personalized and patient-centered approach to medicine has paved the way for a holistic health outcome measure, quality-adjusted life years, which is predominately used by United Kingdom resource allocators. Aortic surgical interventions are resource-intensive, and recent trends have shown the growing economic burden as yearly costs continue to climb. Health economic models are not without their weaknesses and it is important that future analyses assess the impact on society, distributional consequences, and the value of collecting more information to reduce the uncertainty of the economic result.

scholarly journals P108 Service Evaluation - the impact and lessons learnt from the COVID-19 pandemic on a UK burns centre

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Georgina Phillips ◽  
Cyrus Talwar ◽  
Stanislau Makaranka ◽  
Declan Collins ◽  
Stanislau Makaranka
Keyword(s):  
Public Awareness ◽  
Service Evaluation ◽  
Medical Attention ◽  
Delayed Presentation ◽  
Healthcare Provision ◽  
Burn Care ◽  
Lessons Learnt ◽  
Referral Criteria ◽  
The Uk ◽  
The Impact

Abstract The COVID-19 pandemic has dramaticallyimpacted healthcare provision in the UK and burns services have had to adapt to ensure the continuityof a safe care. As we return to " normalit y" we reflect on lessons learnt from our response to this pandemic. A service evaluation was performed from patient notes between March 23rd and May8th 2020 and an anonymoussurveygiven to patients attending outpatient appointments. 258 patients were referred to our burns service and 148 patients completed the survey. Eleven burns were caused bytreatment or prevention of COVID-19. Patients delayed seeking medical attention due to concern of catching COVID-19 (36% adults, 8% children). There was a delayin referral of 17 patients despite them fulfilling the referral criteria. Infection rates were higher following delayed presentation (21% vs 6%). The majorityof burns were managed conservatively (237/258). Dressing changes were performed at home by32% of patients. The outreach team treated 22 patients. During the pandemic telemedicine has improved the efficiencyof outpatient burn care and outreach nurses have enabled treatment of vulnerable patients. More must be done to raise public awareness of preventable causes of burn injuryand to reassure them to seek help when burns occur.

scholarly journals Impact of COVID-19 on surgical services in a District General Hospital in the United Kingdom: benefits versus drawbacks

2021 ◽  
Vol 8 (2) ◽  
pp. 440
Author(s):  
Islam H. El-Abbassy ◽  
Hesham El-Hakim ◽  
Mei Kei Wong ◽  
Robert McIntyre
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Remote Consultation ◽  
Face To Face ◽  
Surgical Services ◽  
The United Kingdom ◽  
Number Of Patients ◽  
Service Activity ◽  
The Uk ◽  
The Impact

Background: COVID-19 outbreak led to significant changes in health services worldwide. This study aimed to assess the impact of this outbreak on the surgical services in a small District General Hospital and to highlight any benefits that we can take forward.Methods: Data were collected retrospectively comparing the surgical service activity during the two months (April and May 2020) around the peak of COVID-19 first wave in the UK and the similar two-month period the year before when activity was at its usual pre-COVID level. A short questionnaire on the use and satisfaction of remote consultation was circulated to all hospital consultants.Results: The total number of patients presenting to the emergency department in all specialities almost halved during the COVID-19 crisis. The number of emergency surgical admissions decreased. All elective lists were cancelled and more patients were managed conservatively. In April and May 2020, 156 patients had outpatient surgical consultations. Only 14 of them were face-to-face, whereas the rest were done either by telephone or video calls. This is compared to 472 patients who had face-to-face consultations in April and May 2019. The results of the questionnaire showed that over 90% of the consultants felt telemedicine consultations were satisfactory and that they would have an important role in the future.Conclusions: COVID-19 had serious impacts on surgical services regarding cancellation of elective lists and prolongation of waiting time. Despite these drawbacks, the increased confidence with telemedicine services was a significant benefit. 

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