scholarly journals COMPARING THE PROGNOSTIC VALUE OF GERIATRIC HEALTH INDICATORS: A POPULATION-BASED STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S609-S609
Author(s):  
Alberto Zucchelli ◽  
Davide Vetrano ◽  
Giulia Grande ◽  
Amaia Calderon-Larranaga ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Assessment Tool ◽  
Frailty Index ◽  
Population Based ◽  
National Study ◽  
Care Providers ◽  
Population Based Study ◽  
Prediction Of Mortality ◽  
Unplanned Hospitalizations

Abstract Several indicators associated with poor outcomes in older persons have been developed, but a direct comparison of their accuracy is lacking. Knowing which indicator performs better in the prediction of specific outcomes could help health care providers to choose the most suitable one. We compared the accuracy in predicting different clinically-relevant outcomes of five indicators: frailty index (FI), frailty phenotype (FP), the Health Assessment Tool (HAT), walking speed (WS), and multimorbidity. Data from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing population-based study including 3363 people 60+, were used. The ability of the five indicators to predict mortality (3- and 5-year), unplanned hospitalizations (1- and 3-year), and 2+ health provider contacts (6 months prior and after assessment) was compared using the area under the ROC curves (AUC). FI, WS, and HAT showed the best accuracy in the prediction of mortality (AUC for 3-year mortality: 0.84, 0.85, 0.87 respectively; AUC for 5-year mortality: 0.84, 0.85, 0.86 respectively; all p < 0.05). Unplanned hospitalizations were better predicted by the FI (AUC: 1-year 0.73; 3-year 0.72) and HAT (AUC: 1-year 0.73; 3-year 0.71).The most accurate predictor of multiple contacts with health providers was multimorbidity (AUC: 0.67; p < 0.05). All indicators, but multimorbidity, showed higher accuracy among older individuals (75+ years). Different indicators can be used to support physicians during their decision-making process. Some of these tools may also be used to forecast future use of health-care resources, including both hospital-based services and outpatient ones .

scholarly journals Comparing the prognostic value of geriatric health indicators: a population-based study

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Alberto Zucchelli ◽  
Davide L. Vetrano ◽  
Giulia Grande ◽  
Amaia Calderón-Larrañaga ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Predictive Accuracy ◽  
Frailty Index ◽  
Healthcare Providers ◽  
Health Indicators ◽  
National Study ◽  
Multiple Contacts ◽  
Prediction Of Mortality ◽  
Increased Risk ◽  
Unplanned Hospitalizations

Abstract Background The identification of individuals at increased risk of poor health-related outcomes is a priority. Geriatric research has proposed several indicators shown to be associated with these outcomes, but a head-to-head comparison of their predictive accuracy is still lacking. We therefore aimed to compare the accuracy of five geriatric health indicators in predicting different outcomes among older persons: frailty index (FI), frailty phenotype (FP), walking speed (WS), multimorbidity, and a summary score including clinical diagnoses, functioning, and disability (the Health Assessment Tool; HAT). Methods Data were retrieved from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing longitudinal study including 3363 people aged 60+. To inspect the accuracy of geriatric health indicators, we employed areas under the receiver operating characteristic curve (AUC) for the prediction of 3-year and 5-year mortality, 1-year and 3-year unplanned hospitalizations (1+), and contacts with healthcare providers in the 6 months before and after baseline evaluation (2+). Results FI, WS, and HAT showed the best accuracy in the prediction of mortality [AUC(95%CI) for 3-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.87), 0.87 (0.85–0.88) and AUC(95%CI) for 5-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.86), 0.86 (0.85–0.88), respectively]. Unplanned hospitalizations were better predicted by the FI [AUC(95%CI) 1-year 0.73 (0.71–0.76); 3-year 0.72 (0.70–0.73)] and HAT [AUC(95%CI) 1-year 0.73 (0.71–0.75); 3-year 0.71 (0.69–0.73)]. The most accurate predictor of multiple contacts with healthcare providers was multimorbidity [AUC(95%CI) 0.67 (0.65–0.68)]. Predictions were generally less accurate among younger individuals (< 78 years old). Conclusion Specific geriatric health indicators predict clinical outcomes with different accuracy. Comprehensive indicators (HAT, FI, WS) perform better in predicting mortality and hospitalization. Multimorbidity exhibits the best accuracy in the prediction of multiple contacts with providers.

scholarly journals A study to assess the clean hospital initiative and quality of health services using kayakalp tool in a first referral unit, of Khordha district of Odisha, India

2018 ◽  
Vol 5 (12) ◽  
pp. 5397 ◽  
Author(s):  
Mayadhar Panda ◽  
Sikata Nanda
Keyword(s):  
Health Care ◽  
Waste Management ◽  
Health Care Providers ◽  
Assessment Tool ◽  
Care Facility ◽  
Health Care Facility ◽  
Family Welfare ◽  
Situational Analysis ◽  
Care Providers

Background: As a part of “Swachh Bharat Abhiyaan” campaign, the Ministry of Health and Family welfare, Govt. of India had launched “Kayakalp” in 2015, an initiative to promote cleanliness and enhance the quality of public health facilities. Our aim was to study the situational analysis of the health institution using Kayakalp tool; to assess the level of cleanliness, hygiene and infection control practices in the facility and to assess the status of Bio-medical waste management in the health care facility and to suggest remedial measures based on the study finding.Methods: It is a hospital based snapshot study done during a period of one year from April 2016 to March 2017. Kayakalp assessment tool was used for analysis.Results: The total scores for upkeep maintenance obtained in 2016-17 was 69 and for the year 2017-18 was 81. There was an increase of total score in the year 2017-18 and it was found to be statistically significant. On assessment in the year 2016-17, for BMW the total score obtained was 58 and in the year 2017-18 it was 81. There was a statistically significant increase in the scores (p=0.001) obtained in the year (2017-18).Conclusions: Improvements in Biomedical waste management can be made by increasing the knowledge, awareness and practices of the health care providers as well as the beneficiaries with regular periodic monitoring. 

The epidemiology of death and symptoms: planning for population-based palliative care

2015 ◽  
Author(s):  
Megan B. Sands ◽  
Dianne L. O’Connell ◽  
Michael Piza ◽  
Jane M. Ingham
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Neurological Disorders ◽  
Population Based ◽  
Modern Medicine ◽  
Care Providers ◽  
Incurable Illness ◽  
Relief Of Suffering ◽  
Nuanced Understanding

Despite the advances of modern medicine, many illnesses continue to evade cure. Chronic, progressive, incurable illness is a major cause of disability, distress, suffering, and, ultimately, death. This is true for many causes of cancer, progressive neurological disorders, AIDS, and other disorders of vital organs. Progressive chronic diseases of this ilk are most common in late adulthood and old age, but they occur in all ages. When cure is not possible, as often it is not, the relief of suffering is the cardinal goal of medicine. The clinical imperative to relive suffering requires a nuanced understanding of the factors that contribute to suffering and the interaction between the distress of the patient, family members, and health-care providers. This chapter reviews those concepts and offers an approach to the evaluation of suffering for patients requiring palliative care.

Burden of Stroke in Maori and Pacific Peoples of New Zealand

2007 ◽  
Vol 2 (3) ◽  
pp. 208-210 ◽  
Author(s):  
Valery L. Feigin ◽  
Harry McNaughton ◽  
Lorna Dyall
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Health Care Providers ◽  
Population Based ◽  
Care Providers ◽  
Health Care Planning ◽  
Stroke Incidence ◽  
Pacific People ◽  
Incidence Studies ◽  
Stroke Epidemiology

Studying ethnic particularities of stroke epidemiology may not only provide a clue to the causes of the observed racial/ethnic differences in stroke mortality but is also important for appropriate, culturally specific health care planning, prevention in stroke and improved health outcomes. This overview of published population-based stroke incidence studies and other relevant research in the multi-ethnic New Zealand population demonstrates an obvious ethnic disparity in stroke in New Zealand, with the greatest and increasing burden of stroke being imposed on Maori, who are indigenous, and Pacific people, who have migrated and settled in this country. These data warrant urgent and effective measures to be undertaken by health policy makers and health care providers to reverse the unfavourable trends in stroke and improve Maori and Pacific people's health.

Changes in health-related quality of life (HRQL) after bladder cancer (BC) diagnosis (DX): A longitudinal population-based study.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 317-317
Author(s):  
Chunkit Fung ◽  
Chintan Pandya ◽  
Elizabeth A. Guancial ◽  
Shri Noel ◽  
Katia Noyes ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Population Based ◽  
Analysis Of Covariance ◽  
Smoking History ◽  
Future Research ◽  
Care Providers ◽  
Comorbid Conditions ◽  
Population Based Study ◽  
Control Subjects ◽  
Muscle Invasive

317 Background: Few studies have examined longitudinal changes in HRQL among BC patients. To our knowledge, this is the largest prospective population-based study to quantify HRQL changes from before to after BC DX and to compare their HRQL with a non-cancer cohort. Methods: Our sample included 179 BC patients (≥ age 65) and 376,986 non-cancer subjects within the SEER-Medicare Health Outcomes Survey database (1998-2007). We assessed HRQL as measured by physical (PCS) and mental (MCS) component summary scores of the veterans RAND 12-item health survey. An analysis of covariance model was used to estimate changes in HRQL scores for patients after BC DX relative to control subjects with adjustment for baseline HRQL scores and covariates. Results: 84.4% (N=151) of BC patients had non-muscle invasive BC (NMIBC) and 15.6% (N=28) had muscle invasive BC (MIBC). 49.2% and 39.1% of BC patients had ≥2 comorbid conditions and ≥1 activities of daily living (ADL) deficit, respectively. Compared to the control subjects, more BC patients were men (67.0% vs 38.5%; P<0.01), current or former smokers (58.7% vs 37.3%; P<0.01), and had income ≥ $50,000(15.1% vs 8.8%; P=0.02). Other baseline demographic and socioeconomic characteristics were similar (P>0.05). After DX, BC patients reported a significant decline in PCS (1.9; 95% CI 0.1, 3.7) score compared to non-cancer controls whereas the decrease in MCS score (1.4; 95% CI -0.1, 3.0) was not statistically significant. For those with NMIBC, HRQL was not significantly different than that of the non-cancer cohort (P>0.05) after DX. However, the PCS and MCS scores of MIBC patients decreased by 5.3 (95% CI 0.9, 9.8) and 3.8 points (95% CI -0.1, 7.7) after DX, respectively. Older age at BC DX, lower educational and income levels, smoking history, and higher numbers of comorbid conditions and ADL deficits were significantly associated with inferior PCS and MCS scores after BC DX (P<0.01). Conclusions: Treatment-related side effects and/or symptoms due to BC adversely affect HRQL of BC patients, especially in those with MIBC, and should be consistently assessed by health care providers. Future research that examines interventions to improve HRQL is critical to improve BC care.

scholarly journals Attitudes and Perceptions of Health Care Providers About the Implementation of Population Based Cancer Screening Program in India. A study From Assam

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 53s-53s
Author(s):  
A. Kedar ◽  
R. Hariprasad ◽  
R. Kanan ◽  
R. Mehrotra
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Health Care Providers ◽  
Screening Program ◽  
Healthcare Providers ◽  
Population Based ◽  
Care Providers ◽  
Cancer Screening Program ◽  
Attitudes And Perceptions ◽  
Study Participants

Background: India is facing noncommunicable diseases epidemic with cancer as one of the main reasons of mortality. To bring this epidemic under control and as a measure of secondary prevention, government of India has rolled out operational framework for population cancer screening. As cancer screening is a new concept for Indian health care providers, this study focuses on the attitudes and perceptions of HCP from a district in Assam. Aim: To know the attitudes and perceptions of healthcare providers in Assam about the implementation of population based cancer screening program in India. Methods: This study was a part of ongoing Indian Council of Medical Research project at Cachar district, Assam. The study was conducted at Silchar, Assam and the study participants were attendees of the master trainers' workshop which was conducted for the pilot cancer screening program rolled out in Cachar district, Assam. Self-administered questionnaires were used to collect data from the health care providers on the last day of the training. Data were gathered from 58 participants. The participants were medical officers, auxillary nurse midwives (ANM), accredited social health activists (ASHA), staff nurses, nongovernmental organization (NGO) representatives and other health care providers from public health facilities. Results: Majority of the study participants agreed with the concept of screening. Half of the study participants stated that they could conduct screening comfortably along with their other responsibilities. Lack of human resources and an overburdened human resource were the main challenges foreseen in the implementation of the program. 91% of the participants wanted GOI to implement the cancer screening program. Majority of the health personnel were in favor of primary health center (PHC) as the first preferable site of population cancer screening followed by subcenter being second on preference for screening. One-third of study participants opined that screening should be done by specialist doctors. Almost one fifth of participants stated that ASHA should do the screening and almost same number of participants thought that medical officer at PHC should do the screening. Conclusion: This is the first pilot study on the population based cancer screening guidelines released by the government of India. The organized screening program is yet to be rolled out in the country. Though many challenges were foreseen by the healthcare providers in carrying out the population based cancer screening, majority were optimistic for the implementation of this screening program.

scholarly journals Accessibility, reliability, and usability of neurosurgical resources

2017 ◽  
Vol 126 (4) ◽  
pp. 1263-1268 ◽  
Author(s):  
Nitin Agarwal ◽  
Sumana S. Kommana ◽  
David R. Hansberry ◽  
Ahmed I. Kashkoush ◽  
Robert M. Friedlander ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Education ◽  
Health Care Providers ◽  
Assessment Tool ◽  
Easy Access ◽  
Medical Professionals ◽  
Care Providers ◽  
Neurosurgical Patient ◽  
Neurological Surgery ◽  
User Friendly

OBJECTIVE Closing the knowledge gap that exists between patients and health care providers is essential and is facilitated by easy access to patient education materials. Although such information has the potential to be an effective resource, it must be written in a user-friendly and understandable manner, especially when such material pertains to specialized and highly technical fields such as neurological surgery. The authors evaluated the accessibility, usability, and reliability of current educational resources provided by the American Association of Neurological Surgeons (AANS), Healthwise, and the National Institute for Neurological Disorders and Stroke (NINDS). METHODS Online neurosurgical patient education information provided by AANS, Healthwise, and NINDS was evaluated using the LIDA scale, a website quality assessment tool, by medical professionals and nonmedical professionals. A high achieving score is regarded as 90% or greater using the LIDA scale. RESULTS Accessibility scores were 76.7% (AANS), 83.3% (Healthwise), and 75.0% (NINDS). Average usability scores for the AANS, Healthwise, and NINDS were 73.3%, 82.6%, and 82.9%, respectively, when evaluated by medical professionals and 78.5%, 80.7%, and 75.9%, respectively, for nonmedical professionals, respectively. Average reliability scores were 58.5%, 53.3%, 72.6%, respectively, for medical professionals and 70.4%, 66.7%, and 78.5%, respectively, for nonmedical professionals when evaluating the AANS, Healthwise, and NINDS websites. CONCLUSIONS Although organizations like AANS, Healthwise, and NINDS should be commended for their ongoing commitment to provide health care–oriented materials, modification of this material is suggested to improve the patient education value.

scholarly journals Viewpoint: An enhanced primary health care role following psychological trauma: the Christchurch earthquakes

2011 ◽  
Vol 3 (3) ◽  
pp. 248 ◽  
Author(s):  
Sean Sullivan ◽  
Sharlene Wong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Assessment Tool ◽  
Psychological Trauma ◽  
Care Providers ◽  
Primary Health ◽  
Increased Risk ◽  
The City

Following the February 2011 earthquake in Christchurch, New Zealand (NZ), the authors participated in counselling local residents, and debriefing and supervising support teams. Indications were that risk for mental health disorders, including Post-Traumatic Stress Disorder (PTSD), may be elevated in residents, and that this risk may continue for some time. Patients may be de-prioritising their mental health issues when these become normalised throughout the city’s population. The authors recommend that primary care patients are assessed using a brief, comprehensive tool (for example, the Case-finding and Help Assessment Tool) that targets many health and behavioural issues identified as increasing in the city following the earthquake. Anxiety and mood disorder symptoms may indicate assessment is appropriate to reduce harm arising from increased risk for PTSD. Concern also is raised for primary health care providers who may have experienced the trauma and additionally may be vicariously affected by patients’ reported trauma.

scholarly journals Use of Salt-Restriction Spoons and Its Associations with Urinary Sodium and Potassium in the Zhejiang Province of China: Results of a Population-Based Survey

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1047
Author(s):  
Xiaofu Du ◽  
Di Zhao ◽  
Megan E. Henry ◽  
Le Fang ◽  
Jianwei Xu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Population Based ◽  
Zhejiang Province ◽  
Urinary Sodium ◽  
Common Source ◽  
Care Providers ◽  
Salt Restriction ◽  
Physical Measurements ◽  
Sodium And Potassium

In China, a major source of sodium is salt added during cooking. In this context, use of a salt-restriction spoon (SRS) has been promoted in public health campaigns and by health care providers. To describe use of and factors associated with SRS use, knowledge of correct use, and actual correct use. This study is a population-based, representative survey of 7512 residents, aged 18 to 69 years, of China’s Zhejiang Province. The survey, which was conducted in 2017 using a multistage random sampling strategy, collected demographic information, SRS use, and physical measurements; a 24-h urine collection was obtained from 1,496 of the participants. The mean age of the participants was 44.8 years, 50.1% were females, and over 1/3 (35.3%) were classified as hypertensive. Mean 24-h urinary sodium and potassium excretions were 167.3(72.2) mmol/24 h and 38.2(18.2) mmol/24 h, respectively. Only 12.0% (899/7512) of participants once used or were currently using SRS; of the 899 users, 73.4% knew how to use the SRS correctly, and just 46.5% actually used it correctly. SRS use was more commonly associated with behavioral factors rather than socio-demographic factors. Initiation of SRS use by health care providers was associated with correct technical knowledge of SRS. Lower sodium-to-potassium ratio was associated with SRS use, while SRS use was not associated with urinary sodium and potassium excretion. Use of SRS was uncommon in Zhejiang Province of China. Given that a common source of sodium in China is salt added during cooking, use of SRS is an appealing strategy, ideally as part of a multi-component campaign.

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