Reduced Mortality During Holidays and the COVID-19 Pandemic in Israel

Evidence suggests varied trends in mortality surrounding the holiday period. Most studies support an association between increased mortality rates and holidays. We compare the effect of the number of holiday days per week on the overall mortality rate in the Israeli population. Between 2000-2020, we see significantly reduced mortality rates in weeks containing national holidays. We observed the same trend in all-cause mortality during the 3-weeks COVID-19 pandemic lockdown. As the Israeli health care system, and hospitals especially, function near peak capacity year-round, we propose that reduced medical service utilization during holidays and the COVID-19 lockdown period might underlie the lower mortality rates.

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All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

European Heart Journal ◽

10.1093/eurheartj/ehab028 ◽

2021 ◽

Cited By ~ 1

Author(s):

Jawad H Butt ◽

Emil L Fosbøl ◽

Thomas A Gerds ◽

Charlotte Andersson ◽

Kristian Kragholm ◽

...

Keyword(s):

Cardiovascular Disease ◽

Mortality Rate ◽

Hospital Mortality ◽

Location Of Death ◽

All Cause Mortality ◽

History Of ◽

Adjusted Incidence Rate ◽

Artery Disease ◽

Adjusted Incidence ◽

Overall Mortality

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

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Characteristics and Outcomes of Critically Ill Patients with COVID-19 Disease in Jordan

10.47363/jsar/2020(1)112 ◽

2020 ◽

pp. 1-3

Author(s):

Hasan Ibrahim Al-Balas ◽

Keyword(s):

Health Care ◽

Mortality Rate ◽

Critically Ill ◽

Critically Ill Patients ◽

Tertiary Hospital ◽

Published Data ◽

First Case ◽

Global Health Care ◽

Novel Coronavirus ◽

Overall Mortality

Introduction: Coronavirus disease 2019 (COVID-19) is an emerging global health care threat that is caused by a novel coronavirus named 2019-nCoV (SARS-CoV-2). The first case of diagnosed COVID-19 patient was declared in Jordan in early March 2020. As of June 8, Jordan had confirmed 831 cases, with 9 deaths, with an overall mortality rate of 1.08%. As there is no published data about critically ill patients in Jordan, we aimed to describe the characteristics and outcomes of critically ill COVID-19 patients in a tertiary hospital in Jordan.

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Lamb mortality in a flock of East African Blackheaded sheep

The Journal of Agricultural Science ◽

10.1017/s0021859600060330 ◽

1966 ◽

Vol 66 (1) ◽

pp. 97-100 ◽

Cited By ~ 2

Author(s):

J. C. M. Trail ◽

G. D. Sacker

Keyword(s):

Birth Weight ◽

Mortality Rate ◽

Mortality Rates ◽

Dry Season ◽

East African ◽

Male And Female ◽

The Mean ◽

Overall Mortality

1. The effects of birth weight, sex, twinning, parity of dam and dry season on mortality rates of lambs were studied between birth and weaning at 20 weeks in a flock of East African Blackheaded sheep.2. The mean birth weights of non-surviving lambs were lower than those of surviving lambs. Singles from gimmers and twins from ewes were 0.5 and 1.0 lb., respectively, lighter at birth, and had higher mortality rates than singles from ewes. The overall mortality rate of singles from ewes was 16%, singles from gimmers 20% and twins from ewes 28%. Male and female lambs born alive had similar mortality rates (18%).

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Prevalence, Demographic Patterns, and Outcome of Childhood Malignancies in a Tertiary Hospital in Nigeria: A 15-Year Retrospective Study

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz117.011 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S89-S90

Author(s):

Oluwakemi Otokiti ◽

Edamisan Temiye

Keyword(s):

Health Care ◽

Retrospective Study ◽

Mortality Rate ◽

Hematological Malignancies ◽

Financial Burden ◽

Age At Diagnosis ◽

Childhood Cancers ◽

Childhood Malignancies ◽

Wilm’S Tumor ◽

Overall Mortality

Abstract Objectives Childhood cancers are increasingly recognized as a cause of childhood morbidity and mortality following improvement in immunization programs and sanitation against communicable diseases. With improvement in health care, better survival outcomes have been reported in childhood cancers worldwide. However, mortality associated with childhood cancers remains high in developing countries. This study aims to determine the prevalence, demographic characteristics, and outcome of childhood cancers seen in Lagos University Teaching Hospital, Lagos, Nigeria. Methods A retrospective study analyzed 749 cases of childhood malignancies between 2003 and 2017. Data on gender, age at diagnosis, diagnosis, and outcome were extracted using a data extraction proforma. Data were analyzed using SPSS v23. P value of .05 was considered statistically significant. Results Median age at diagnosis was 4.75 years with a male to female ratio of 1.3:1. Highest prevalence was noticed with hematological malignancies (41%), Wilm’s tumor (18%), retinoblastoma (13%), and soft tissue tumors (6.5%) and lowest prevalence with testicular cancers (0.3%). Apart from liver malignancy, males had a higher incidence in all malignancies. Median age at diagnosis was 12 years for nasopharyngeal carcinoma, 11 years for bone cancers, 8 years for gynecological cancers, 6 years for hematological cancers, and 0.47 years for testicular cancers. Overall mortality rate was 30%, and a significant number (53%) were lost to follow-up (discharged against medical advice, defaulted, financial burden, medical tourism). Hematological malignancies had the highest mortality rates, with Wilm’s tumor having best survival chances (lowest mortality). Conclusion Prevalence patterns mirror what was obtained in other centers (Jos, Ife, and Ibadan). A mortality rate of 30% is significant. Financial burden, religious beliefs, delay in presentation, and ignorance are major hindrances to health care and might contribute significantly to overall mortality and outcome. More needs to be done concerning childhood cancers.

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Withdrawal of Care in a Trauma Intensive Care Unit: The Impact on Mortality Rate

The American Surgeon ◽

10.1177/000313481408000824 ◽

2014 ◽

Vol 80 (8) ◽

pp. 764-767 ◽

Cited By ~ 2

Author(s):

Leonard J. Weireter ◽

Jay N. Collins ◽

Rebecca C. Britt ◽

T. J. Novosel ◽

L. D. Britt

Keyword(s):

Intensive Care Unit ◽

Decision Making ◽

Mortality Rate ◽

Trauma Center ◽

Mortality Rates ◽

Active Aging ◽

Neurologic Injury ◽

Trauma Service ◽

The Impact ◽

Overall Mortality

Withdrawal of care has increased in recent years as the population older than 65 years of age has increased. We sought to investigate the impact of this decision on our mortality rate. We retrospectively reviewed a prospectively collected database to determine the percentage of cases in which care was actively withdrawn. Neurologic injury as the cause for withdrawal, age of the patient, number of days to death, number of cases thought to be treatment failures, and the reason for failure were analyzed. Between January 2008 and December 2012, there were 536 trauma service deaths; 158 (29.5%) had care withdrawn. These patients were 67 (6 18.5) years old and neurologic injury was responsible in 63 per cent (6 5.29%). Fifty-two per cent of the patients died by Day 3; 65 per cent by Day 5; and 74 per cent Day 7. A total of 22.7 per cent (6 7.9%) could be considered a treatment failure. Accounting for cases in which care was withdrawn for futility would decrease the overall mortality rate by approximately 23 per cent. Trauma center mortality calculation does not account for care withdrawn. Treating an active, aging population, with advance directives, requires methodologies that account for such decision-making when determining mortality rates.

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Impact of stroke unit in a public hospital on length of hospitalization and rate of early mortality of ischemic stroke patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130120 ◽

2013 ◽

Vol 71 (10) ◽

pp. 774-779 ◽

Cited By ~ 7

Author(s):

Maria Sheila G. Rocha ◽

Ana Claudia F. Almeida ◽

Osorio Abath Neto ◽

Marianna P. R. Porto ◽

Sonia Maria D. Brucki

Keyword(s):

Mortality Rate ◽

Stroke Unit ◽

Public Hospital ◽

Unit Group ◽

Mortality Rates ◽

General Ward ◽

Early Mortality ◽

Stroke Patients ◽

Length Of Hospitalization ◽

Overall Mortality

We ascertained whether a public health stroke unit reduces the length of hospitalization, the rate of inpatient fatality, and the mortality rate 30 days after the stroke. Methods We compared a cohort of stroke patients managed on a general neurology/medical ward with a similar cohort of stroke patients managed in a str oke unit. The in-patient fatality rates and 30-day mortality rates were analyzed. Results 729 patients were managed in the general ward and 344 were treated at a comprehensive stroke unit. The in-patient fatality rates were 14.7% for the general ward group and 6.9% for the stroke unit group (p<0.001). The overall mortality rate 30 days after stroke was 20.9% for general ward patients and 14.2% for stroke unit patients (p=0.005). Conclusions We observed reduced in-patient fatalities and 30-day mortality rates in patients managed in the stroke unit. There was no impact on the length of hospitalization.

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Health care utilization and HIV clinical outcomes following Affordable Care Act implementation in California: A longitudinal study

10.21203/rs.3.rs-21308/v1 ◽

2020 ◽

Author(s):

Derek D. Satre ◽

Sujaya Parthasarathy ◽

Michael J. Silverberg ◽

Michael Horberg ◽

Kelly C. Young-Wolff ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Health Care Utilization ◽

Service Utilization ◽

Health Care System ◽

Affordable Care Act ◽

Viral Suppression ◽

Insurance Coverage ◽

Care Utilization ◽

Integrated Health Care System

Abstract Background: The Affordable Care Act (ACA) increased insurance coverage for people with HIV (PWH) in the United States, yet post-ACA health care utilization and HIV outcomes have rarely been examined. Methods: Among PWH newly enrolled in an integrated health care system (Kaiser Permanente Northern California) in 2014 (N=880), we examined use of health care and modeled associations between enrollment mechanisms (enrolled in a Qualified Health Plan through the California Exchange vs. other sources), deductibles (none, $1-$999 and >= $1000), receipt of benefits from the California AIDS Drug Assistance Program (ADAP), demographic factors, and three-year patterns of health service utilization (primary care, psychiatry, substance treatment, emergency, inpatient) and HIV outcomes (CD4 counts, viral suppression). Results: Health care use was greatest immediately after enrollment and decreased over three years. Those with high deductibles were less likely to use primary care (OR=0.64, 95% CI=0.49 - 0.83, p < 0.001) or psychiatry OR=0.58, 95% CI=0.36, 0.93, p=0.02) than those with low or no deductibles. Enrollment via the Exchange was associated with fewer psychiatry visits (rate ratio [RR]=0.38, 95% CI=0.17 - 0.83; p=0.02), but ADAP was positively associated with number of psychiatry visits (RR=2.22, 95% CI=1.22 – 4.05 p=0.01). There was no association between enrollment mechanism or deductibles and HIV outcomes, but ADAP enrollment was associated with viral suppression (OR=2.23, 95% CI=1.35 - 3.68, p<0.001). Non-white PWH were less likely to be virally suppressed, (OR=0.47, 95% CI= 0.31 - 0.71, p< 0.001). Conclusions: In this sample of PWH drawn from an integrated health care system in California, findings suggest that enrollment via the Exchange and higher deductibles were negatively associated with some aspects of service utilization but did not impact HIV outcomes; support from ADAP appeared to help patients achieve viral suppression; ethnic disparities remain important to address in post-ACA health services for PWH even among those with access to insurance coverage.

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MEDICAL SERVICE OF RURAL POPULATION OF TERNOPIL REGION

Regional’ni aspekti rozvitku produktivnih sil Ukraїni ◽

10.35774/rarrpsu2018.23.133 ◽

2018 ◽

pp. 133-136

Author(s):

Larysa Zaporozhan ◽

Myroslava Fesh

Keyword(s):

Health Care ◽

Health Care System ◽

Rural Areas ◽

Rural Population ◽

Medical Service ◽

High Quality ◽

Local Residents ◽

Socially Relevant ◽

To Receive ◽

Medical Process

Reformation of the health care system of Ukraine has become urgent and socially relevant. A scientifically grounded change in the organization of provision of medical services in rural areas will provide an opportunity to receive qualitative and timely diagnostics for local residents. Carrying out high-quality medical examination in rural areas, timely detection of diseases, especially genetic in the early stages, systemic supervision of certain groups of patients, carrying out of preventive and sanitary measures will allow to effectively carry out medical process.

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A Comprehensive Analysis of COVID-19 Transmission and Fatality Rates at the County level in the United States considering Socio-Demographics, Health Indicators, Mobility Trends and Health Care Infrastructure Attributes

10.1101/2020.08.03.20164137 ◽

2020 ◽

Cited By ~ 1

Author(s):

Tanmoy Bhowmik ◽

Sudipta Dey Tirtha ◽

Naveen Chandra Iraganaboina ◽

Naveen Eluru

Keyword(s):

Health Care ◽

Mortality Rate ◽

Health Indicators ◽

Mortality Rates ◽

County Level ◽

Model Framework ◽

Transmission Rates ◽

Health Care Infrastructure ◽

The Impact ◽

At Home

Background: Several research efforts have evaluated the impact of various factors including a) socio-demographics, (b) health indicators, (c) mobility trends, and (d) health care infrastructure attributes on COVID-19 transmission and mortality rate. However, earlier research focused only on a subset of variable groups (predominantly one or two) that can contribute to the COVID-19 transmission/mortality rate. The current study effort is designed to remedy this by analyzing COVID-19 transmission/mortality rates considering a comprehensive set of factors in a unified framework. Method: We study two per capita dependent variables: (1) daily COVID-19 transmission rates and (2) total COVID-19 mortality rates. The first variable is modeled using a linear mixed model while the later dimension is analyzed using a linear regression approach. The model results are augmented with a sensitivity analysis to predict the impact of mobility restrictions at a county level. Findings: Several county level factors including proportion of African-Americans, income inequality, health indicators associated with Asthma, Cancer, HIV and heart disease, percentage of stay at home individuals, testing infrastructure and Intensive Care Unit capacity impact transmission and/or mortality rates. From the policy analysis, we find that enforcing a stay at home order that can ensure a 50% stay at home rate can result in a potential reduction of about 30% in daily cases. Interpretation: The model framework developed can be employed by government agencies to evaluate the influence of reduced mobility on transmission rates at a county level while accommodating for various county specific factors. Based on our policy analysis, the study findings support a county level stay at home order for regions currently experiencing a surge in transmission. The model framework can also be employed to identify vulnerable counties that need to be prioritized based on health indicators for current support and/or preferential vaccination plans (when available). Funding: None.

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