Quality of care factors associated with unplanned readmissions of older medical patients: a case-control study

Background: Diabetic neuropathy is one among the most common complication in diabetes mellitus. Diabetic peripheral neuropathy hinders the quality of life causing morbidity and mortality. The purpose of this study was to find the risk factors associated with diabetic neuropathy.Methods: This case control study involved 100 diabetic patients attending the Dohnavur fellowship hospital, Dohnavur from October 2019 to March 2020. Sociodemographic profile and diabetic characteristics of the study group were obtained and analysed. Diagnosis of Diabetic Neuropathy was done by using the diagnostic method proposed by American Diabetic Association.Results: Of the total study population with mean age 59.43 years, 63% had family history of diabetes. Almost 70% had poor diabetic control. Statistically significant relationships were found between neuropathy and duration of diabetes, glycaemic control, history of hypertension, monofilament test and pinprick sensation.Conclusions: In this study, glycemic control, dyslipidemia and hypertension were modifiable risk factors for diabetic neuropathy. Early interventional programs to sensitize diabetics on these factors could improve the quality of life of Diabetic patients.

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Understanding maternal mortality in women with obesity and the role of care they receive: a national case-control study

International Journal of Obesity ◽

10.1038/s41366-020-00691-4 ◽

2020 ◽

Vol 45 (1) ◽

pp. 258-265

Author(s):

Monica Saucedo ◽

◽

Ana Paula Esteves-Pereira ◽

Lucile Pencolé ◽

Agnès Rigouzzo ◽

...

Keyword(s):

Quality Of Care ◽

Pregnant Women ◽

Maternal Death ◽

Case Control Study ◽

Case Control ◽

Overweight Women ◽

Suboptimal Care ◽

Control Study

Abstract Objective Obesity has significant implications for the health of pregnant women. However, few studies have quantified its association with maternal mortality or examined the relevant underlying causes and the role of care, although this remains the most severe maternal outcome. Our objectives were to quantify the risk of maternal death by prepregnancy body mass index and to determine whether obesity affected the quality of care of the women who died. Desing This is a national population-based case–control study in France. Cases were 364 maternal deaths from the 2007–2012 National Confidential Enquiry. Controls were 14,681 parturients from the nationally representative 2010 perinatal survey. We studied the association between categories of prepregnancy BMI and maternal death by multivariable logistic regression, estimating adjusted odds ratios and 95% confidence intervals, overall and by specific causes of death. Individual case reviews assessed the quality of care provided to the women who died, by obesity status. Results Compared with women with normal BMI, underweight women (<18.5 kg/m2) had an adjusted OR of death of 0.75 (95% CI, 0.42–1.33), overweight women (25–29.9 kg/m2) 1.65 (95% CI, 1.24–2.19), women with class 1 obesity (30–34.9 kg/m2) 2.22 (95% CI, 1.55–3.19) and those with class 2–3 obesity (≥35 kg/m2) 3.40 (95% CI, 2.17–5.33). Analysis by cause showed significant excess risk of maternal death due to cardiovascular diseases, venous thromboembolism, hypertensive complications and stroke in women with obesity. Suboptimal care was as frequent among women with (35/62, 57%) as without obesity (136/244, 56%), but this inadequate management was directly related to obesity among 14/35 (40%) obese women with suboptimal care. Several opportunities for improvement were identified. Conclusions The risk of maternal death increases with BMI; it multiplied by 1.6 in overweight women and more than tripled in pregnant women with severe obesity. Training clinicians in the specificities of care for pregnant women with obesity could improve their outcomes.

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Stillbirths and quality of care during labour at the low resource referral hospital of Zanzibar: a case-control study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-016-1142-2 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 20

Author(s):

Nanna Maaløe ◽

Natasha Housseine ◽

Ib Christian Bygbjerg ◽

Tarek Meguid ◽

Rashid Saleh Khamis ◽

...

Keyword(s):

Quality Of Care ◽

Case Control Study ◽

Case Control ◽

Referral Hospital ◽

Low Resource ◽

Control Study

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Factors associated with enrollment for community-based health insurance scheme in Western Ethiopia: Case-control study

PLoS ONE ◽

10.1371/journal.pone.0252303 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252303

Author(s):

Meseret Belete Fite ◽

Kedir Teji Roba ◽

Bedasa Taye Merga ◽

Belay Negash Tefera ◽

Gemechu Ayela Beha ◽

...

Keyword(s):

Health Care ◽

Case Control Study ◽

Wealth Index ◽

Case Control ◽

Perceived Health Status ◽

Community Based ◽

Factors Associated ◽

Perceived Quality Of Care ◽

Control Study

Introduction Modern health services utilization in developing countries has continued low. Financial shortage to access health-care services might be averted by stirring from out-of-pocket payment for health care at the time of use. The government of Ethiopia; depend greatly on foreign aid (50%) and out-of-pocket payments (34%) to fund health services for its population. This study was aimed to identify factors associated with households’ enrollment to CBHI scheme membership. Methods Case-control study design was conducted from May 18–July 27, 2019 among 332 participants (166 enrolled and 166 non-enrolled to CBHI scheme). Simple random sampling technique was used to select the study participants. Bi-variable and multivariable logistic regression model were fitted to identify factors associated with enrollment to community based health insurance. Adjusted odds ratio (AOR) with 95% CI was used to report association and significance was declared at P<0.05. Result A total of 332 (100% response rate) were involved in the study. Educational status (College and above, AOR = 3.90, 95%CI; 1.19, 12.75), good awareness about CBHI scheme (AOR = 21.595, 95% CI; 7.561, 61.681), affordability of premium payment (AOR = 3.403, 95% CI; 5.638–4.152), wealth index {(Poor, AOR = 2.59, 95%CI; 1.08, 6.20), (Middle, AOR = 4.13, 95%CI; 1.11, 15.32)} perceived health status (AOR = 5.536; 95% CI; 1.403–21.845), perceived quality of care (AOR: 21.014 95%CI; 4.178, 105.686) and treatment choice (AOR = 2.94, 95%CI; 1.47, 5.87) were factors significantly associated with enrollment to CBHI. Conclusion Enrolment to CBHI schemes is influenced by educational level, awareness level, affordability of premium, wealth index, perceived health status, perceived quality of care and treatment choice. Implementation strategies aimed at raising community awareness, setting affordable premium, and providing quality healthcare would help in increasing enrollment of all eligible community groups to the CBHI scheme.

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