Impact of COVID ‐19 public health restrictions on hospital admissions for young infants in Victoria, Australia

Hospitalisations for acute exacerbations of COPD (AECOPD) carry significant morbidity and mortality. Respiratory viral infections (RVIs) are the most common cause of AECOPD and are associated with worse clinical outcomes. During the COVID-19 pandemic, public health measures, such as social distancing and universal masking, were originally implemented to reduce transmission of SARS-CoV-2; these public health measures were subsequently also observed to reduce transmission of other common circulating RVIs. In this study, we report a significant and sustained decrease in hospital admissions for all AECOPD as well as RVI-associated AECOPD, which coincided with the introduction of public health measures during the COVID-19 pandemic.

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Evaluation of Dietitian Counselling Access Revealed Reduced Pediatrician-Reported Hospital Admissions and Increased Parental Knowledge and Confidence

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2016-036 ◽

2017 ◽

Vol 78 (2) ◽

pp. 81-85 ◽

Cited By ~ 1

Author(s):

Katherine (Kay) Watson-Jarvis ◽

Lorna Driedger ◽

Tanis R. Fenton

Keyword(s):

Public Health ◽

Health Professionals ◽

Hospital Admissions ◽

Response Rate ◽

Parental Knowledge ◽

Well Being ◽

Public Health Nurses ◽

Child Feeding ◽

N 93 ◽

High Degree

Based on a 1999 needs assessment a pediatric community-based outpatient dietitian counselling service was created. By 2010 annual referrals had grown to almost 1500 (62% from physicians; 38% from public health nurses). An evaluation was undertaken to gather perspectives of practitioners and parents about access, satisfaction, referral practices, and changes in knowledge, attitudes, behaviour, and child well-being. Health professionals surveyed via email were 62 pediatricians (response rate 71%), 25 family physicians (21%), 87 public health nurses (31%), and 7 dietitian providers (100%). Parents (n = 93, response rate 75% of those contacted) were interviewed by telephone. Pediatricians reported a significantly lower rate of 7% (95% confidence interval (CI), 0.8%–23%) for admitting children to hospital to access a dietitian, compared to 1999 of 39% (95% CI, 22%–59%) (P = 0.005). Health professionals reported a high degree of agreement on benefits of the service to their practice and on child health problems and a high degree of satisfaction with the service. Parents reported gaining knowledge (76%), confidence (93%), and making behaviour changes in foods offered (77%). Our evaluation demonstrated health practitioners saw a need for access to dietitians for pediatric dietitian counselling and parents reported more confidence and improved child feeding practices after dietitian counselling.

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Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-210783 ◽

2019 ◽

Vol 73 (6) ◽

pp. 537-543 ◽

Cited By ~ 2

Author(s):

Roger Daglius Dias ◽

Jacson Venancio de Barros

Keyword(s):

Public Health ◽

Hospital Mortality ◽

Older People ◽

Health System ◽

Hospital Admissions ◽

Public Health System ◽

Average Length ◽

Admission Rate ◽

Older Population ◽

Icu Admission

BackgroundThe world’s population is progressively ageing, and this trend imposes several challenges to society and governments. The aim of this study was to investigate the burden generated by the hospitalisation of older (>60 years) compared with non-older population, as well as the epidemiology of these hospital admissions.MethodsUsing the Brazilian Unified Health System (known as ‘Sistema Único de Saúde’ (SUS)), an analysis of all hospital admissions of adult patients in the SUS from 2009 to 2015 was undertaken. The following indicators were used: hospital admission rate, intensive care unit (ICU) admission rate, average length of hospital and ICU stay, hospital mortality and average reimbursement per hospitalisation.ResultsA total of 61 958 959 admissions during the 7-year period, were analysed, encompassing 17 893 392 (28.9%) older patients. Elderly represent 15% (n=21 294 950) of the Brazilian adult population, but are responsible for 29% (n=17 893 392) of hospitalisations, 52% (n=1 731 299) of ICU admissions and 66% (n=1 885 291) of hospital mortality. Among the adults, elderly represents 39% of the total reimbursement made related to admission/hospitalisation. For 2009 to 2015, while the older population increased 27%, ICU admission rate increased 20%; the average length of ICU stay was 12% higher in 2015 (6.5 days) compared with 2009 (5.8 days); and the hospital mortality increased from 9.8% to 11.2%.ConclusionThese findings illustrate the current panorama of the burden due to hospitalisation of older people in the Brazilian public health system, and evidence the consolidation of the epidemiological transition toward the predominance of non-communicable diseases as the main cause of hospitalisation among the elderly in Brazil.

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Hospital Admissions Related to Tuberculosis in Brazil: Epidemiological and Economic Profile, from the Public Health Care Perspective

Value in Health ◽

10.1016/j.jval.2013.08.148 ◽

2013 ◽

Vol 16 (7) ◽

pp. A347

Author(s):

L.M. Amaral ◽

R.A. Fernandes ◽

M. Takemoto ◽

J.F. Vasconcellos ◽

L.C. Haas ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Hospital Admissions ◽

Public Health Care ◽

The Public ◽

Economic Profile

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Programming Physical Activity in Young Infants At-Risk for Early Onset of Obesity

Kinesiology Review ◽

10.1123/krj.2.4.221 ◽

2013 ◽

Vol 2 (4) ◽

pp. 221-232 ◽

Cited By ~ 6

Author(s):

Dale A. Ulrich ◽

Janet L. Hauck

Keyword(s):

Public Health ◽

Physical Activity ◽

At Risk ◽

Motor Development ◽

Early Onset ◽

Sensitive Period ◽

Postnatal Life ◽

Innovative Strategies ◽

Young Infants ◽

Single Strategy

The purpose of this article is to discuss the growing problem of very early onset of obesity occurring before two years of age and to review infant motor development, physical activity, and effective pediatric disability motor interventions that may offer potential strategies to help reduce this growing problem earlier in life. Based on the review of physical activity interventions used with infants with a disability, we will propose strategies to consider to program early physical activity exposures into nondisabled young infants who are at risk for obesity. These proposed physical activity strategies will need to be combined with successful public health approaches to reducing early onset of obesity during infancy. Lucas (1991) conceived the termprogrammingreferring to permanent or extended effects of an environmental exposure occurring during a sensitive developmental period. In this paper, we propose that a very sensitive period for early onset of obesity is the first six months of postnatal life. If innovative strategies to increase the frequency of daily exposures to physical activity in young infants can be identified, these strategies could be combined with current public health approaches to preventing obesity in women before, during, and following pregnancy. Given the complexity of the obesity problem, no single strategy for prevention should be expected to be very successful.

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The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽

10.1371/journal.pone.0252441 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252441

Author(s):

Elissa Rennert-May ◽

Jenine Leal ◽

Nguyen Xuan Thanh ◽

Eddy Lang ◽

Shawn Dowling ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Hospital Admissions ◽

Population Based ◽

Emergency Department Visits ◽

System Capacity ◽

Population Based Study ◽

Health Measures ◽

Ed Visits ◽

The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

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Hospitalization budget impact during the COVID-19 pandemic in Spain

Health Economics Review ◽

10.1186/s13561-021-00340-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

F. J. Carrera-Hueso ◽

L. Álvarez-Arroyo ◽

J. E. Poquet-Jornet ◽

P. Vázquez-Ferreiro ◽

R. Martínez-Gonzalbez ◽

...

Keyword(s):

Public Health ◽

Budget Impact ◽

Hospital Admissions ◽

Case Scenario ◽

Worst Case ◽

Health Budget ◽

Spanish Hospital ◽

Isolation Ward ◽

Mean Cost ◽

The Impact

Abstract Objectives The aim was to determine the direct impact of the COVID-19 pandemic on Spain’s health budget. Methods Budget impact analyses based on retrospective data from patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) admitted to a Spanish hospital between February 26 and May 21, 2020. Direct medical costs from the perspective of the hospital were calculated. We analyzed diagnostic tests, drugs, medical and nursing care, and isolation ward and ICU stays for three cohorts: patients seen in the emergency room only, hospitalized patients who tested positive for SARS-CoV-2, and patients who tested negative. Results The impact on the hospital’s budget for the 3 months was calculated at €15,633,180, 97.4% of which was related to health care and hospitalization. ICU stays accounted for 5.3% of the total costs. The mean cost per patient was €10,744. The main costs were staffing costs (10,131 to 11,357 €/patient for physicians and 10,274 to 11,215 €/patient for nurses). Scenario analysis showed that the range of hospital expenditure was between €14,693,256 and €16,524,924. The median impact of the pandemic on the Spanish health budget in the sensitivity analysis using bootstrapped individual data was €9357 million (interquartile range [IQR], 9071 to 9689) for the conservative scenario (113,588 hospital admissions and 11,664 ICU admissions) and €10,385 million (IQR, 110,030 to 10,758) for the worst-case scenario (including suspected cases). Conclusion The impact of COVID-19 on the Spanish public health budget (12.3% of total public health expenditure) is greater than multiple sclerosis, cancer and diabetes cost.

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The importance of age-specific data in routine syndromic surveillance

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7602 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Roger Morbey ◽

Alex J. Elliot ◽

Gillian E. Smith

Keyword(s):

Public Health ◽

Hospital Admissions ◽

Age Distribution ◽

Age Groups ◽

Health Indicators ◽

Older Age ◽

Outbreak Detection ◽

Detection Methods ◽

Surveillance Systems ◽

Wide Range

ObjectiveTo investigate whether aberration detection methods for syndromicsurveillance would be more useful if data were stratified by age band.IntroductionWhen monitoring public health incidents using syndromicsurveillance systems, Public Health England (PHE) uses the ageof the presenting patient as a key indicator to further assess theseverity, impact of the incident, and to provide intelligence on thelikely cause. However the age distribution of cases is usually notconsidered until after unusual activity has been identified in the all-ages population data. We assessed whether monitoring specific agegroups contemporaneously could improve the timeliness, specificityand sensitivity of public health surveillance.MethodsFirst, we examined a wide range of health indicators from the PHEsyndromic surveillance systems to identify for further study thosewith the greatest seasonal variation in the age distribution of cases.Secondly, we examined the identified indicators to ascertain whetherany age bands consistently lagged behind other age bands. Finally,we applied outbreak detection methods retrospectively to age specificdata, identifying periods of increased activity that were only detectedor detected earlier when age-specific surveillance was used.ResultsSeasonal increases in respiratory indicators occurred first inyounger age groups, with increases in children under 5 providingearly warning of subsequent increases occurring in older age groups.Also, we found age specific indicators improved the specificity ofsurveillance using indicators relating to respiratory and eye problems;identifying unusual activity that was less apparent in the all-agespopulation.ConclusionsRoutine surveillance of respiratory indicators in young childrenwould have provided early warning of increases in older age groups,where the burden on health care usage, e.g. hospital admissions, isgreatest. Furthermore this cross-correlation between ages occurredconsistently even though the age distribution of the burden ofrespiratory cases varied between seasons. Age specific surveillancecan improve sensitivity of outbreak detection although all-agesurveillance remains more powerful when case numbers are low.

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In-hospital mortality in patients with acute limb ischemia over a 12-year period in the Brazilian public health-care system

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.210107 ◽

2021 ◽

Vol 20 ◽

Author(s):

João Henrique Fonseca do Nascimento ◽

André Gusmão Cunha ◽

André Bouzas de Andrade ◽

Monique Magnavita Borba da Fonseca Cerqueira

Keyword(s):

Public Health ◽

Hospital Mortality ◽

Hospital Admissions ◽

Public Health Problem ◽

Secondary Data ◽

Limb Ischemia ◽

Public Health Care ◽

Acute Limb Ischemia ◽

Atypical Manifestations ◽

Icd 10

Abstract Background Arterial diseases represent a severe public health problem in the 21st century. Although men have a higher overall prevalence, reports have suggested that women may exhibit atypical manifestations, be asymptomatic, and have hormonal peculiarities, resulting in worse outcomes and severe emergencies, such as acute limb ischemia (ALI). Objectives To analyze the morbidity and mortality profile of ALI emergencies in Brazil between 2008 and 2019. Methods An ecological study was carried out with secondary data from SIH/SUS, using ICD-10 code I.74 The proportions of emergency hospital admissions and in-hospital mortality rates (HMR) by gender, ethnicity, and age were extracted from the overall figures. P<0.05 was considered significant. Results From 2008 to 2019, there were 195,567 urgent hospitalizations due to ALI in Brazil, 111,145 (56.8%) of which were of men. Women had a higher HMR (112:1,000 hospitalizations) than men (85:1,000 hospitalizations) (p<0.05), and a higher chance of death (OR=1.36; p<0.05). Furthermore, mean survival was significantly higher among men (8,483/year versus 6,254/year; p<0.05). Stratified by ethnicity, women who self-identified as white (OR=1.44; p<0.05), black (OR=1.33; p<0.05), and brown (RR=1.25; p <0.05) had greater chances of death than men in the same ethnicity categories. Moreover, women over the age of 50 years had a higher chance of death, with a progressive increment in risk as age increased. Conclusions There was a trend to worse prognosis in ALI emergencies associated with women, especially in older groups. The literature shows that the reasons for these differences are still poorly investigated and more robust studies of this relevant disease in the area of vascular surgery are encouraged.

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