scholarly journals Efficiency measures of emergency departments: an Italian systematic literature review

2021 ◽  
Vol 10 (3) ◽  
pp. e001058
Author(s):  
Danilo Di Laura ◽  
Lucia D'Angiolella ◽  
Lorenzo Mantovani ◽  
Ginevra Squassabia ◽  
Francesco Clemente ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Emergency Departments ◽  
Critical Role ◽  
Evidence Base ◽  
Healthcare Systems ◽  
Cochrane Library ◽  
Number Of Patients ◽  
The World

Life expectancy globally increased in the last decades: the number of people aged 65 or older is consequently projected to grow, and healthcare demand will increase as well. In the recent years, the number of patients visiting the hospital emergency departments (EDs) rocked in almost all countries of the world. These departments are crucial in all healthcare systems and play a critical role in providing an efficient assistance to all patients. A systematic literature review covering PubMed, Scopus and the Cochrane Library was performed from 2009 to 2019. Of the 718 references found in the literature research, more than 25 studies were included in the current review. Different predictors were associated with the quality of EDs care, which may help to define and implement preventive strategies in the near future. There is no harmonisation in efficiency measurements reflecting the performance in the ED setting. The identification of consistent measures of efficiency is crucial to build an evidence base for future initiatives. The aim of this study is to review the literature on the problems encountered in the efficiency of EDs around the world in order to identify an organisational model or guidelines that can be implemented in EDs to fill inefficiencies and ensure access optimal treatment both in terms of resources and timing. This review will support policy makers to improve the quality of health facilities, and, consequently of the entire healthcare systems.

scholarly journals "Aneurysmal Bone Cyst of the Pelvis: A Systematic Literature Review"

2020 ◽  
Author(s):  
Ayesha Saeed ◽  
Elke Rometsch ◽  
Anahí Hurtado-Chong
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Treatment Modality ◽  
Case Series ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Bone Lesions ◽  
Quality Of Reporting ◽  
Level Of Evidence

Abstract Background:Aneurysmal bone cysts (ABC) are rare benign, vascular, osteolytic bone lesions. Pelvic ABCs account for 8 -12% of these tumors and no clear guidelines for their treatment are available. To our knowledge, this is the first systematic literature review regarding pelvic ABCs. Our primary objective was to identify treatment modalities and to assess the bone healing, measured as the degree of radiological ossification. Secondary objectives were to describe demographics, tumor characteristics, clinical and functional outcomes and recurrence.Methods: Searches were conducted in PubMed, Cochrane Library, and Web of Science. Based on the scarcity of reports, inclusion criteria were kept broad and comprised primary or recurrent pelvic ABCs, with a minimum follow up of one year and available information on radiological ossification. Data was extracted on the individual patient-level and grouped according to treatment modality. Results:Forty-nine studies reporting on 194 patients were included. The level of evidence was low (29 case reports and 20 retrospective case series) and the reporting of outcomes inconsistent. Patients had a median age of 15 years and 52% were male. Five major treatment groups were identified and divided into 11 subgroups. The largest subgroup was curettage (23%) followed by selective arterial embolization (20%). Most ABCs were located in the ilium. Variations in mean tumor size (4.5-22.2cm) and degree of ossification (60-100%) depended on the treatment modality. Overall, in 77% cases the cyst ossified completely. Recurrence was reported in 22 patients (11%) and 2 patients (1%) died during the course of the treatment.Conclusion:Despite the low quality of reporting, this systematic review provides the first comprehensive overview of pelvic ABC treatment modalities and their radiological and clinical outcomes. Neoadjuvant sclero-embolic treatments appear to be used most in recent years, but further comparative studies and better quality of reporting are needed to determine their effectiveness. Quality of reporting should be improved by following reporting guidelines.Level of Evidence: IV

HASTANELERİN HİZMET KALİTESİNİN HASTA TATMİN ÖLÇEĞİ İLE ÖLÇÜLMESİ: KARABÜK DEVLET HASTANESİNDE YATAN HASTALAR ÜZERİNDE BİR ARAŞTIRMA THE MEASUREMENT SERVICE QUALITY OF THE HOSPITALS BY THE PATIENT SCALE: A RESEARCH ON THE PATIENTS IN KARABUK STATE HOSP

2013 ◽  
Vol 1 (1) ◽  
pp. 100
Author(s):  
Selçuk Yurtsever
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Literature Review ◽  
Private Sector ◽  
State Hospital ◽  
Continuous Change ◽  
Satisfaction Scale ◽  
The World ◽  
Main Factors

It has been known that both in the world and in Turkey a continuous change has been experienced in the provision of health services in recent years. In this sense by adopting the customer(client) focused approach of either public or private sector hospitals; it has been seen that they are in the struggle for presenting a right, fast, trustuble, comfy service. The purpose of this research is to measure the satisfaction degree, expectations and perceptions of the patients in Karabük State Hospital through comparison. In this context, the patient satisfaction scale which has been developed as a result of literature review has been used and by this scale it has been tried to measure the satisfaction levels of the patients in terms of material and human factors which are the two main factors of the service that was presented. In the study, with the scales of Servqual and 0-100 Points together, in the part of the analysis MANOVA have been used. The expectations and the perceptions of the patient has been compared first by generally and then by separating to different groups according to the various criterias and in thisway it has been tried to be measured their satisfaction levels. According to the results that were obtained, although, the satisfaction levels of the patients who have taken service from Karabük State Hospital are high in terms of thedoctors and the nurses; it has been reached to the result that their satisfaction levels are low in terms of the materials that have been used at the presenting of the service and the management.

scholarly journals AB0602 IMPACT OF SOCIOECONOMIC FACTORS ON PAIN AND FUNCTION IN KNEE OSTEOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1337.2-1337
Author(s):  
T. W. Swinnen ◽  
M. Willems ◽  
I. Jonkers ◽  
F. P. Luyten ◽  
J. Vanrenterghem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Knee Osteoarthritis ◽  
Socioeconomic Factors ◽  
Systematic Literature Review ◽  
Intervention Effects ◽  
Socioeconomic Outcomes ◽  
And Function ◽  
The Impact

Background:The personal and societal burden of knee osteoarthritis (KOA) urges the research community to identify factors that predict its onset and progression. A mechanistic understanding of disease is currently lacking but needed to develop targeted interventions. Traditionally, risk factors for KOA are termed ‘local’ to the joint or ‘systemic’ referring to whole-body systems. There are however clear indications in the scientific literature that contextual factors such as socioeconomic position merit further scientific scrutiny, in order to justify a more biopsychosocial view on risk factors in KOA.Objectives:The aims of this systematic literature review were to assess the inclusion of socioeconomic factors in KOA research and to identify the impact of socioeconomic factors on pain and function in KOA.Methods:Major bibliographic databases, namely Medline, Embase, CINAHL, Web of Science and Cochrane, were independently screened by two reviewers (plus one to resolve conflicts) to identify research articles dealing with socioeconomic factors in the KOA population without arthroplasty. Included studies had to quantify the relationship between socioeconomic factors and pain or function. Main exclusion criteria were: a qualitative design, subject age below 16 years and articles not written in English or Dutch. Methodological quality was assessed via the Cochrane risk of bias tools for randomized (ROB-II) and non-randomized intervention studies (ROBIN-I) and the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies. Due to heterogeneity of studies with respect to outcomes assessed and analyses performed, no meta-analysis was performed.Results:Following de-duplication, 7639 articles were available for screening (120 conflicts resolved without a third reader). In 4112 articles, the KOA population was confirmed. 1906 (25%) were excluded because of knee arthroplasty and 1621 (21%) because of other issues related to the population definition. Socioeconomic factors could not be identified in 4058 (53%) papers and were adjusted for in 211 (3%) articles. In the remaining papers covering pain (n=110) and/or function (n=81), education (62%) and race (37%) were most frequently assessed as socioeconomic factors. A huge variety of mainly dichotomous or ordinal socioeconomic outcomes was found without further methodological justification nor sensitivity analysis to unravel the impact of selected categories. Although the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the most popular instrument to assess pain and function, data pooling was not possible as socioeconomic factors estimates were part of multilevel models in most studies. Overall results showed that lower education and African American race were consistent predictors of pain and poor function, but those effects diminished or disappeared when psychological aspects (e.g. discrimination) or poverty estimates were taken into account. When function was assessed using self-reported outcomes, the impact of socioeconomic factors was more clear versus performance-based instruments. Quality of research was low to moderate and the moderating or mediating impact of socioeconomic factors on intervention effects in KOA is understudied.Conclusion:Research on contextual socioeconomic factors in KOA is insufficiently addressed and their assessment is highly variable methodologically. Following this systematic literature review, we can highlight the importance of implementing a standardised and feasible set of socioeconomic outcomes in KOA trials1, as well as the importance of public availability of research databases including these factors. Future research should prioritise the underlying mechanisms in the effect of especially education and race on pain and function and assess its impact on intervention effects to fuel novel (non-)pharmacological approaches in KOA.References:[1]Smith TO et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis J Rheumatol 2019. 46:981–9.Disclosure of Interests:None declared.

scholarly journals 593 Quality of life following a road traffic injury: a systematic literature review

2016 ◽  
Vol 22 (Suppl 2) ◽  
pp. A213.1-A213
Author(s):  
Ritva Rissanen ◽  
Hans-Yngve Berg ◽  
Marie Hasselberg
Keyword(s):  
Quality Of Life ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Traffic Injury

scholarly journals 1468. Culture Conversion and Mortality in Patients With Mycobacterium abscessus (MAB) Lung Disease: A Systematic Literature Review

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S736-S736
Author(s):  
Kevin L Winthrop ◽  
Kevin C Mange ◽  
Zhanna Jumadilova ◽  
Kristan B Cline ◽  
Patrick A Flume
Keyword(s):  
Literature Review ◽  
Lung Disease ◽  
Systematic Literature Review ◽  
Panel Member ◽  
Cochrane Library ◽  
Attributable Mortality ◽  
Research Support ◽  
Persistent Symptoms ◽  
Conversion Rates ◽  
Culture Conversion

Abstract Background Prognosis for patients with MAB lung disease is poor. We sought to examine the potential association between culture conversion and outcomes (progression, mortality) in patients with MAB lung disease. Methods English-language MAB lung disease studies with ≥ 10 patients and reporting mortality and/or microbiological outcomes were identified from Embase, PubMed, relevant congress abstracts, and the Cochrane Library (data cutoff, September 24, 2019) using the National Institute for Health and Clinical Excellence guidance for systematic literature reviews. Two independent reviewers screened 1,551 indexed records; relevant extracted data are expressed as population-weighted means. Results Mean all-cause mortality across 17 studies (N=1,291) was 12.1% (range, 3%–33%); mortality attributable to MAB lung disease was 7.6% (range, 0%–27%; N=526, 9 studies). Culture conversion across 44 studies (N=2,237) was 46.7% (range, 0%–98.6%), with higher rates reported for M. massiliense subspecies (76.9%; N=507,15 studies) than M. abscessus subspecies (35.8%; N=834,18 studies). No direct comparisons were made between mortality and culture conversion; in the 13 studies (N=1,202) that reported both outcomes there was a moderate correlation between increased rate of culture conversion and decreased MAB-attributable mortality (R2=0.60). The most common definition of progression (21 studies) was radiographic worsening supported by persistent symptoms and/or positive cultures. Across 8 studies (N=415) 57.8% patients had improvement while 35.2% progressed with treatment. A broad variance in treatment regimen and duration (range, 32 days to > 3 years) was observed. Limitations include a small number of studies, and inconsistency in methods and outcomes definitions. Conclusion In this systematic literature review, available data suggest that culture conversion was achieved in less than half of patients and was lower in patients with M. abscessus compared with M. massiliense. One third of patients had disease progression despite treatment. Some data suggest lower MAB-attributed mortality outcomes in studies with higher culture conversion rates, more evidence is needed to demonstrate a survival benefit associated with culture conversion. Disclosures Kevin L Winthrop, MD, MPH, Insmed Incorporated (Consultant, Grant/Research Support) Kevin C Mange, MD, MSCE, Insmed Incorporated (Employee) Zhanna Jumadilova, MD, Insmed Incorporated (Employee) Kristan B Cline, PhD, Insmed Incorporated (Employee) Patrick A Flume, MD, Insmed Incorporated (Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member)

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