Time for time off? Secondary public holiday shows minimal net hospitalisation benefit

2020 ◽  
pp. jech-2020-215327
Author(s):  
Lucy Frances Telfar Barnard
Keyword(s):  
New Zealand ◽  
Hospital Admissions ◽  
Health Effect ◽  
The Public ◽  
Admission Rates ◽  
New Public ◽  
Significant Difference ◽  
Elective Treatment ◽  
Public Holidays ◽  
Acute Admissions

BackgroundWe aimed to use New Zealand’s Anzac Day to test the public health effect of secondary public holidays; and to use weekly hospitalisation counts to identify which dates were more health suitable for a potential new public holiday.MethodsWe conducted a retrospective population cohort study of hospital admissions in New Zealand between 23 April and 27 May 1988–2018. We compared acute and arranged hospitalisation and mortality rates in holiday (Anzac Day Monday to Friday) and non-holiday (Anzac Day Saturday or Sunday) years, for mid-week holidays and long weekends; and measured total weekly average acute and arranged hospitalisation counts.ResultsHospitalisation rates were lower in holiday years than non-holiday years (rate ratio (RR) 0.96, 95% CI 0.95 to 0.96, p<0.001), with fewer arranged admissions (RR 0.93, 95% CI 0.93 to 0.94, p<0.001), but no significant difference for acute admissions (RR 1.00, 95% CI 0.99 to 1.00, p=0.087). Holiday year acute admission rates were lower than non-holiday years for children aged 0–4 years, but higher for adults aged 15–44 years. Holidays reduced arranged admissions most in children and areas of higher socioeconomic deprivation. There was no significant difference for mortality. Average weekly acute hospitalisations were higher than arranged admissions between 10 June and 7 October.ConclusionSecondary holidays do not reduce deaths; or acute hospital admissions except in the holiday week; and may delay elective treatment. However, if New Zealand is to add a new public holiday, it would have least detrimental health effect scheduled between 10 June and 7 October.

Abstract 13197: Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Outpatient Setting

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Krishna Patel ◽  
Laura Young ◽  
Erik H Howell ◽  
Bo Hu ◽  
Shannon J Morrison ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Outpatient Setting ◽  
Uncontrolled Hypertension ◽  
Office Visits ◽  
Hypertensive Urgency ◽  
Admission Rates ◽  
Coronary Syndrome ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Hypertensive Urgencies

Background: Hypertensive urgency is a commonly encountered outpatient problem. Prevalence and short term outcomes of this condition are unknown. JNC VII recommends aggressive BP control over several days. However, a small percentage of patients are sent to the emergency department. It is unknown whether hospital management of these patients is better than outpatient BP management. Methods: Retrospective cohort study of all patients presenting to an office in a large health care system from 2008-2013 with SBP ≥180mmHg or DBP ≥ 110mmHg. We excluded pregnant women and patients referred to the hospital for symptoms or treatment of other conditions. Patients were divided into 2 groups: those sent home and those referred to hospital. We recorded baseline demographic and clinical data. Propensity matched outcomes recorded included MACE (acute coronary syndrome, stroke/TIA) uncontrolled hypertension (≥140/90 mmHg) and hospital admissions. Results: Of 2,199,019 office visits, 58,583 (5%) had hypertensive urgency. Mean age was 63±15 yrs, 58% were females, 76% Caucasian, mean BMI was 31±8 kg/m2 and mean SBP and DBP were 182±16 and 96±16 mmHg. Only 426 (0.7%) patients were referred to the ED/hospital. On propensity matched analysis between the patients referred to the hospital and sent home, there was no significant difference in MACE events at 7 days (0% vs. 0.13%, p=1), 30 days (0.25% vs. 0%, p=1) or 6 months (0.5% vs. 0.13%, p=0.26). Compared to patients sent home, patients referred to the hospital had less uncontrolled hypertension at 1 month (81% vs. 88%, p=0.001) but not at 6 months (65% vs 69%, p=0.16). They also had higher 7- and 30-day hospital admission rates (8.5% vs. 4.9%, p=0.01; 11.8% vs 7.6%, p=0.02). Conclusion: Hypertensive urgency occurs commonly, but the rate of MACE in asymptomatic patients is very low. ED visits increased hospitalizations, but did not improve outcomes. Most patients with hypertensive urgencies still had uncontrolled hypertension at 6 months.

Does Citizens’ Self-Identification of Their Public Role Affect Their Satisfaction with Public Services?

2020 ◽  
Vol 35 (1) ◽  
pp. 75-100
Author(s):  
Hemin Choi ◽  
Jong Seon Lee
Keyword(s):  
Public Service ◽  
Public Management ◽  
New Public Management ◽  
The Public ◽  
Public Role ◽  
New Public ◽  
Significant Difference ◽  
Service Expectations ◽  
Manova Analysis

This study investigates how citizens define their role qua citizen and how the public role they assign themselves matters in their assessment of satisfaction with public service performance. We compared survey respondents who identified their citizen role as customer (n=280), partner (n=353) or owner (n=467) to test this relation. Theoretically, the dominance of New Public Management (NPM) scholarship has resulted in the framing of citizens as simply customers, but our empirical study finds that citizens consider themselves more as partners or owners of government. This mismatch in conception was our research hypothesis for further research. We then ran a number of t-tests and carried out a MANOVA analysis, the results of which indicate that there is a significant difference between the customer and partner groups regarding expectations and satisfaction on the quality of their living area but not regarding performance. There is also evidence that shows that the role citizens assign to themselves is related to their public service expectations but that the connection between their view of their role and their assessment of performance is weak.

Trends of reported chlamydia infections and related complications in New Zealand, 1998 - 2008

Sexual Health ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 412 ◽  
Author(s):  
Jane Morgan ◽  
Chanukya Colonne ◽  
Anita Bell
Keyword(s):  
New Zealand ◽  
Ectopic Pregnancy ◽  
Hospital Admissions ◽  
Specific Rate ◽  
Complication Rates ◽  
Detection Rates ◽  
Admission Rates ◽  
Chlamydia Testing ◽  
Data Limitations ◽  
Targeted Testing

Aim To compare trends in chlamydia (Chlamydia trachomatis) testing and detection with trends in hospital discharge rates of chlamydia-related diseases in the upper North Island of New Zealand during 1998–2008. Methods: Analysis of trends in chlamydia testing and detection rates and age-specific hospital admission rates per 100 000 females for pelvic inflammatory disease (PID), female infertility and ectopic pregnancy, and per 100 000 males for epididymo-orchitis. Results: Regional laboratory testing volumes increased from 3732 tests per 100 000 population in 1998 to 9801 tests per 100 000 in 2008. Two of three regions had a significant increase in percent test positivity over time. The highest detection rates and greatest increase in reported cases were amongst women aged 15–24 years, at 1992 per 100 000 in 1998, to 5737 per 100 000 in 2008. For women aged 15–24 years, the rate of hospital admissions for PID and chlamydia-related pelvic infections declined during 1998–2004 but rose in 2005–08, the rate of publicly-funded infertility admissions fell and the ectopic pregnancy rate was unchanged. The age-specific rate for epididymo-orchitis admissions amongst 15–44-year-old men remained stable. Conclusion: Chlamydia testing volumes from three New Zealand regions have trebled since 1998, as have reported infection rates, although disease complication rates do not appear to have increased. Test positivity increases may reflect better targeted testing of those more at risk or a rising chlamydia incidence. The recent rise in hospital admissions for PID among women aged 15–24 is a concern; ongoing monitoring of these trends, despite data limitations, is important.

scholarly journals Crisis resolution and home treatment teams for older people with mental illness

2008 ◽  
Vol 32 (7) ◽  
pp. 268-270 ◽  
Author(s):  
Claire Dibben ◽  
Humera Saeed ◽  
Konstantinos Stagias ◽  
Golam Mohammed Khandaker ◽  
Judy Sasha Rubinsztein
Keyword(s):  
Mental Illness ◽  
Older People ◽  
Hospital Admissions ◽  
Length Of Hospital Stay ◽  
Home Treatment ◽  
Crisis Resolution ◽  
Admission Rates ◽  
People With Mental Illness ◽  
Significant Difference ◽  
The Impact

Aims and MethodWe examined the impact of a crisis resolution and home treatment teams (CRHTT) on hospital admission rates, bed days and treatment satisfaction among older people with mental illness and their carers. We compared these factors in the 6 months before the service started and 6 months after its introduction.ResultsThe CRHTT significantly reduced admissions (P<0.001), but there was no significant difference in the length of hospital stay as compared before and after the introduction of this service. There was a trend towards carers, but not patients, being more satisfied with treatment after the introduction of the CRHTT.Clinical ImplicationsThe CRHTT reduced hospital admissions for older people by 31% and carers preferred the service. Further research on crisis teams in older people with mental illness is needed using randomised controlled methodology.

scholarly journals Antidepressants and public health in Iceland

2004 ◽  
Vol 184 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Tómas Helgason ◽  
Helgi Tómasson ◽  
Tómas Zoëga
Keyword(s):  
Public Health ◽  
Depressive Disorders ◽  
Hospital Admissions ◽  
Adult Population ◽  
Health Impact ◽  
The Public ◽  
Admission Rates ◽  
Outpatient Visits ◽  
Disability Adjusted Life ◽  
Life Years

BackgroundMajor depressive disorder is the second leading cause of disability-adjusted life-years in developed regions of the world and antidepressants are the third-ranking therapy class worldwide.AimsTo test the public health impact of the escalating sales of antidepressants.MethodNationwide data from Iceland are used as an example to study the effect of sales of antidepressants on suicide, disability, hospital admissions and outpatient visits.ResultsSales of antidepressants increased from 8.4 daily defined doses per 1000 inhabitants per day in 1975 to 72.7 in 2000, which is a user prevalence of 8.7% for the adult population. Suicide rates fluctuated during 1950–2000 but did not show any definite trend. Rates for outpatient visits increased slightly over the period 1989–2000 and admission rates increased even more. The prevalence of disability due to depressive and anxiety disorders has not decreased over the past 25 years.ConclusionsThe dramatic increase in the sales of antidepressants has not had any marked impact on the selected public health measures. Obviously, better treatment for depressive disorders is still needed in order to reduce the burden caused by them.

scholarly journals Contributions and challenges of ‘New Public Management’: New Zealand since 1984

2008 ◽  
Vol 4 (3) ◽  
Author(s):  
Judy Whitcombe
Keyword(s):  
New Zealand ◽  
Public Sector ◽  
Public Service ◽  
Public Management ◽  
New Public Management ◽  
Reform Process ◽  
Rigorous Analysis ◽  
The Public ◽  
New Public ◽  
The World

When New Public Management (NPM) swept around the world in the 1980s the New Zealand public sector embraced its theories and embarked upon a rigorous reform process which brought both praise and some scepticism. New Zealand was seen at that time, by some observers, to be a ‘world leader’. However, in the years following the initial impact of NPM the euphoria has given way to a more rigorous analysis of the performance of the public sector and a re-examination of the functions and responsibilities of the public service.

The Rise of a New Public Bureaucracy in New Zealand?

2021 ◽  
pp. 009539972110133
Author(s):  
Karl Löfgren ◽  
Ben Darrah-Morgan ◽  
Patrik Hall ◽  
Linda Alamaa
Keyword(s):  
New Zealand ◽  
Public Sector ◽  
Main Task ◽  
The Public ◽  
Organizational Functions ◽  
Public Sector Reforms ◽  
New Public ◽  
Public Bureaucracy ◽  
Complex Picture

One recurrent narrative in the discussion about managerial public sector reforms is the growth in organizational professionals as a response to new accountability regimes. New Zealand has experienced modest growth rates in the general public sector workforce. Less studied, though, is whether the composition of the public sector workforce has changed, with an increase in organizational functions supportive to management. Based on descriptive workforce data, followed by follow-up interviews, this article presents a multifaceted and complex picture of a growing new public bureaucracy with the main task of managing chains of accountability.

Ritual and commemoration in contemporary Russia

Focaal ◽  
2013 ◽  
Vol 2013 (67) ◽  
pp. 61-73
Author(s):  
Tobias Köllner
Keyword(s):  
Russian Orthodox ◽  
Orthodox Church ◽  
Religious Revival ◽  
National Narratives ◽  
Russian Orthodox Church ◽  
The Public ◽  
National Symbols ◽  
New Public ◽  
The Russian Federation ◽  
Public Holidays

Since state atheism was abandoned in the 1990s, the Russian Federation entered what can be called a postsecular phase. Religion, formerly limited to the private sphere, reappeared in the public and underwent an astonishing religious revival. During the time of my fieldwork in 2006/2007, a tendency to favor the Russian Orthodox Church (ROC) and to facilitate its return to the public reached its climax. In this article I draw attention to how the political, the secular, and the religious are interconnected and allow for new vernacular forms of legitimating power and authority. One example is the introduction of new public holidays and public rituals. They connect local and national narratives and relate to ideas about the communality of the Russian people. They create new forms of a divine kinship, which draw heavily on religious and national symbols and merge the sacred and the profane.

Welfare State Values and Public Service Media in the Era of Datafication

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Kaarina Nikunen ◽  
Jenni Hokka
Keyword(s):  
Public Service ◽  
Well Being ◽  
Welfare States ◽  
Social Solidarity ◽  
Media Environment ◽  
The Public ◽  
Media Companies ◽  
Data Practices ◽  
Public Media ◽  
New Public

Welfare states have historically been built on values of egalitarianism and universalism and through high taxation that provides free education, health care, and social security for all. Ideally, this encourages participation of all citizens and formation of inclusive public sphere. In this welfare model, the public service media are also considered some of the main institutions that serve the well-being of an entire society. That is, independent, publicly funded media companies are perceived to enhance equality, citizenship, and social solidarity by providing information and programming that is driven by public rather than commercial interest. This article explores how the public service media and their values of universality, equality, diversity, and quality are affected by datafication and a platformed media environment. It argues that the embeddedness of public service media in a platformed media environment produces complex and contradictory dependencies between public service media and commercial platforms. The embeddedness has resulted in simultaneous processes of adapting to social media logics and datafication within public service media as well as in attempts to create alternative public media value-driven data practices and new public media spaces.

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