scholarly journals 73 Hospital admissions and hospital deaths in meadow house hospice (MHH) community patients

2021 ◽  
Author(s):  
Lucy Ison ◽  
Treena Saini
Keyword(s):  
Hospital Admissions ◽  
Hospital Deaths ◽  
Community Patients

scholarly journals Epidemiology of SARS-CoV-2 infection and SARS-CoV-2 positive hospital admissions among children in South Africa

2021 ◽  
Author(s):  
Tendesayi Kufa ◽  
Waasila Jassat ◽  
Cheryl Cohen ◽  
Stefano Tempia ◽  
Maureen Masha ◽  
...  
Keyword(s):  
South Africa ◽  
Public Hospital ◽  
Hospital Admissions ◽  
Case Fatality ◽  
Outcome Data ◽  
Middle Income ◽  
Female Age ◽  
Hospital Deaths ◽  
Male Sex ◽  
Attending Physician

Introduction: We describe epidemiology and outcomes of confirmed SARS-CoV-2 infection and admissions among children <18 years in South Africa, an upper-middle income setting with high inequality. Methods: Laboratory and hospital COVID-19 surveillance data, 28 January - 19 September 2020 was used. Testing rates were calculated as number of tested for SARS-CoV-2 divided by population at risk; test positivity rates were calculated as positive tests divided by total number of tests. In-hospital case fatality ratio (CFR) was calculated based on hospitalized positive admissions with outcome data who died in-hospital and death was judged SARS-CoV-2 related by attending physician. Findings: 315,570 children aged <18 years were tested for SARS-CoV-2; representing 8.9% of all 3,548,738 tests and 1.6% of all children in the country. Of children tested, 46,137 (14.6%) were positive. Children made up 2.9% (n=2,007) of all SARS-CoV-2 positive admissions to sentinel hospitals. Among children, 47 died (2.6% case-fatality). In-hospital deaths were associated with male sex [adjusted odds ratio (aOR) 2.18 (95% confidence intervals (CI) 1.08 - 4.40)] vs female; age <1 year [aOR 4.11 (95% CI 1.08-15.54)], age 10-14 years [aOR 4.20 (95% CI1.07-16.44)], age 15-17 years [aOR 4.86 (95% 1.28 -18.51)] vs age 1-4 years; admission to a public hospital [aOR 5.07(95% 2.01 -12.76)] vs private hospital and ≥1 underlying conditions [aOR 12.09 (95% CI 4.19-34.89)] vs none Conclusions: Children with underlying conditions were at greater risk of severe SARS-CoV-2 outcomes. Children > 10 years and those with underlying conditions should be considered for increased testing and vaccination.

scholarly journals Prevalence of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae in Community Patients in Blantyre, Malawi

2021 ◽  
Author(s):  
Onduru G. Onduru ◽  
Rajhab S. Mkakosya ◽  
Said Aboud ◽  
Susan F. Rumisha
Keyword(s):  
Hospital Admissions ◽  
Positive Culture ◽  
Test Method ◽  
Clinical Samples ◽  
Prior History ◽  
P Value ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
History Of ◽  
Community Patients

Abstract Background Antimicrobial resistance due to production of extended-spectrum β-lactamase (ESBL) by Enterobacteriaceae is a global health problem contributing to increased morbidity and mortality particularly in resource-constrained countries. We examined in the current study the prevalence of extended spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) in community patients in Blantyre, Malawi. Methods This was a cross sectional study conducted between March and September 2020 at selected outpatient health facilities in Blantyre, Malawi. Clinical samples were first screened for ESBL-E using CHROMagar™ ESBL medium and later confirmed by a combination disk test method (CDT). The isolates were identified to species level using a commercially acquired biochemical substrate strips (Microbact™ GNB, Oxoid). Descriptive summary statistics were generated as frequencies and proportions. Chi square or Fishers Exact tests and student’s t-test were used where appropriate. Association between variables was determined by logistic regression analysis. Results were presented as odds ratio and 95% confidence interval. A p-value ≤ 0.05 was regarded as statistically significant. Results A total of 199 rectal swabs and 101 urine samples from 300 outpatient adults were screened for ESBL-E. Of these, seventy three (24.33%; 95%, CI = 19.45–29.22%) gave positive culture. Prevalence of community acquired ESBL-E was 16.67% (50/300, 95% CI = 12.43–20.91%). The most common ESBL-E species isolated were Escherichia coli (66%). Community prevalence of ESBL-E was higher in male 56% (28/50) compared to female 44% (22/50) patients. Prevalence of ESBL-E was higher in community patients who lacked history of surgery 88% (44/50) and prior history of antibiotic use in the last three months 80% (40/50) compared to those with same characteristics. All community patients with isolated ESBL-E had no history of admission in the last three months and neither demographic characteristics nor clinical characteristics of participants showed any degree of association with the carriage of ESBL-E. Conclusion Our findings revealed moderate presence of ESBL-E phenotypes in a community patients who lacked history of hospital admissions in the past three months an indication of community acquisition of ESBL-E in Blantyre, Malawi. Low prevalence of ESBL-E in the community settings in Blantyre can be maintained if strong infection and antimicrobial use control strategies are to be implemented.

scholarly journals Estimating the state of the Covid-19 epidemic in France using a non-Markovian model

2020 ◽  
Author(s):  
Raphaël Forien ◽  
Guodong Pang ◽  
Étienne Pardoux
Keyword(s):  
Hospital Admissions ◽  
Current Knowledge ◽  
The State ◽  
Markovian Model ◽  
Hospital Data ◽  
Ode Model ◽  
Ode Models ◽  
Hospital Deaths ◽  
Paris Region ◽  
Theoretical Results

AbstractIn this paper, we use a deterministic non-Markovian epidemic model to estimate the state of the Covid-19 epidemic in France. This model allows us to consider realistic distributions for the exposed and infectious periods in a SEIR model, contrary to standard ODE models which only consider exponentially distributed exposed and infectious periods. We present theoretical results linking the (unobserved) parameters of the model to various quantities which are more easily measured during the early stages of an epidemic. We also stress the main quantitative differences between the non-Markovian and the Markovian (ODE) model. We then apply these results to estimate the state of the Covid-19 epidemic in France by analyzing three regions: the Paris region, the northeast regions and the rest of the country, based on current knowledge on the infection fatality ratio and the exposed and infectious periods distributions for Covid-19. Our analysis is based on the hospital data published daily by Santé Publique France (daily hospital admissions, intensive care unit admissions and hospital deaths).

scholarly journals Positive views on antipsychotic long-acting injections: results of a survey of community patients prescribed antipsychotics

2019 ◽  
Vol 9 ◽  
pp. 204512531986097 ◽  
Author(s):  
Shubhra Mace ◽  
Oscar Chak ◽  
Sharanjeet Punny ◽  
Daniel Sedough-Abbasian ◽  
Chirag Vegad ◽  
...  
Keyword(s):  
Injection Site ◽  
Hospital Admissions ◽  
Oral Treatment ◽  
Oral Medication ◽  
Same Gender ◽  
Long Acting ◽  
The Right ◽  
To Receive ◽  
Study Questionnaire ◽  
Community Patients

Background: We aimed to assess patients’ views about antipsychotic long-acting injections (LAIs). Methods: We interviewed patients prescribed an antipsychotic (oral or LAI) in our community teams. In a subanalysis, responses were analysed for differences between patients currently receiving an LAI and those prescribed only oral medication. Results: In total, 226 patients (57%) completed the study questionnaire. The majority agreed that LAIs ensured delivery of the right amount of medication and protection against hospital admissions (57% and 60%, respectively). A minority of participants were more concerned than not about the use of a needle (46%), pain from injection (48%) and the need to travel to receive the injection (34%). A majority expressed a preference for injection site (deltoid or gluteal) (65%) and clinic location (69%). A higher proportion of patients currently receiving an LAI compared with those prescribed oral medication thought an LAI was beneficial because this formulation obviated the need to: swallow tablets (63% versus 41%; p = 0.0013), remember to take tablets daily (75% versus 51%; p = 0.0004), remember tablets when away from home (72% versus 49%; p = 0008). Current LAI users were more likely than those on oral treatment to agree that LAIs keep patients out of hospital (76% versus 44%; p = 0.0001) and that the injection ensured delivery of the right amount of medication (71% versus 44%; p = 0.0002). Women were more likely than men to prefer administration by a clinician of the same gender (34% versus 12%; p = 0.0001). Conclusions: In our study, a greater proportion of patients prescribed an LAI regarded LAIs as beneficial compared with those on oral medication.

The Impact of Sociodemographic Factors and Emergency Admissions on the Place of Death of Gynecological Cancer Patients in England: An Analysis of a National Mortality–Hospital Episode Statistics–Linked Data Set

2018 ◽  
Vol 28 (9) ◽  
pp. 1714-1721
Author(s):  
Sonali Kaushik ◽  
Luke Hounsome ◽  
Catherine Blinman ◽  
Robert Gornall ◽  
Julia Verne
Keyword(s):  
Hospital Admissions ◽  
Gynecological Cancer ◽  
Sociodemographic Factors ◽  
Hospital Episode Statistics ◽  
Patient Choice ◽  
Place Of Death ◽  
Data Set ◽  
Emergency Admissions ◽  
Hospital Deaths ◽  
The Impact

ObjectiveThe aim of this study was to develop a predictive model for risk of death in hospital for gynecological cancer patients specifically examining the impact of sociodemographic factors and emergency admissions to inform patient choice in place of death.MethodsThe model was based on data from 71,269 women with gynecological cancer as underlying cause of death in England, January 1, 2000, to July 1, 2012, in a national Hospital Episode Statistics–Office for National Statistics database. Two thousand eight hundred eight deaths were used for validation of the model. Logistic regression identified independent predictors of a hospital death: adjusting for year of death, age group, income deprivation quintile, Strategic Health Authority, gynecological cancer site, and number of elective and emergency hospital admissions and respective total durations of stay.ResultsForty-three percent of deaths from gynecological cancer occurred in hospital. The variables significantly predicting death in hospital were less recent year of death (odds ratio [OR], 0.93; P < 0.001), increasing age (OR, 1.17; P < 0.001), increasing deprivation (OR, 1.06; P < 0. 001), increasing frequency and length of elective and emergency admissions (P < 0.001). The model correctly identified 73% of hospital deaths with a sensitivity of 75% and a specificity of 72%. The areas under the receiver operating curve were 0.78 for the predictive model and 0.71 for the validation data set. Each subsequent emergency admission in the last month of life increased the odds of death in hospital by 2.4 times (OR, 2.38; P < 0.001). Hospital deaths were significantly lower in all other regions compared with London. The model predicted a 16% reduction of deaths in hospital if 50% of emergency hospital admissions in the last month of life could be avoided by better community care.ConclusionsOur findings could enable identification of patients at risk of dying in hospital to ensure greater patient choice for place of death.

scholarly journals Global and Regional Burden of Hospital Admissions for Pneumonia in Older Adults: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 222 (Supplement_7) ◽  
pp. S570-S576 ◽  
Author(s):  
Ting Shi ◽  
Angeline Denouel ◽  
Anna K Tietjen ◽  
Jen Wei Lee ◽  
Ann R Falsey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hospital Admission ◽  
Disease Burden ◽  
Hospital Admissions ◽  
Case Fatality ◽  
Admission Rate ◽  
Case Definition ◽  
Hospital Admission Rate ◽  
Hospital Deaths

AbstractPneumonia constitutes a substantial disease burden among adults overall and those who are elderly. We aimed to identify all studies investigating the disease burden among older adults (age, ≥65 years) admitted to the hospital with pneumonia. We estimated the hospital admission rate and in-hospital case-fatality ratio (CFR) of pneumonia in older adults, stratified by age and economic status (industrialized vs developing), with data from a systematic review of studies published from 1996 through 2017 and from 8 unpublished population-based studies. We applied these rate estimates to population estimates for 2015 to calculate the global and regional burden in older adults who would have been admitted to the hospital with pneumonia that year. We estimated the number of in-hospital pneumonia deaths by combining in-hospital CFRs with hospital admission estimates from hospital-based studies. We identified 109 eligible studies; 73 used clinical pneumonia as the case definition, and 36 used radiologically confirmed pneumonia as the case definition. We estimated that, in 2015, 6.8 million episodes (uncertainty range [UR], 5.8–8.0 episodes) of clinical pneumonia resulted in hospital admissions of older adults worldwide. The hospital admission rate increased with advancing age and was higher in men. The total disease burden was likely underestimated when using the definition of radiologically confirmed pneumonia. Based on data from 52 hospital studies reporting data on pneumonia mortality, we estimated that about 1.1 million in-hospital deaths (UR, 0.9–1.4 in-hospital deaths) occurred among older adults. The burden of pneumonia requiring hospitalization among older adults is substantial. Appropriate prevention and management strategies should be developed to reduce its impact.

The health care burden of patients with epilepsy in the United States: an analysis of a nationwide database over 15 years

2012 ◽  
Vol 32 (3) ◽  
pp. E1 ◽  
Author(s):  
Andrew C. Vivas ◽  
Ali A. Baaj ◽  
Selim R. Benbadis ◽  
Fernando L. Vale
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
The United States ◽  
Average Hospital ◽  
Care Burden ◽  
Health Care Burden ◽  
The Us ◽  
Hospital Deaths ◽  
Patients With Epilepsy

Object The aim of this study was to analyze the national health care burden of patients diagnosed with epilepsy in the US and to analyze any changes in the length of stay, mean charges, in-hospital deaths (mortality), and disposition at discharge. Methods A retrospective review of the Nationwide Inpatient Sample (NIS) database for epilepsy admissions was completed for the years from 1993 to 2008. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with epilepsy were identified using ICD-9 codes beginning with 345.XX. Approximately 1.1 million hospital admissions were identified over a span of 15 years. Results Over this 15-year period (between 1993 and 2008), the average hospital charge per admission for patients with epilepsy has increased significantly (p < 0.001) from $10,050 to $23,909, an increase of 137.9%. This is in spite of a 33% decrease in average length of stay from 5.9 days to 3.9 days. There has been a decrease in the percentage of in-hospital deaths by 57.9% and an increase in discharge to outside medical institutions. Conclusions The total national charges associated with epilepsy in 2008 were in excess of $2.7 billion (US dollars, normalized). During the studied period, the cost per day for patients rose from $1703.39 to $6130.51. In spite of this drastic increase in health care cost to the patient, medical and surgical treatment for epilepsy has not changed significantly, and epilepsy remains a major source of morbidity.

scholarly journals Global hospital admissions and in-hospital mortality associated with all-cause and virus-specific acute lower respiratory infections in children and adolescents aged 5–19 years between 1995 and 2019: a systematic review and modelling study

2021 ◽  
Vol 6 (7) ◽  
pp. e006014
Author(s):  
Xin Wang ◽  
You Li ◽  
Xin Mei ◽  
Erin Bushe ◽  
Harry Campbell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Syncytial Virus ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Human Metapneumovirus ◽  
Parainfluenza Virus ◽  
Acute Lower Respiratory Infections ◽  
Hospital Deaths ◽  
Syncytial Virus ◽  
Human Parainfluenza Virus

IntroductionThe burden of acute lower respiratory infections (ALRI), and common viral ALRI aetiologies among 5–19 years are less well understood. We conducted a systematic review to estimate global burden of all-cause and virus-specific ALRI in 5–19 years.MethodsWe searched eight databases and Google for studies published between 1995 and 2019 and reporting data on burden of all-cause ALRI or ALRI associated with influenza virus, respiratory syncytial virus, human metapneumovirus and human parainfluenza virus. We assessed risk of bias using a modified Newcastle-Ottawa Scale. We developed an analytical framework to report burden by age, country and region when there were sufficient data (all-cause and influenza-associated ALRI hospital admissions). We estimated all-cause ALRI in-hospital deaths and hospital admissions for ALRI associated with respiratory syncytial virus, human metapneumovirus and human parainfluenza virus by region.ResultsGlobally, an estimated 5.5 million (UR 4.0–7.8) all-cause ALRI hospital admissions occurred annually between 1995 and 2019 in 5–19 year olds, causing 87 900 (UR 40 300–180 600) in-hospital deaths annually. Influenza virus and respiratory syncytial virus were associated with 1 078 600 (UR 4 56 500–2 650 200) and 231 800 (UR 142 700–3 73 200) ALRI hospital admissions in 5–19 years. Human metapneumovirus and human parainfluenza virus were associated with 105 500 (UR 57 200–181 700) and 124 800 (UR 67 300–228 500) ALRI hospital admissions in 5–14 years. About 55% of all-cause ALRI hospital admissions and 63% of influenza-associated ALRI hospital admissions occurred in those 5–9 years globally. All-cause and influenza-associated ALRI hospital admission rates were highest in upper-middle income countries, Asia-Pacific region and the Latin America and Caribbean region.ConclusionIncidence and mortality data for all-cause and virus-specific ALRI in 5–19 year olds are scarce. The lack of data in low-income countries and Eastern Europe and Central Asia, South Asia, and West and Central Africa warrants efforts to improve the development and access to healthcare services, diagnostic capacity, and data reporting.

Appropriateness and avoidability of terminal hospital admissions: Results of a survey among family physicians

2016 ◽  
Vol 31 (5) ◽  
pp. 456-464 ◽  
Author(s):  
Thijs Reyniers ◽  
Luc Deliens ◽  
H Roeline W Pasman ◽  
Robert Vander Stichele ◽  
Bart Sijnave ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Family Physicians ◽  
Acute Hospital ◽  
University Hospital ◽  
Academic Level ◽  
Hospital Deaths ◽  
Time Of Admission ◽  
Acute Hospital Setting

Background: Although the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life. Aim: To examine what proportion of terminal hospital admissions among their patients family physicians consider to have been avoidable and/or inappropriate; which patient, family physician and admission factors are associated with the perceived inappropriateness or avoidability of terminal hospital admissions; and which interventions could have prevented them, from the perspective of family physicians. Design: Survey among family physicians, linked to medical record data. Setting: Patients who had died non-suddenly in the acute hospital setting of a university hospital in Belgium between January and August 2014. Results: We received 245 completed questionnaires (response rate 70%) and 77% of those hospital deaths ( n = 189) were considered to be non-sudden. Almost 14% of all terminal hospital admissions were considered to be potentially inappropriate, almost 14% potentially avoidable and 8% both, according to family physicians. The terminal hospital admission was more likely to be considered potentially inappropriate or potentially avoidable for patients who had died of cancer, when the patient’s life expectancy at the time of admission was limited, by family physicians who had had palliative care training at basic, postgraduate or post-academic level, and when the admission was initiated by the patient, partner or other family. Conclusion: Timely communication with the patient about their limited life expectancy and the provision of better support to family caregivers may be important strategies in reducing the number of hospital deaths.

scholarly journals Hospitalizations due to self-inflicted injuries - Brazil, 2002 to 2013

2015 ◽  
Vol 20 (3) ◽  
pp. 689-699 ◽  
Author(s):  
Rosane Aparecida Monteiro ◽  
Camila Alves Bahia ◽  
Eneida Anjos Paiva ◽  
Naíza Nayla Bandeira de Sá ◽  
Maria Cecília de Souza Minayo
Keyword(s):  
Health System ◽  
Suicidal Behavior ◽  
Hospital Admissions ◽  
Descriptive Study ◽  
Vulnerable Groups ◽  
Prevention Strategies ◽  
Factors Associated ◽  
Unified Health System ◽  
Hospital Deaths ◽  
Observational Descriptive Study

The scope of this article is to describe hospitalizations resulting from intentionally self-inflicted injuries attended by the Unified Health System (SUS) for the 2002-2013 period. It is an observational, descriptive study of hospital admissions in the SUS arising from intentionally self-inflicted injuries in Brazil between 2002 and 2013. A decreasing trend was observed for the rate of hospitalization in individuals aged 10 and above. Hospitalizations were concentrated between 30 to 49 years of age for men, while for women it was between 20 to 29 years of age. The highest rates of hospitalization and hospital deaths were in the Southeast. The main cause of hospitalization was intentional intoxication with medication and unspecified biological substances. Studies of this type provide input for defining prevention strategies taking into consideration the most vulnerable groups and the complexity of factors associated with suicidal behavior.

Sign in / Sign up

Export Citation Format

Share Document