Abstract P172: What Facilities Reserve Public Access Defibrillation Programs? A Suvey from a Japanese Metropolis

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hiroshi Kaneko ◽  
Tetsuo Hatanaka ◽  
Aki Nagase ◽  
Hiroko Noguchi ◽  
Tetsuya Sakamoto ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Average Length ◽  
Age Distribution ◽  
Cost Effective ◽  
Fire Service ◽  
Incidence Rates ◽  
Public Access ◽  
Public Access Defibrillation ◽  
Average Length Of Stay ◽  
Pass Through

Previous reports have described several facility categories as important locations for public access defibrillation (PAD) program. However, in decision-making process as to what specific facilities may deserve PAD programs, each facility needs to estimate the number of shockable cardiac arrest (CA). Such estimation depends not only on the expected number of visitors/workers but also on the profile of the visitors/workers, which may vary among types of facilities. [Methods] Nagoya City has a population of 2.2 million with ~2,000 CA annually. Locations of CA were abstracted from data collected by Nagoya FD from 2003 through 2007. Types of public facilities were tallied and grouped into 36 categories consistent with Ordinance for Enforcement of Fire Service Act, and the number of CA within each category was determined. Data on the number of visitors/workers in each category were collected from governmental databases on metropolitan statistics. The incidence rate was calculated as numbers of all CA and CA with VF per 1 billion person.year. [Results] In 8 location categories, the databases for CA and the database for numbers of visitors/workers coincided in the categorization rules of the locations. The incidence rates are shows in the table . [Discussion] The incidence rate of shockable CA varies substantially among the location categories, presumably reflecting the variations of age distribution, average length of stay and intensity of physical activities of people who gather there. Schools (teachers) and factories have the highest incidence of shockable CA. However, our data may indicate that a school with small numbers of workers (teachers) may have a low priority of a PAD program. On the contrary, a station with low incidence rate of 0.05 may be a preferred target of a PAD program if a large number of travelers are expected to pass through. Thus our study provides fundamental data to detect important and cost-effective target locations of a PAD program. Number of CA per 1 billion preson.year

scholarly journals The incidence of pneumonia in the paediatric population in Poland in light of the maps of health needs

2021 ◽  
Author(s):  
Joanna Lange ◽  
Jerzy Kozielski ◽  
Kinga Bartolik ◽  
Paweł Kabicz ◽  
Tomasz Targowski
Keyword(s):  
Average Length ◽  
Age Groups ◽  
Paediatric Population ◽  
Incidence Rates ◽  
Education Development ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Social Fund ◽  
Hospital Deaths ◽  
Reported Data

Abstract In Poland, no statistical data are available concerning the analysis of the incidence of pneumonia in inpatient children. The requirement for these data results mainly from the need to prepare systemic and economic solutions. Aim This study aimed to use reported data for evaluating pneumonia incidence rates among hospitalised children and other parameters in various age groups. Subject and methods A detailed analysis was performed as part of the Operational Programme Knowledge Education Development co-financed by the European Social Fund. Services reported to the National Health Fund in 2014 were considered, including pneumonia incidence among hospitalised children and mortality in specific age groups. Results In 2014, a total of 68,543 children were hospitalised for pneumonia (68% of all hospitalisations for acute respiratory diseases). Within each of the analysed age groups, boys were hospitalised more frequently. Irrespective of the place of residence, infants were most commonly hospitalised. It was observed that there was a significant difference between the incidence rate of pneumonia among hospitalised children in all analysed groups depending on the province. The average length of stay was 7.29 days, with infants requiring the longest stays (7.96 days), and 1.8% of children were rehospitalised within 30 days due to recurrence of pneumonia. The most commonly coded pathogens responsible for pneumonia included Mycoplasma pneumoniae, Streptococcus pneumoniae and Chlamydia spp. A total of 19 inpatient hospital deaths in the course of pneumonia were reported. Conclusions Based on our findings, it is warranted to utilize epidemiological knowledge for the planning of an appropriate level of service commissioned both in outpatient and inpatient facilities as well as for the estimation of institutional and staff needs necessary to secure these services.

P6563Time trends in incidence rates of atrial fibrillation in Norway 2004–2014. A CVDNOR project

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L J Kjerpeseth ◽  
J Igland ◽  
R Selmer ◽  
H Ellekjaer ◽  
T Berge ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Incidence Rate ◽  
Cause Of Death ◽  
Adult Population ◽  
Age Distribution ◽  
Age Groups ◽  
Incidence Rates ◽  
Hospital Death ◽  
Secondary Diagnosis ◽  
Norwegian Population

Abstract Background The reported incidence and prevalence of atrial fibrillation (AF) has been inconsistent among studies. Purpose We aimed to study time trends in incidence (first time) of AF hospitalizations or AF deaths in Norway in the period 2004–2014 by age and sex. Methods Nationwide hospital discharge diagnoses in the Cardiovascular Disease in Norway (CVDNOR) database and in the National Patient Registry were linked to the National Cause of Death Registry. All hospitalizations with AF as primary or secondary diagnosis and out-of-hospital deaths with AF as underlying cause (ICD-9: 427.3 or ICD 10: I48; AF or atrial flutter) in individuals ≥18 years were obtained during 1994–2014. Incident AF was defined as first hospitalization or out-of-hospital death due to AF with no previous hospitalization for AF the past 10 years. Age-standardized incidence rates with 95% confidence intervals (CIs) were calculated using direct standardization to the age-distribution in the Norwegian population per Jan 1st 2004. Age-adjusted average yearly incidence rate ratios (IRR) with 95% CIs were estimated by Poisson regression analyses. Accumulated prevalence during 1994–2014 was assessed in Norwegian residents 18 years and older per Dec 31st 2014. Results During 39,865,498 person years of follow up from 2004 to 2014 we identified 175,979 incident AF cases of which 30% were registered with AF as primary diagnosis, 69% as secondary diagnosis and 1% as out-of-hospital cause of death. The age-standardized incidence rate of AF hospitalization or out-of-hospital death per 100,000 person years was stable at 433 (426–440) in 2004 and 440 (433–447) in 2014. IRR were stable or declining across age groups of both sexes, except for the youngest age group 18–44 years, where incidence rates of AF hospitalization or out-of-hospital death increased by 2% per year, IRR 1.02 (1.01, 1.03). By 2014, the prevalence of AF assessed from hospital or death records was 2.9% in the adult population 18 years and older. Conclusion We found overall stable incidence rates of AF from 2004 to 2014 in the adult Norwegian population. Increased incidence rates of AF in the population 18–44 years are worrying and need further investigation. Acknowledgement/Funding The Norwegian Atrial Fibrillation Reseach Network

scholarly journals PECULIARITIES OF TREATING PATIENTS WITH CARDIAC SURGICAL PROFILE WITH INFECTIOUS COMPLICATIONS AFTER STERNOTOMY BY VAC THERAPY

2020 ◽  
pp. 120-123
Author(s):  
V. V. Boyko ◽  
Ya. V. Shafer ◽  
O. V. Buchneva
Keyword(s):  
Average Length ◽  
Median Sternotomy ◽  
Cost Effective ◽  
Infectious Complications ◽  
Treatment Results ◽  
Standard Methods ◽  
Vac Therapy ◽  
Average Length Of Stay ◽  
Results Of Treatment ◽  
Cost Effective Method

Summary. Infectious complications from the sternotomic wound in patients with a cardiac surgical profile are a very threatening factor that prolongs hospitalization, disability, and sometimes leads to death The aim. Improving the results of treatment of patients with cardiac surgical profile with on infectious complications of sternotomy wounds using by VAC-therapy. Materials and methods. The treatment results are analyzed with the help of VAC-therapy in 14 patients from 2015 to 2018 year inclusive, where there were complications after performing longitudinal median sternotomy. Results and discussion. In 100% of patients, a positive result was achieved. The average length of stay of patients in the clinic who used VAC-therapy was 15 ± 6.5 days, which is half that when treating identical wounds with standard methods. Conclusions. Treatment of infectious complications of longitudinal median sternotomy with the help of VAC-therapy is a safe, effective and cost-effective method in patients with cardiac surgery.

scholarly journals Assessment of performance of services in a tertiary care Neuropsychiatric Institute using Pabon Lasso Model

2016 ◽  
Vol 7 (6) ◽  
pp. 69-74 ◽  
Author(s):  
Chandra Bhushan Tripathi ◽  
Rajesh Kumar ◽  
Ramesh Chandra Sharma ◽  
Rachna Agarwal
Keyword(s):  
Tertiary Care Hospital ◽  
Average Length ◽  
Tertiary Care ◽  
Cost Effective ◽  
Care Hospital ◽  
Bed Occupancy ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Quantitative Performance

Background: The objective of the study to assess optimal utilisation of hospital facilities &  evaluate their performance in a tertiary care hospital using Pabon Lasso Model using indicators- bed turnover (BTO), bed occupancy rate (BOR) and average length of stay (ALS).Aims and Objective: To assess optimal utilisation of hospital facilities various wards catering to psychiatric, neurological and neurosurgery services in a tertiary care hospital using Pabon Lasso model and to identify strategies for more efficient use of the existing health service resources.Materials and Methods: This cross-sectional descriptive study was carried out in 2015 at the Institute of Human Behaviour and Allied Sciences, Delhi, India. This study involved various wards catering to psychiatric, neurological and neurosurgery facilities in the institute. Their performance was evaluated over 8 year period (2007- 2014) using three performance indicators (BTO, BOR & ALS) to assess optimal utilisation of hospital facilities.Results: Psychiatry department was initially located in quadrant IV in 2007 & shifted to quadrant III in 2014 which suggests department’s good quantitative performance with small proportion of unused beds. Similarly Neurosurgery department was in quadrant I at its inception in 2010, but shifted to quadrant III in 2014. However, Neurology department was located in quadrant III initially (2007), but shifted to quadrant II indicating either excess bed supply or less need for utilisation.Conclusion: Pabon Lasso model can be used by hospital management for evaluating the performance of health services in cost effective manner.Asian Journal of Medical Sciences Vol.7(5) 2016 69-74

scholarly journals STARR surgery in treatment of SRUS: an observational study on clinical outcomes

2018 ◽  
Vol 5 (2) ◽  
pp. 507
Author(s):  
Ashwin Porwal ◽  
Paresh Gandhi ◽  
Deepak Kulkarni
Keyword(s):  
Length Of Stay ◽  
Staple Line ◽  
Average Length ◽  
Cost Effective ◽  
Excessive Bleeding ◽  
Patient’S Satisfaction ◽  
Average Length Of Stay ◽  
Post Surgery ◽  
Postoperative Length ◽  
History Of

Background: SRUS is a condition with inadequately learned pathogenesis and usually associated with disorders of pelvic floor. Commonly seen in young adults and impairs quality of life. Because of these facts the management of SRUS is difficult and there is no clear consensus over it.Methods: An observational, prospective study was planned at a single center with purposive sampling. All clinically diagnosed, histologically and endoscopically confirmed SRUS patients treated with STARR surgery and followed for two years. Data collected and analyzed to evaluate the effectiveness and patients satisfaction.Results: Total of 46 patients with median age 47.8 years; of which 27 (58.70%) were females underwent STARR surgery. The average procedure time was 40 minutes, average length of stay was 24 hours and minimum duration of follow up was about 2 years (range 2-4 years). All patients had a pre-surgery history of digitations, which resolved in 91.3% patients post-surgery. There was a significant improvement in the ODS scores at the end of 2 years (82%; P <0.001). Excessive bleeding from staple line (48.57%), staple line dehiscence in 34.28% and staple line stricture (15.71% all males) are complications observed. No recurrence reported at the end of 4 years.Conclusions: Short postoperative length of stay and the short time to return to work after the STARR procedure for management SRUS, minimal manageable complications, no recurrence and patient’s satisfaction makes STARR a cost-effective procedure. 

Implementing a guideline for acute tonsillitis using an ambulatory medical unit

2019 ◽  
Vol 133 (05) ◽  
pp. 386-389
Author(s):  
C Perkins ◽  
F Ray Brown ◽  
K Pohl ◽  
O McLaren ◽  
J Powles ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Retrospective Review ◽  
Average Length ◽  
Significant Proportion ◽  
Cost Effective ◽  
Effective Intervention ◽  
Acute Tonsillitis ◽  
Medical Unit ◽  
Average Length Of Stay ◽  
Safe Management

AbstractObjectiveAcute tonsillitis represents a significant proportion of admissions to ENT departments nationally. Given current hospital pressures, it is vital to look for safe alternatives to admission. This study explores the safe management of patients in an ambulatory medical unit, without the need for admission.MethodsA retrospective review of 48 patients’ notes was carried out. Following the development and implementation of a guideline for acute tonsillitis, a prospective re-audit of 41 patients was carried out, measuring length of stay, overnight admissions and re-admissions.ResultsThe rate of overnight admission following implementation of the guideline fell from 0.75 to 0.29, and average length of stay dropped from 19.2 to 9.5 hours. There were two re-admissions in each cycle of the audit, which represents a non-significant increase.ConclusionThe tonsillitis guideline has significantly reduced admissions and length of stay. Re-admissions remain low, demonstrating that this is a safe and cost-effective intervention.

scholarly journals 752 Routine In-Hospital Radiographs Following Anterior Cervical Discectomy and Fusion Surgery: Neither Necessary nor Cost-Effective?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R McCabe ◽  
J Davis ◽  
M Grainger
Keyword(s):  
Average Length ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Additional Cost ◽  
Fusion Surgery ◽  
X Ray ◽  
Average Length Of Stay ◽  
Operative Complications ◽  
Clinical Purpose ◽  
Unnecessary Radiation

Abstract Aim To evaluate whether a post-operative radiograph of the cervical spine before discharge is either clinically justified or cost-effective in patients who have undergone an ACDF, despite having satisfactory intra-operative imaging. Method A retrospective review of 101 ACDF patients from a single neurosurgical centre. 78 had an in-hospital post-operative radiograph, 23 did not. In 95 of these, it was documented that there was ‘satisfactory intra-operative imaging’. All patients had intra-operative imaging of completed instrumentation. Any post-operative complications were noted, and the length of hospital stay (LOS) recorded. Study parameters also included: levels operated on, whether or not a plate was used with a cage, additional costings to the hospital. Results There was one post-operative complication relating to the metalwork in the 101 patients. However, the decision to perform this x-ray was based purely on the deteriorating post-operative clinical picture. In the cohort that had POXR’s, the average length of stay was 66.7 hours. Without POXR, it was 21 hours. The additional cost to the trust of performing the in-hospital radiographs was calculated to be £71,523 per year. Conclusions In patients who undergo ACDF surgery with an uneventful post-operative course and satisfactory intra-operative imaging, in-hospital post-operative radiographs serve no clinical purpose and delay discharge. This gives additional cost to the trust, unnecessary radiation exposure and occupies potential bedspace.

Incidence and prevalence of synovial sarcoma in the US: An analysis using SEER*Stat.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e22535-e22535
Author(s):  
Nedra Joseph ◽  
Samantha St. Laurent ◽  
Jeanenne Joy Nelson ◽  
Shan Zheng ◽  
Heide Stirnadel-Farrant
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Incidence Rate ◽  
Synovial Sarcoma ◽  
Disease Burden ◽  
Age Distribution ◽  
Incidence Rates ◽  
Cancer Statistics ◽  
The Us ◽  
Incident Cases

e22535 Background: Synovial sarcoma (SS) is a rare and aggressive soft tissue sarcoma which primarily affects the extremities of the arms and legs, and can also occur in the head and neck, lungs and pleura, and the trunk. The disease burden of SS is generally extrapolated from overall soft tissue sarcoma (STS) with SS accounting for 4.5% of all STS (587 cases estimated in 2018 in the US) (Noone, 2018; Siegel, 2018). The objective of this study was to provide disease burden estimates specific to SS in the US. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries, Nov. 2017 (2000-2015) were analyzed using SEER*Stat software (v8.3.5). The incidence and prevalence of SS was estimated by utilizing SS-specific International Classification of Diseases for Oncology, V.3 (ICD-O-3) and histology codes. Data from 2011-2015 were used to project incidence rates (age-specific and age-adjusted), 5-year limited duration prevalence, number of incidence and prevalent cases, and the age distribution of synovial sarcoma for 2018. Results: In the US, the age-adjusted incidence rate of SS was 0.177 per 100,000 (estimated 580 incident cases) in 2018. SS is more frequently manifested in patients aged 20-49 years, with the highest occurrence of new cases in patients between 45-49 years (incidence rate 0.26 per 100,000). The prevalence rate of SS across all ages was 0.65 per 100,000 (estimated 2129 prevalent cases) as of January 1, 2018. Conclusions: We described incidence and prevalence rates of SS, including age-specific and age-standardized rates, and characterized the age distribution of SS. This approach provided more precise estimates that are specific to SS without extrapolation from STS, and which are not available in the literature. References: Noone AM, et al. (ed). SEER CSR, 1975-2015, https://seer.cancer.gov/csr/1975_2015/ . Siegel RL, et al. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7–30.

Hospital Utilization by Children

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 797-799
Author(s):  
A. Frederick North
Keyword(s):  
Average Length ◽  
Age Distribution ◽  
The United States ◽  
Hospital Utilization ◽  
Population Projections ◽  
Pediatric Care ◽  
Admission Rates ◽  
Average Length Of Stay ◽  
Hospitalization Rates ◽  
Future Needs

There is little support from available data for the hypothesis that better pediatric care is keeping children out of hospitals. The available data suggest that the observed reduction in hospital utilization by children is largely the result of the changed age distribution of the child population of the United States. Slight reductions in age-specific utilization rates appear to be entirely the result of reduced average length of stay in the hospital following admission which were not offset by slightly increasing admission rates. Those responsible for planning hospital facilities for children should not base predictions for future needs on the apparent trend to lower hospitalization rates for children. Unless further data establish that such trends are real, rather than a manifestation of changed demography, planners will be most prudent if they estimate future needs by applying current age-specific rates to future age-specific population projections.

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