COVID-19 Infection Epidemic in the South Pacific Island of New Caledonia and in the Greater Paris: Where Is the Highest Wave?

2021 ◽  
pp. 101053952110146
Author(s):  
Elisabeth Merlin ◽  
Laurent Goix ◽  
Caroline Moret ◽  
Tomislav Petrovic ◽  
Frédéric Langeron ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Health Care System ◽  
New Caledonia ◽  
South Pacific ◽  
Medical System ◽  
Emergency Medical System ◽  
Mobile Intensive Care Unit

Introduction New-Caledonia, an island located in the South-Pacific, was the first (overseas) French country hit by the coronavirus disease-2019 (COVID-19) pandemic to come out of lockdown. The epidemic was rapidly controlled. Analyzing the impact of an epidemic only makes sense if it is compared with a zone with a similar health care system. Objective To compare epidemic evolution in New-Caledonia and Paris suburb. Methods Health care organization is similar in New-Caledonia and Seine-Saint-Denis, based on an Emergency Medical System call center. We recorded the numbers of patients managed by SAMU (Service d’Aide Médicale Urgente)-Emergency Medical System, transferred to the emergency department and managed in prehospital setting by mobile intensive care unit. We compared these parameters during the reference (February 1-23, 2020) and the COVID-19 (February 24, 2020, to April 19, 2020) periods. Primary end-point: number of days over the 95th percentile of the reference period. Results Number of patients managed was over the 95th percentile during 27 and 47 days in New-Caledonia and Seine-Saint-Denis, respectively. Number of emergency department transfers was more than the 95th percentile during 4 and 31 days, respectively. Number of mobile intensive care unit sent was over the 95th percentile during 3 and 14 days, respectively. Peaks were similar. Conclusion The duration of the critical period rather than its spread affected the health care system.

scholarly journals Health-care system distrust in the intensive care unit

2012 ◽  
Vol 27 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Yael Schenker ◽  
Douglas B. White ◽  
David A. Asch ◽  
Jeremy M. Kahn
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care System ◽  
Care System

scholarly journals Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization

2020 ◽  
Vol 29 (4) ◽  
pp. 311-317
Author(s):  
Patricia S. Andrews ◽  
Sophia Wang ◽  
Anthony J. Perkins ◽  
Sujuan Gao ◽  
Sikandar Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Health Care Utilization ◽  
Mortality Risk ◽  
Hazard Ratio ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Increased Risk

Background Critical care patients with delirium are at an increased risk of functional decline and mortality long term. Objective To determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge. Methods A secondary data analysis of the Pharmacological Management of Delirium and Deprescribe randomized controlled trials. Patients were assessed twice daily for delirium or coma using the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Delirium severity was measured using the CAM-ICU-7. Mean delirium severity (from time of randomization to discharge) was categorized as rapidly resolving, mild to moderate, or severe. Cox proportional hazards regression was used to model time to death, first emergency department visit, and rehospitalization. Analyses were adjusted for age, sex, race, Charlson Comorbidity Index, Acute Physiology and Chronic Health Evaluation II score, discharge location, diagnosis, and intensive care unit type. Results Of 434 patients, those with severe delirium had higher mortality risk than those with rapidly resolving delirium (hazard ratio 2.21; 95% CI, 1.35-3.61). Those with 5 or more days of delirium or coma had higher mortality risk than those with less than 5 days (hazard ratio 1.52; 95% CI, 1.07-2.17). Delirium severity and number of days of delirium or coma were not associated with time to emergency department visits and rehospitalizations. Conclusion Increased delirium severity and days of delirium or coma are associated with higher mortality risk 2 years after discharge.

scholarly journals Intensive Care Unit Admitting Patterns in the Veterans Affairs Health Care System

2012 ◽  
Vol 172 (16) ◽  
pp. 1220 ◽  
Author(s):  
Lena M. Chen ◽  
Marta Render ◽  
Anne Sales ◽  
Edward H. Kennedy ◽  
Wyndy Wiitala ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care System ◽  
Veterans Affairs ◽  
Care System

scholarly journals The role of culture in quality improvement in the intensive care unit: A literature review

2013 ◽  
Vol 2 (2) ◽  
pp. 97 ◽  
Author(s):  
Kim Lam Soh ◽  
Kim Geok Soh ◽  
Patricia M Davidson
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Literature Review ◽  
Health Care System ◽  
Power Relationships ◽  
Cultural Systems ◽  
Quality Of Patient Care ◽  
Care System

Improving the quality of patient care and patient outcomes is a major concern internationally.  In a developing health care system, implementing quality improvement is challenging due not only to resource and workforce issues but also cultural factors.  Using the method of a focussed literature review, this paper discusses the importance of assessing a societal view of culture, social mores and customs, and power relationships in quality improvement activities using the intensive care unit as an exemplar.   We conclude that implementing quality improvement strategies in a developing health care system needs to address the broader perspectives of social and cultural systems particularly hierarchical relationships and issues of non-disclosure. 

Impact of an Intensive Care Unit Telemedicine Program on a Rural Health Care System

2009 ◽  
Vol 121 (3) ◽  
pp. 160-170 ◽  
Author(s):  
Edward T. Zawada ◽  
Patricia Herr ◽  
Deanna Larson ◽  
Robert Fromm ◽  
David Kapaska ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Rural Health ◽  
Health Care System ◽  
Rural Health Care ◽  
Care System

Impact of an Intensive Care Unit Telemedicine Program on Patient Outcomes in an Integrated Health Care System

2014 ◽  
Vol 174 (7) ◽  
pp. 1160 ◽  
Author(s):  
Boulos S. Nassar ◽  
Mary S. Vaughan-Sarrazin ◽  
Lan Jiang ◽  
Heather S. Reisinger ◽  
Robert Bonello ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Health Care System ◽  
Integrated Health Care ◽  
Integrated Health ◽  
Integrated Health Care System ◽  
Care System

scholarly journals Potential Intensive Care unit Ventilator Demand/Capacity Mismatch due to Novel Swine-Origin H1N1 in Canada

2009 ◽  
Vol 20 (4) ◽  
pp. e115-e123 ◽  
Author(s):  
Paul Smetanin ◽  
David Stiff ◽  
Anand Kumar ◽  
Paul Kobak ◽  
Ryan Zarychanski ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Prevention ◽  
Health Care System ◽  
Attack Rate ◽  
H1n1 Virus ◽  
Prevention Measures ◽  
Icu Patients ◽  
Second Wave

PURPOSE: To investigate the ability of Canadian intensive care units (ICUs) and ventilators to handle widespread re-emergence of the swine-origin H1N1 virus in the context of an aggressive strategy of vaccination.METHOD: Data collected during the first wave in Winnipeg, Manitoba, were applied to a variety of second wave pandemic models to determine potential ICU and ventilator demand.RESULTS: For attack rates greater than 20% to 25%, significant shortages in ventilators may be expected across Canada regardless of the duration of the pandemic if vaccination is not considered. The shortfall arises largely due to the extended durations that patients must remain on ventilation. From the Winnipeg study, 50% of patients required ventilation for more than two weeks. For larger attack rates of 35%, ventilator demand may exceed capacity for over five weeks, with a peak shortfall of 700 ventilators. Vaccination can significantly reduce the attack rates, and is expected to reduce ventilator demand to manageable levelsCONCLUSION: Canada’s health care system must be prepared for the possibility of a significant influx of ICU patients during the second wave of swine-origin H1N1. Efficient vaccination and other disease prevention measures can reduce the attack rate to manageable levels.

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