scholarly journals Admissions to Norwegian Hospitals during the COVID-19 Pandemic

2021 ◽  
pp. 140349482110008 ◽  
Author(s):  
Jon Helgeland ◽  
Kjetil E. Telle ◽  
Mari Grøsland ◽  
Beate M. Huseby ◽  
Siri Håberg ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Age Groups ◽  
Admission Rate ◽  
Well Being ◽  
Future Research ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Individual Level ◽  
Admission Rates ◽  
Level Information

Background: In mid-March 2020, the Norwegian government implemented measures to contain the coronavirus disease 2019 (COVID-19) pandemic, and hospitals prepared to handle an unpredictable inflow of patients with COVID-19. Aim: The study was performed to describe the changes in hospital admissions during the first phase of the pandemic. Methods: The Norwegian Institute of Public Health established a national preparedness register with daily updates on COVID-19 cases and the use of health services. We used individual-level information on inpatients from the electronic journal systems for all hospitals in Norway to estimate daily hospital admissions. Results: Before the onset of the pandemic in March, there was an average of 2400 inpatient admissions per day in Norway, which decreased to approximately 1500 in the first few days after lockdown measures were implemented. The relative magnitudes of the decreases were similar in men and women and across all age groups. The decreases were substantial for both elective (54%) and emergency (29%) inpatient care. The admission rate gradually increased and reached pre-pandemic levels in June. However, the reductions in admissions for pneumonia and chronic obstructive pulmonary disease seemed to persist. Conclusions: The elective and emergency inpatient admission rates were substantially reduced a few days after the pandemic response measures were implemented. The ways in which the lack or postponement of care may have affected the health and well-being of patients is an important issue to be addressed in future research.

scholarly journals Trends in Hospital Admissions for Chronic Obstructive Pulmonary Disease in Men and Women in SPAIN, 1998 to 2018

2021 ◽  
Vol 10 (7) ◽  
pp. 1529
Author(s):  
Domingo Orozco-Beltrán ◽  
Juan Manuel Arriero-Marin ◽  
Concepción Carratalá-Munuera ◽  
Juan J. Soler-Cataluña ◽  
Adriana Lopez-Pineda ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Chronic Obstructive ◽  
Annual Percent Change ◽  
Data Set ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Admission Rates ◽  
Percent Change

The prevalence of chronic obstructive pulmonary disease (COPD) is rising faster in women in some countries. An observational time trends study was performed to assess the evolution of hospital admissions for COPD in men and women in Spain from 1998 to 2018. ICD-9 diagnostic codes (490–492, 496) from the minimum basic data set of hospital discharges were used. Age-standardised admission rates were calculated using the European Standard Population. Joinpoint regression models were fitted to estimate the annual percent change (APC). In 2018, the age-standardised admission rate per 100,000 population/year for COPD was five times higher in men (384.8, 95% CI: 381.7, 387.9) than in women (78.6, 95% CI: 77.4, 79.9). The average annual percent change (AAPC) was negative over the whole study period in men (−1.7%/year, 95% CI: −3.1, −0.2) but positive from 2010 to 2018 (1.1%/year, 95% CI: −0.8, 2.9). In women, the APC was −6.0% (95%CI: −7.1, −4.9) from 1998 to 2010, but the trend reversed direction in the 2010–2018 period (7.8%/year, 95% CI: 5.5, 10.2). Thus, admission rates for COPD decreased from 1998 to 2010 in both men and women but started rising again until 2018, modestly in men and sharply in women.

scholarly journals Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)

2021 ◽  
Author(s):  
Sergio Palacios Fernández ◽  
Mario Salcedo ◽  
Gregorio Gonzalez-Alcaide ◽  
Jose-Manuel Ramos-Rincon
Keyword(s):  
Length Of Stay ◽  
Elderly Patients ◽  
Hospital Admissions ◽  
Age Groups ◽  
Chronic Obstructive ◽  
Percentage Increase ◽  
Very Elderly ◽  
Data Set ◽  
Obstructive Pulmonary Disease ◽  
Neck Fracture

Abstract Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in very elderly inpatients (≥ 85 years) in Spain from 2000 to 2015.Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends.Results There were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3% to 39.7%, p<0.001), and they had a higher risk of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p<0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). Conclusions The very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. M ean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.

scholarly journals Defining, quantifying, and characterizing adult frequent users of a suburban Canadian emergency department

CJEM ◽  
2013 ◽  
Vol 15 (04) ◽  
pp. 214-226 ◽  
Author(s):  
Jessica Moe ◽  
Allan L. Bailey ◽  
Ryan Oland ◽  
Linda Levesque ◽  
Heather Murray
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Administrative Database ◽  
Fiscal Year ◽  
Future Research ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Frequent Users ◽  
Targeted Interventions ◽  
Admission Rates

ABSTRACTIntroduction:Frequent emergency department (ED) users are inconsistently defined and poorly studied in Canada. The purpose of this study was to develop uniform definitions, quantify ED burden, and characterize adult frequent users of a suburban community ED.Methods:We retrospectively reviewed the administrative database of the WestView ED in Alberta for patients ≥ 18 years of age presenting during the fiscal year of 2010. Adult frequent users and extreme frequent users were defined as patients with yearly visit numbers greater than the 95th and 99th percentiles, respectively. Demographic information including age, sex, ED length of stay, diagnoses, Canadian Triage and Acuity Scale (CTAS) level, and disposition were collected and stratified by ED frequency of use categories.Results:The study included 22,333 ED visits by 14,223 patients. Frequent users represented 3.1% of patients and 13.8% of visits. Extreme frequent users represented 0.8% of patients, 5.4% of visits, and 568,879 cumulative ED minutes (395 days). Nonfrequent users had one to four, frequent users had five or more, and extreme frequent users had eight or more visits over a 12-month period. Frequent users and extreme frequent users had a significantly longer ED length of stay overall and in most age categories. Alcohol-related behavioural disorders, anxiety, nausea/vomiting, and chronic obstructive pulmonary disease were prominent diagnoses, suggesting that psychiatric, somatic, and chronic illnesses may underlie recurrent visits. Admission rates were significantly higher for frequent compared to nonfrequent users.Conclusions:We propose reproducible definitions for adult frequent and extreme frequent ED users and provide information on the characteristics and burden of care of these groups at a community Canadian suburban ED. Adoption of these definitions would allow comparison across centres in future research and facilitate targeted interventions for frequent and extreme frequent ED users.

scholarly journals A Longitudinal Trajectory of Loneliness and the COVID-19 Pandemic Among the Oldest-Old Population

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1029-1029
Author(s):  
Jinmyoung Cho ◽  
Shinae Choi ◽  
Gelareh Rahimighazikalayeh ◽  
Peter Martin ◽  
Melinda Heinz ◽  
...  
Keyword(s):  
Linear Models ◽  
Oldest Old ◽  
Age Groups ◽  
Well Being ◽  
Longitudinal Change ◽  
Future Research ◽  
Old Adults ◽  
Individual Level ◽  
Younger Age ◽  
The Individual

Abstract Loneliness is significantly associated with health and well-being among oldest-old adults. Due to the outbreak of the COVID-19, physical and social distancing policies might elevate loneliness among the oldest-old population. This study examined the trends and changes in the prevalence of feeling lonely using the 2020 HRS COVID-19 module merged to the 15 waves of the HRS RAND longitudinal datasets from 1992 to 2018. A total of 14,371 respondents, including 614 respondents aged 80 years and older were included. Generalized linear models compared age group differences within the 2020 module. Generalized estimating equations assessed the longitudinal change at the individual level and the trend of feeling loneliness among oldest-old adults from 1992 to 2020. Loneliness was assessed with one item of the CES-D scale (i.e., during the past week, felt lonely). After adjusting for demographic characteristics and health, the results showed that oldest-old adults were more likely to feel lonely compared to younger age groups (18% for 80’s vs. 14% for 50’s) during the early months of the pandemic. A longitudinal trajectory also showed that they feel lonelier than in prior years (19% in 2020 vs. 14% in 2018). However, compared to same-age groups from earlier years, a significantly lower prevalence of feeling lonely was observed (18% in 2020 vs. 27% in 1994). The results show that the outbreak of the COVID-19 may elevate feeling lonely, but the recent cohorts be less lonely than earlier cohorts. Future research should continue to explore protective factors for loneliness among oldest-old adults.

scholarly journals The risk of severe COVID-19: hospital and ICU admission rates in Norway

2020 ◽  
Author(s):  
Morten Munkvik ◽  
Ingvild Vatten Alsnes ◽  
Lars Vatten
Keyword(s):  
Hospital Admissions ◽  
Age Groups ◽  
Admission Rate ◽  
Epidemiological Studies ◽  
Population Based ◽  
Western Region ◽  
Eastern Region ◽  
Detailed Data ◽  
Admission Rates ◽  
Restrictive Measures

Background: Epidemiological studies of COVID-19 with population based information may add to the knowledge needed to prioritise resources and advice on how restrictive measures should be targeted. This study provides admission rates to hospitals and intensive care units (ICU) in Norway, aiming to better understand the risk of severe COVID-19 infection. Methods: Data from official reports from The Norwegian Institute of Public Health (NIPH) and the Norwegian Directorate of Health were used to calculate admission rates to hospitals and to ICU per 100 000 inhabitants. We compared rates of hospitalisation between the four health regions and provide separate rates for Oslo. We also assessed national admissions to ICU stratified by age. Results: The admission rate in the south-eastern region was 3.1 per 100 000, and the rate for Oslo was 5.8. Compared to the western region (reference), the Oslo rate was 4.0 times (confidence interval (CI) 3.0-5.5) higher. In Norway as a whole, the rate of ICU admissions was 3.9 per 100 000, and in the age groups 60-69 and 70-79, ICU rates were 10.3 and 11.5, respectively. These rates were 9.5 (CI 6.3-14.3) and 10.6 (CI 6.9-16.2) times higher compared to people younger than 50 years. Conclusion: Hospital admissions due to Covid-19 are much higher in Oslo than anywhere else in Norway, and in the country as a whole, ICU admissions are highest among people 60-79 years of age. These results and more detailed data could provide better advice on how restrictions can be safely lessened.

Hospitalisation in Children with Adrenal Insufficiency and Hypopituitarism: Is There a Differential Burden between Boys and Girls and between Age Groups?

2017 ◽  
Vol 88 (5) ◽  
pp. 339-346 ◽  
Author(s):  
R. Louise Rushworth ◽  
Georgina L. Chrisp ◽  
Benjamin Dean ◽  
Henrik Falhammar ◽  
David J. Torpy
Keyword(s):  
Adrenal Insufficiency ◽  
Hospital Admissions ◽  
Age Groups ◽  
Admission Rate ◽  
Adrenal Crisis ◽  
Age Group ◽  
Adrenal Hyperplasia ◽  
Prevention Strategies ◽  
Principal Diagnosis ◽  
Admission Rates

Background/Aims: To determine the burden of hospitalisation in children with adrenal insufficiency (AI)/hypopituitarism in Australia. Methods: A retrospective study of Australian hospitalisation data. All admissions between 2001 and 2014 for patients aged 0–19 years with a principal diagnosis of AI/hypopituitarism were included. Denominator populations were extracted from national statistics datasets. Results: There were 3,779 admissions for treatment of AI/hypopituitarism in patients aged 0–19 years, corresponding to an average admission rate of 48.7 admissions/million/year. There were 470 (12.4%) admissions for an adrenal crisis (AC). Overall, admission for AI/hypopituitarism was comparable between the sexes. Admission rates for all AI, hypopituitarism, congenital adrenal hyperplasia (CAH), and “other and unspecified causes” of AI were highest among infants and decreased with age. Admissions for primary AI increased with age in both sexes. Males had significantly higher rates of admission for hypopituitarism. AC rates differed by both sex and age group. Conclusion: This nationwide study of the epidemiology of hospital admissions for a principal diagnosis of AI/hypopituitarism shows that admissions generally decreased with age; males had higher rates of admission for hypopituitarism; females had higher rates of admission for CAH and “other and unspecified causes” of AI; and AC incidence varied by age and sex. Increased awareness of AI and AC prevention strategies may reduce some of these admissions.

scholarly journals Study of potentially preventable hospitalisations (PPH) for chronic conditions: what proportion are preventable and what factors are associated with preventable PPH?

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038415
Author(s):  
Jennifer Johnston ◽  
Jo Longman ◽  
Dan Ewald ◽  
Jonathan King ◽  
Sumon Das ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Hospital Admissions ◽  
Medication Management ◽  
Community Dwelling ◽  
Living Alone ◽  
Chronic Obstructive ◽  
Discharge Diagnosis ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Study Sites

IntroductionThe proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.SettingThree hospitals in NSW, Australia.ParticipantsCommunity-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes complications or angina pectoris. Data were collected from patients, their general practitioners (GPs) and hospital records.Outcome measuresAssessments of the preventability of each admission by an Expert Panel.Results323 admissions were assessed for preventability: 46% (148/323) were assessed as preventable, 30% (98/323) as not preventable and 24% (77/323) as unclassifiable. Statistically significant differences in proportions preventable were found between the three study sites (29%; 47%; 58%; p≤0.001) and by primary discharge diagnosis (p≤0.001).Significant predictors of an admission being classified as preventable were: study site; final principal diagnosis of CHF; fewer diagnoses on discharge; shorter hospital stay; GP diagnosis of COPD; GP consultation in the last 12 months; not having had a doctor help make the decision to go to hospital; not arriving by ambulance; patient living alone; having someone help with medications and requiring help with daily tasks.ConclusionsThat less than half the chronic PPH were assessed as preventable, and the range of factors associated with preventability, including site and discharge diagnosis, are important considerations in the validity of PPH as an indicator. Opportunities for interventions to reduce chronic PPH include targeting patients with CHF and COPD, and the provision of social welfare and support services for patients living alone and those requiring help with daily tasks and medication management.

scholarly journals COVID-19 Shuts Doors to Flu but Keeps Them Open to Rhinoviruses

Biology ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 733
Author(s):  
Irina Kiseleva ◽  
Andrey Ksenafontov
Keyword(s):  
Influenza Pandemic ◽  
Age Groups ◽  
Influenza Viruses ◽  
Interferon Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mild Disease ◽  
Viral Interference ◽  
The Common

It is well known that rhinoviruses are distributed across the globe and are the most common cause of the common cold in all age groups. Rhinoviruses are widely considered to be harmless because they are generally perceived as respiratory viruses only capable of causing mild disease. However, they may also infect the lower respiratory tract, inducing chronic obstructive pulmonary disease and exacerbations of asthma, bronchiolitis, etc. The role of rhinoviruses in pathogenesis and the epidemiological process is underestimated, and they need to be intensively studied. In the light of recent data, it is now known that rhinoviruses could be one of the key epidemiological barriers that may influence the spread of influenza and novel coronaviruses. It has been reported that endemic human rhinoviruses delayed the development of the H1N1pdm09 influenza pandemic through viral interference. Moreover, human rhinoviruses have been suggested to block SARS-CoV-2 replication in the airways by triggering an interferon response. In this review, we summarized the main biological characteristics of genetically distinct viruses such as rhinoviruses, influenza viruses, and SARS-CoV-2 in an attempt to illuminate their main discrepancies and similarities. We hope that this comparative analysis will help us to better understand in which direction research in this area should move.

scholarly journals Symptomatic Patent Foramen Ovale with Hemidiaphragm Paralysis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Hussain Ibrahim ◽  
Adnan Khan ◽  
Shawn P. Nishi ◽  
Ken Fujise ◽  
Syed Gilani
Keyword(s):  
Right Atrium ◽  
Chronic Conditions ◽  
Patent Foramen Ovale ◽  
Hospital Admissions ◽  
Clinical Suspicion ◽  
Chronic Obstructive ◽  
Foramen Ovale ◽  
Obstructive Pulmonary Disease ◽  
Benign Condition ◽  
High Clinical Suspicion

Dyspnea accounts for more than one-fourth of the hospital admissions from Emergency Department. Chronic conditions such as Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Asthma are being common etiologies. Less common etiologies include conditions such as valvular heart disease, pulmonary embolism, and right-to-left shunt (RLS) from patent foramen ovale (PFO). PFO is present in estimated 20–30% of the population, mostly a benign condition. RLS via PFO usually occurs when right atrium pressure exceeds left atrium pressure. RLS can also occur in absence of higher right atrium pressure. We report one such case that highlights the importance of high clinical suspicion, thorough evaluation, and percutaneous closure of the PFO leading to significant improvement in the symptoms.

scholarly journals Reducing hospital admissions for COPD: perspectives following the Christchurch Earthquake

2018 ◽  
Vol 5 (1) ◽  
pp. e000286 ◽  
Author(s):  
Michael Epton ◽  
Carol Limber ◽  
Carolyn Gullery ◽  
Graham McGeoch ◽  
Brett Shand ◽  
...  
Keyword(s):  
Community Care ◽  
Hospital Admissions ◽  
Healthcare Delivery ◽  
Care Process ◽  
Chronic Obstructive ◽  
Process Of Change ◽  
Obstructive Pulmonary Disease ◽  
Healthcare Environment ◽  
Christchurch Hospital ◽  
Subsequent Response

The devastating 2011 earthquake in Christchurch destroyed or badly damaged healthcare infrastructure, including Christchurch Hospital. This forced change in management of exacerbations of chronic obstructive pulmonary disease (COPD), which until that point had frequently led to admission to hospital and focused attention on providing safe community options for care. This paper describes the process of understanding factors contributing to high admission frequency with exacerbations of COPD and also describes a process of change, predominantly to healthcare delivery systems and philosophies, and the subsequent outcomes. What became clear in understanding admissions with COPD to Christchurch Hospital was that the behaviour of the patient, in the context of exacerbations, and the subsequent response of the system to the patient, led to admission being the default option, in spite of low severity of the exacerbation itself. By altering systems’ responses to exacerbations, with a linked care process between ambulances, community care and hospitals, we were able to safely reduce admissions for COPD, with a sustained overall reduction in bed-day occupancy for COPD of ~48%. We would encourage these discussions and changes to occur without the stimulus of an earthquake in your healthcare environment!

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