Total patient load, regional disparities and in-hospital mortality of intubated COVID-19 patients in Greece, from September 2020 to May 2021

2021 ◽  
pp. 140349482110599
Author(s):  
Theodore Lytras ◽  
Sotirios Tsiodras
Keyword(s):  
Quality Of Care ◽  
Hospital Mortality ◽  
Poisson Regression ◽  
Healthcare Services ◽  
Regional Disparities ◽  
Time Varying ◽  
Total Patient ◽  
Patient Load ◽  
Time Varying Covariates

Aims: While healthcare services have been expanding capacity during the COVID-19 pandemic, quality of care under increasing patient loads has received less attention. We examined in-hospital mortality of intubated COVID-19 patients in Greece, in relation to total intubated patient load, intensive care unit (ICU) availability and hospital region. Methods: Anonymized surveillance data were analyzed from all intubated COVID-19 patients in Greece between 1 September 2020 and 6 May 2021. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates. Results: Mortality was significantly increased above 400 patients, with an adjusted hazard ratio of 1.25 (95% confidence interval (CI): 1.03–1.51), rising progressively up to 1.57 (95% CI: 1.22–2.02) for 800+ patients. Hospitalization outside an ICU or away from the capital region of Attica were also independently associated with significantly increased mortality. Conclusions: Our results indicate that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load even without exceeding capacity, as well as by regional disparities. This highlights the need for more substantial strengthening of healthcare services, focusing on equity and quality of care besides just expanding capacity.

Telepsychiatry Use in Rural Areas in the United States

2020 ◽  
Vol 13 (4) ◽  
pp. 1-13
Author(s):  
Alberto Coustasse ◽  
Morgan Ruley ◽  
Tonnie C. Mike ◽  
Briana M. Washington ◽  
Anna Robinson
Keyword(s):  
Mental Health ◽  
United States ◽  
Quality Of Care ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Access And Quality

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

scholarly journals Overpriced? Are Hospital Prices Associated with the Quality of Care?

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 135
Author(s):  
Brad Beauvais ◽  
Glen Gilson ◽  
Steve Schwab ◽  
Brittany Jaccaud ◽  
Taylor Pearce ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Clinical Care ◽  
Healthcare Services ◽  
Cost Ratio ◽  
Performance Score ◽  
Significant Positive Association ◽  
The Public ◽  
Total Performance

In most consumer markets, higher prices generally imply increased quality. For example, in the automobile, restaurant, hospitality, and airline industries, higher pricing generally conveys a signal of complexity and superiority of a service or product. However, in the healthcare industry, there is room to challenge the price-quality connection as both health prices and health quality can be difficult to interpret. In the best of circumstances, health care costs, prices, and quality can often be difficult to isolate and measure. Recent efforts by the Trump Administration and the Center for Medicare and Medicaid Services (CMS) have required the pricing of hospital services to be more transparent. Specifically, hospital chargemaster (retail) prices must now be available to the public. However, many continue to question if the pricing of health care services reflects the quality of service delivery. This research focuses on investigating the prices hospitals charge for their services in relation to the costs incurred and the association with the quality of care provided. By analyzing data from a nationwide sample of U.S. hospitals, this study considers the relationship between hospital pricing (as measured by the charge-to-cost ratio) and hospital quality performance as measured by the Value Based Purchasing Total Performance Score (TPS) and its associated sub-domains. Results of the study indicate that hospital prices, as measured by our primary independent variable of interest, the charge-to-cost ratio, are significantly and negatively associated with Total Performance Score, Patient Experience, and the Efficiency and Cost Reduction domains. A marginal statistically significant positive association is shown in the Clinical Care domain. The findings indicate that unlike most other industries, in medicine, higher pricing compared to cost does not necessarily associate with higher quality and, in fact, might indicate the opposite. The results of this study suggest that purchasers of healthcare, at all levels, have justification in challenging the pricing of healthcare services considering the quality scores available in the public domain.

scholarly journals Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara Hassanein ◽  
Jeffrey Edwards ◽  
Benedikte Victoria Lindskog
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
System Capacity ◽  
Cross Sectional ◽  
Study Results ◽  
Catchment Areas ◽  
The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

scholarly journals COVID-19 and regional differences in the timeliness of hip-fracture surgery: an interrupted time-series analysis

2021 ◽  
Author(s):  
Davide Golinelli ◽  
Jacopo Lenzi ◽  
Emanuele Adorno ◽  
Maria Michela Gianino ◽  
Maria Pia Fantini
Keyword(s):  
Time Series ◽  
Quality Of Care ◽  
Hip Fracture ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Healthcare Services ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
The Impact

Background. It is of great importance to examine the impact of the healthcare reorganization adopted to confront the COVID19 pandemic on the quality of care provided by healthcare systems to non COVID 19 patients. The aim of this study is to assess the impact of the COVID19 national lockdown (March 9, 2020) on the quality of care provided to patients with hip fracture (HF) in Piedmont and Emilia-Romagna, 2 large regions of northern Italy severely hit by the pandemic. Methods. We calculated the percentage of HF patients undergoing surgery within 2 days of hospital admission. An interrupted time-series analysis was performed on weekly data from December 11, 2019 to June 9, 2020 (6 months), interrupting the series in the 2nd week of March. The same data observed the year before were included as a control time series with no intervention (lockdown) in the middle of the observation period. Results. Before the lockdown, 2day surgery was 69.9% in Piedmont and 79.2% in Emilia-Romagna; after the lockdown, these proportions were equal to 69.8% (-0.1%) and 69.3% (-9.9%), respectively. While Piedmont did not experience any drop in the amount of surgery, Emilia-Romagna exhibited a significantly decline at a weekly rate of -1.29% (95% CI = -1.71 to -0.88). Divergent trend patterns in the 2 study regions reflect local differences in pandemic timing as well as in healthcare services capacity, management, and emergency preparedness.

scholarly journals An encouragement to publish powerful studies on innovation in health: A journal preface

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Muji Setiyo ◽  
Heni Setyowati Esti Rahayu
Keyword(s):  
Higher Education ◽  
Quality Of Care ◽  
Academic Work ◽  
Healthcare Services ◽  
Health Problems ◽  
Community Practice ◽  
Health Innovation ◽  
Knowledge Triangle ◽  
Better Than

The health manifesto highlighted that studies on innovation flourish when all sides of the knowledge triangle (research, academia, and industry) work in tandem in terms of enhancing the quality of care. This opportunity should go much better than the implementation of theoretical and academic work in universities worldwide. To respond to this, health innovation is currently being developed by experts in higher education. Therefore, this preface coming from two experts in the field encourages how important to publish studies on innovation in health for reducing the health problems along with issues on healthcare services in clinical or community practice.

scholarly journals Hospital Information Systems (HIS) in the Examination Rooms and Wards: Doctors Perceived Positive Impact on Quality of Care and Patient Safety

2018 ◽  
Vol 7 (2.29) ◽  
pp. 871 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
. .
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Information Systems ◽  
Positive Impact ◽  
Healthcare Services ◽  
Hospital Information Systems ◽  
Structured Interviews ◽  
Healthcare Organizations ◽  
The Impact

Hospital Information Systems [HIS] is developed to support healthcare organizations in providing efficient, quality, and safe healthcare services. The objective of this study is to identify and describe doctors’ perspective on the impact of HIS use in the examination rooms and wards on quality of care and patient safety. Semi-structured interviews were carried out with thirty one doctors from three Malaysian government hospitals. Thematic qualitative analysis was performed by using ATLAS.ti to deduce the relevant themes. HIS were commonly believed to improve quality of care and patient safety in terms of : [1] accessibility of patients’ record, [2] efficient patient-care, [3] well-structured report viewing, [4] less missing patients’ records, [5] legibility of patients’ records, and [6] safety features. In conclusion, the use of HIS in examination rooms and wards suggests to improve the quality of care and patient safety.  

The Study of Public Reporting in Healthcare

2016 ◽  
pp. 115-136 ◽  
Author(s):  
Ubaldo Comite
Keyword(s):  
Quality Of Care ◽  
Healthcare Services ◽  
Considerable Change ◽  
Public Reporting ◽  
Healthcare Sector ◽  
The Public ◽  
Reporting Systems ◽  
Comparative Information ◽  
The Way

Public reporting, intended as the public disclosure of information on healthcare performance, is linked to the improvement of the quality of care through the incentives of selection and change, which are in turn determined by the availability of comparative information that is used by those outside the system (citizens) and those from within (organizations and professionals). In the last few decades, the healthcare sector, have undergone considerable change. This change is inevitably destined to modify the way in which citizens turn to healthcare services, and the way in which hospitals are called upon to be transparent and accountable in how they provide services. It is within this context that public reporting became widespread, as a strategy geared towards promoting informed choices to consumers and stimulating the improvement of quality of care. The aim of this paper is to highlight how public reporting systems have the potential to not only support healthcare users in making informed choices, but to also foster healthcare structures in the improvement of their services.

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