Retrospective study of impact of race and health care insurance on stage at presentation of common cancer at a rural university hospital over a 10 years period—1996 to 2005

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 17537-17537
Author(s):  
N. C. D’Cunha ◽  
M. Chiriva Internati ◽  
E. Cobos ◽  
S. Sugathadasa
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
University Hospital ◽  
Health Care Insurance ◽  
Common Cancer ◽  
Race And Health

scholarly journals Occupational Exposure to Positive Blood and Body Fluids among Health Care Workers in a Chinese University Hospital: A Three Years Retrospective Study

2016 ◽  
Vol 9 (4) ◽  
pp. 156
Author(s):  
Xiubin Tao ◽  
Hui Peng ◽  
Lihua Qian ◽  
Yan Li ◽  
Qun Wu ◽  
...  
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Nursing Students ◽  
Occupational Exposure ◽  
Health Care Workers ◽  
Occupational Exposures ◽  
Body Fluids ◽  
Common Type ◽  
University Hospital ◽  
Care Workers

<p>Health care workers (HCWs) are exposed to blood and body fluids (BBF) due to occupational accidents. However, few studies have investigated the prevalence of occupational exposure in Chinese HCWs thus far. There is a clearly a critical need to characterize its epidemiology more fully in China so that effective prevention programs can be implemented. We conducted a retrospective study at a university hospital in China, giving an epidemiological analysis on these exposed HCWs whose pathogens of BBF from patients were positive [human immunodeficiency virus (HIV) / hepatitis B (HBV) / hepatitis C (HCV)]. From July 1st 2011 to June 30th 2014, a total of 155 occupational exposures to positive BBF were reported, with an incidence of 16.64 (/1000 person-years). Percutaneous injuries were the most common type of exposure episodes (89.03%). The most common type of exposed blood-borne pathogens was HBV (83.87%), and the majority of the respondents were nursing students, with an incidence of 34.22 (/1000 person-years). More effective preventive strategies on HCWs’ BBF occupational exposure should be implemented in China, especially for nursing students.</p>

Mammographic Microcalcifications and Breast Cancer: A Radio-Pathological Correlation

2021 ◽  
Vol 104 (5) ◽  
pp. 814-817
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Retrospective Study ◽  
Breast Imaging ◽  
Data System ◽  
University Hospital ◽  
Patient Risk ◽  
Predictive Values ◽  
Common Cancer ◽  
Keywords Breast

Background: Breast cancer is the most common cancer for women, often asymptomatic, and diagnosed from combined screening using mammography and ultrasound. Abnormal findings include microcalcifications with widely variable positive predictive values (PPVs) for malignancy, ranging from 2% to 95%. PPVs for each type of microcalcification are unknown. Objective: To assess PPVs for all abnormal microcalcifications in Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 as seen by mammography. Materials and Methods: The present study was a retrospective study of 62 female patients with abnormal microcalcifications that underwent mammography-guided needle localized excision between September 2011 and December 2018, at Thammasat University Hospital. Results: Of all 72 abnormal microcalcifications, PPVs were coarse heterogeneous 25%, amorphous 37.93%, fine pleomorphic 42.31%, and fine linear or linear branching 33.33%. Conclusion: Abnormal microcalcifications rated BI-RADS 4 or 5 have greatly varying malignancy risks, thus, tissue biopsies should be considered in line with microcalcification morphology and individual patient risk factors. Keywords: Breast cancer, Mammography, Microcalcification, Radio-pathologic correlation, Needle localized excision

scholarly journals 472. The Utility of Infectious Diseases E-consults in the Era of COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
Hala Saad ◽  
Kruti Yagnik ◽  
Helen King ◽  
Roger Bedimo ◽  
Richard J Medford
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Infection Prevention ◽  
Panel Member ◽  
University Hospital ◽  
North Texas ◽  
Review Panel ◽  
The North ◽  
Time To Completion ◽  
Texas Health

Abstract Background During the COVID-19 pandemic, rapid Infectious Diseases (ID) consultation has been required to answer novel questions regarding SARS-CoV-2 testing and infection prevention. We sought to evaluate the utility of e-consults to triage and provide rapid ID recommendations to providers. Methods We performed a retrospective study reviewing ID e-consults in three institutions in the North Texas region: Clements University Hospital (CUH), Parkland Hospital and Health System (PHHS), and the VA North Texas Health Care System (VA) from March 1, 2020 to May 15, 2020. Variables collected include age, sex, ethnicity, comorbidities, time to completion, reason for consult and outcome of consult (initiation or removal of personal protective equipment (PPE) and recommendation to test or retest for COVID-19). Results We performed all analysis using R studio (Version 1.3.959). Characteristics of 198 patients included: 112(57%) male, 86(43%) female, 86(43%) Caucasian, 71(36%) Hispanic, 42(21%) African American, 6(3%) Asian and mean(sd) age of 55.1(15.9). Patient comorbidities included: 89(45%) with a heart condition, 77(39%) diabetes, 30(15%) asthma and 14(7%) liver disease. Median time to completion for all hospitals was 4 hours(h); ((CUH (4h) vs PHHS (2h), p&lt; 0.05; VA (5.5h) vs PHHS (2h) p&lt; 0.05)). Most common reasons for e-consult included: (63)32% regarding re-testing ((CUH 14(21%) vs PHHS 43(50%), p&lt; 0.05; CUH vs VA 14(27%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)), (61)31% testing ((CUH 25(37%) vs PHHS 39(45%), p&lt; 0.05; CUH vs VA 7(16%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)) and 61(31%) infection prevention (IP). Based on the e-consult recommendation, 53(27%) of patients were tested ((CUH 31(45%) vs PHHS 11(13%), p&lt; 0.05, CUH vs VA 11(25%), PHHS vs VA, p&lt; 0.05)), 45(23%) were re-tested, 44(22%) of patients had PPE started on and 19% had PPE removed ((CUH 0(0%) vs PHHS 16(19%), p&lt; 0.05; CUH vs VA 21(48%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)). Reason for Consult Conclusion E-consult services can provide prompt ID input during the COVID-19 pandemic, minimizing the risk of infection to the patient and health care workers while preserving PPE and testing supplies. Disclosures Roger Bedimo, MD, MS, Gilead Sciences (Consultant)Merck & Co. (Advisor or Review Panel member)ViiV Healthcare (Advisor or Review Panel member, Research Grant or Support)

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals P1490MONTHLY TREND AND SEASONALITY IN ACUTE AND CHRONIC HEMODIALYSIS; RESULT FROM NATIONWIDE DATABASE OF MEDICAL BILLS OF UNIVERSAL HEALTH CARE INSURANCE SYSTEM IN JAPAN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ryoya Tsunoda ◽  
Hirayasu Kai ◽  
Masahide Kondo ◽  
Naohiro Mitsutake ◽  
Kunihiro Yamagata
Keyword(s):  
Health Care ◽  
Seasonal Variation ◽  
Chronic Hemodialysis ◽  
Universal Health Care ◽  
Health Care Insurance ◽  
Individual Data ◽  
Insurance System ◽  
Number Of Patients ◽  
Medical Bills ◽  
Universal Health

Abstract Background and Aims Although knowing the accurate number of patients of hemodialysis important, data collection is a hard task. Establishing a simplified and prompt method of data collection for perspective hemodialysis is strongly needed. In Japan, there is a universal health care insurance system that covers almost all population. This study aimed to know a seasonal variation of hemodialysis patients using the big database of medical bills in Japan. Method Japanese Ministry of Health, Labour and Welfare established a big database named National Database (NDB), that consists of medical bills data in Japan. All bills data were sent to the data server from The Examination and Payment Agency, the organization that receives all medical bills from each medical institution and judge validity for payment. Each record of the database consists of bill data of one patient of a month for each medical institution. All data were anonymized before saved in the server and gave virtual patient identification number (VPID) that is unique for each patient. VPID is a hash value calculated by patient’s individual data such as name, date of birth, so that the value cannot be duplicate. Calculation of VPID is executed by an irreversible way to make it difficult to decrypt VPID into patient’s individual data. This database includes all information about medical care of whole population in Japan except for patients not under the insurance system (patients under public assistance system, victims of the war, or any other specified people under the public medical expense). Using this database, we investigated monthly number of patients who were recorded to be undergone hemodialysis (HD, includes hemodiafiltration). We searched chronic HD patients who have undergone HD on the month and continued it for 3 months, and acute HD patients who have discontinued HD within 3 months. Results In NDB, the number of chronic HD patients under public insurance system who confirmed to have undergone HD in December 2014 was 284 433. In contrast, the number of HD patients identified from the year-end survey by Japanese Society of Dialysis Therapy in the same year was of 311 193, but this number includes patients not under insurance system. Incidence rate of acute HD in Japan was persisted at 30-39 per million per month. There is a reproducible seasonal variation in number of acute HD patients, that increases in every winter and decreasing in every summer. The significantly highest frequency was observed in February(38.5/million/month) compared with September(30.6/million/month), the lowest month of the year (p&lt;0.01). Conclusion We could show the trend in number of HD patients using nationwide bills data. Seasonality in some clinical factors in patients under chronic hemodialysis such as blood pressure, intradialytic body weight gain, morbidity of congestive heart failure, and, mortality, has been reported in many observational studies. Also, there are a few former reports about seasonality in AKI. However, a report about acute RRT is few. From our knowledge, this is the first report that revealed monthly dynamics of HD in a whole nation and rising risk of acute HD in winter. The true mechanism of this seasonality remains unclear. We have to establish a method to collect clinical data such as prevalence of CKD, causative diseases of AKI, kinds of precedent operations, and medications in connection with billing data.

scholarly journals Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Meike M. Neuwirth ◽  
Frauke Mattner ◽  
Robin Otchwemah
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
University Hospital ◽  
Protective Equipment ◽  
Care Workers

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

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