Analysis of Dental Care Clinic Visits and Causes of Tooth Injuries by Age and Sex

2020 ◽  
Vol 14 (1) ◽  
pp. 67-78
Author(s):  
Young-Hee Kim ◽  
◽  
Sang-Sook Bea
Keyword(s):  
Dental Care ◽  
Tooth Injuries ◽  
Care Clinic ◽  
Age And Sex ◽  
Clinic Visits

scholarly journals 594. Characteristics of an At-Risk Patient Population Presenting to a Philadelphia Student-Run Free Clinic within 30 Days of Hospital Visit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S360-S360
Author(s):  
Kaitlyn Thomesen ◽  
Matthew Lipow ◽  
Tess S Munoz ◽  
Sara K Schultz
Keyword(s):  
At Risk ◽  
Patient Population ◽  
Urgent Care ◽  
Risk Patient ◽  
Syringe Exchange ◽  
Hospital Visit ◽  
Readmission Rates ◽  
Care Clinic ◽  
Medical Needs ◽  
Clinic Visits

Abstract Background 30-day readmission rates are the parameter that hospitals and insurance companies use to measure clinical quality of care and set reimbursement levels for care (McCormack, et al., 2013). The 2019 readmission rate for United States hospitals was 14.9%; however, reported readmission rates vary in accuracy due to exclusion of at-risk populations or patients who seek care outside the hospital network (America’s Health Rankings, 2020; Gupta, et al., 2018). As coordinators of a student-run urgent care clinic operating within a Philadelphia syringe exchange and harm-reduction social services organization, we serve an at-risk patient population that includes a large portion of individuals who are transiently housed, people who engage in sex work, and people who use drugs (PWUD). We sought to determine our at-risk population’s impact on current readmission rates and the ability of hospitalization to meet their unique medical needs. Methods We conducted a retrospective review of 607 electronic charts for patients who sought care at our student run clinic associated with a syringe exchange in Kensington, Philadelphia from January 2017 to January 2020, and identified patients who visited our clinic within 30 days of self-reported hospitalization. We identified time since hospitalization, purpose for hospitalization, and reason for clinic visit. Results Of 607 visits, 100 (16.5%) self-reported hospitalization within 30 days clinic presentation. Of these 100 clinic visits, 64% presented with the same chief complaint as their reason for hospitalization, and 21% presented with a complication related to their hospital visit. 33% of visits associated with previous hospitalization were from infections associated with IV drug use, including abscess, cellulitis, and osteomyelitis. On average, patients presented 7.5 days following hospital departure. Conclusion We identified a high incidence of clinic visits for medical needs associated with recent hospitalization, particularly injection-related infection, which suggests insufficient hospital care for this at-risk population. The number of readmissions for this population is underestimated due to their ability to seek medical care outside of the hospital network. Disclosures All Authors: No reported disclosures

scholarly journals The Prevalence of Root Fractures among Patients Visiting a Specialised Tertiary Care Dental Care Clinic

2018 ◽  
Vol 1 (12) ◽  
pp. 377-381
Author(s):  
Savita Sharma ◽  
Abhey Chowdhry
Keyword(s):  
Dental Care ◽  
Tertiary Care ◽  
T Test ◽  
Endodontic Treatment ◽  
Endodontically Treated Teeth ◽  
Care Clinic ◽  
Root Fracture ◽  
Vertical Fracture ◽  
Study Population ◽  
Root Fractures

INTRODUCTION: Following endodontic therapy, the development of root fracture(s) is considered to be a risk factor. It can be diagnosed accurately with the help of various radiographic aids.AIM: To assess the prevalence of horizontal and vertical root fractures among endodontically treated teeth among patients visiting a specialised tertiary care dental care clinic.METHODOLOGY: Patients suspected of having root fracture (due to endodontic treatment or non-endodontic treatment) were confirmed with the help of radiographic aids (IOPAR, OPG and occlusal radiographs). Root fractures due to endodontic treatment were then classified as horizontal and vertical root factures and analysed using the student’s t-test, ANOVA and odd’s ratio (OR). Data was analysed using SPSS version 21.0RESULTS: The study population comprised of 383 subjects. Males (207, 54%) formed a majority of the study population. Majority of fractures were seen in females [(162, 58.5%), endodontically treated teeth], while a slightly increased prevalence was seen among males (92, 86.8%) in non-endodontically treated teeth. A total of 277(72.3%) teeth were endodontically treated [155(55.9%) horizontal and 122(44.1%) vertical fracture], while 106(27.7%) were 155 non-endodontically treated teeth [63(59.4%) horizontal and 43(40.6%) vertical fracture]. A significance difference between horizontal and vertical root fractures [p=.005(t-test), p=.0025(ANOVA)] was seen. Odd’s ratio analysis revealed that horizontal fractures (OR=2.2) were more prone to develop as compared to vertical fractures.CONCLUSION: Owing to the fact that endodontically treated teeth are more brittle as compared to non-endodontically treated teeth, it is advised that the dental clinician should closely routinely follow- up endodontically treated teeth for signs of root fracture and confirm with a radiographical aid when such fractures are suspected.

Abstract 230: Internal Medicine Trainee Understanding and Reaction to Out of Pocket Costs

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Jeffrey P Chidester ◽  
Sandeep R Das ◽  
Rebecca Vigen
Keyword(s):  
Internal Medicine ◽  
Decision Making ◽  
Safety Net ◽  
Cost Of Care ◽  
Care Hospital ◽  
Care Clinic ◽  
Significant Difference ◽  
Safety Net Hospital ◽  
Out Of Pocket Costs ◽  
Clinic Visits

Introduction: Out-of-pocket costs (OOPC) are a significant barrier to care and drive suboptimal medical therapy in ASCVD. Despite this, there is minimal attention paid to these costs in post-graduate education. To define a potential knowledge gap, we surveyed trainee understanding of OOPC. Methods: We surveyed Internal Medicine residents at a large academic program comprised of a large county safety-net hospital, a VA, and a private tertiary care hospital, about knowledge and practices surrounding patient OOPC. Residents rotate on services at all sites and the vast majority have primary care clinic at the county or VA hospital. Participants answered questions considering their most recent inpatient panel and their clinic patient panel. Familiarity was ranked on a 5-point Likert scale, and for the purposes of presentation, was divided into “Poor” and “Moderate or Better”. Non-parametric analysis was used to test differences between outpatients v inpatients and by year of training. Results: Of 159 residents, 106 (67%) responded. Familiarity with patient insurance status was moderate or better in 135 of 159 (85%). Moderate or better understanding of costs associated with medications (52% [83 of 159]), testing (19% [30 of 159]) and clinic visits (30% [48 of 159]) was less common. Respondents had higher familiarity with OOPC for clinic patients compared with their most recent inpatient panel: clinic visits (39% v 21% [62 v 33 of 159 p < 0.005]), testing (25.7% v 12.4% [41 v 20 of 159 p = 0.002]), and medications (62% v 42% [99 v 67 of 159 p <0.005]) Knowledge of cost of care was not an often-considered factor in decision making (27% “Often” or “Always” [43 of 159]). There was no significant difference in response by year of training. Discussion: Our survey demonstrates that trainee familiarity with OOPC was low overall but modestly higher for established clinic patients, perhaps reflecting longitudinal experience with them or the heterogeneity of admitted patient funding status. Familiarity with patient OOPC was not an often-considered factor in decision making and did not significantly improve over years of training. This suggests an important gap in trainee education. Teaching greater familiarity with patient OOPC during residency can increase awareness of the financial realities of patients, enabling more patient-centered care.

Use of a voice and video internet technology as an alternative to in-person urgent care clinic visits

2015 ◽  
Vol 21 (4) ◽  
pp. 219-226 ◽  
Author(s):  
Patrick H Brunett ◽  
Albert DiPiero ◽  
Christine Flores ◽  
Dongseok Choi ◽  
Hayley Kum ◽  
...  
Keyword(s):  
Internet Technology ◽  
Urgent Care ◽  
Care Clinic ◽  
Urgent Care Clinic ◽  
Clinic Visits

scholarly journals Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lixia Ge ◽  
Chun Wei Yap ◽  
Bee Hoon Heng ◽  
Woan Shin Tan
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Outpatient Clinic ◽  
Healthcare Utilisation ◽  
Day Surgery ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Care Clinic ◽  
Community Dwelling Older Adults ◽  
Clinic Visits

Abstract Background Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among community-dwelling older adults in Singapore. Methods Data from a population health survey among community-dwelling adults were linked with an administrative database to retrieve data of healthcare utilisation (including government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations) occurred during a six-month look-back period and six-month post-baseline respectively. Baseline frailty status was measured using the five-item FRAIL scale, which was categorised into three groups: robust (0), pre-frail (1–2), and frail (3–5). Negative binomial regression was applied to examine the association between frailty with respective healthcare utilisation (dependent variables), controlling for other confounding variables. Results In our sample of 701 older adults, 64.8% were of robust health, 27.7% were pre-frail, and 7.6% were frail. Compared to the robust group, frail individuals had a higher rate of specialised outpatient clinic visits (incidence rate ratio (IRR): 2.8, 95% confidence interval (CI): 1.2–6.5), emergency department visits (IRR: 3.1, 95%CI: 1.1–8.1), day surgery attendances (IRR: 6.4, 95%CI: 1.3–30.9), and hospitalisations (IRR: 6.7, 95%CI: 2.1–21.1) in the six-month period prior to the baseline and in subsequent 6 months (IRR: 3.3, 95%CI: 1.6–7.1; 6.4, 2.4–17.2; 5.8, 1.3–25.8; 13.1, 4.9–35.0; respectively), controlling for covariates. Conclusions Frailty was positively associated with the number of specialised outpatient clinic visits, emergency department visits, day surgeries and hospitalisations occurred during 6 months prior to and after the baseline. As frailty is a potentially reversible health state with early screening and intervention, providing preventive activities that delay the onset or progression of frailty should have potential effect on delaying secondary and tertiary care utilisation.

scholarly journals A Low-Cost Ultrasound Program Leads to Increased Antenatal Clinic Visits and Attended Deliveries at a Health Care Clinic in Rural Uganda

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e78450 ◽  
Author(s):  
Andrew B. Ross ◽  
Kristen K. DeStigter ◽  
Matthew Rielly ◽  
Sonia Souza ◽  
Gabriel Eli Morey ◽  
...  
Keyword(s):  
Health Care ◽  
Low Cost ◽  
Antenatal Clinic ◽  
Care Clinic ◽  
Clinic Visits

Description of attendance of scheduled follow up clinic visits and weight changes among low-birthweight infants post discharge at a tertiary hospital in Kampala, Uganda.

2019 ◽  
Author(s):  
Flaviah B Namiiro ◽  
Joseph Rujumba ◽  
Jolly Nankunda ◽  
Phillip Kasirye ◽  
Anthony Batte ◽  
...  
Keyword(s):  
Birth Weight ◽  
Hospital Discharge ◽  
Preterm Infants ◽  
Low Birthweight ◽  
Community Support ◽  
Care Clinic ◽  
One Year ◽  
Clinic Visits

Abstract Background: Follow up after hospital discharge is a recommended and common medical practice for high risk infants like those born with low birthweight and at preterm, this however is rare in LIC. Premature babies are at risk of long term disabilities and require continued care both at home and in designated facilities. We sought to determine the attendance of scheduled follow up clinic visits for preterm infants post hospital discharge. Methods: A review of records for all infants seen in the preterm clinic at Mulago National Referral Hospital between January and December 2015 was done. After discharge from the SCBU, infants are followed up in the Kangaroo Mother Care clinic every fortnight until they weigh 2500 grams. They then transition to the Preterm Care Clinic where they are followed up every two to three months until 18 months of corrected age. Findings: Between September 2014 and December 2015, 7224 neonates were admitted to the SCU of Mulago Hospital. Of these, 3537 (49 %) weighed less or equal to 2500 grams, thus majority were eligible for follow up in the special clinics after discharge. Of the 590 babies registered in the PTC during 2016; 423 (71.7%) were included for analysis and 167 (28.3) % were excluded due to missing or incomplete data. Majority of the infants weighed 1501-2000gms (50%), only 3% weighed less than 1000gms, 14% more than 2000gms and 5% record of birth weight was missing. Almost 90% of the visits during KMC clinic were on schedule as compared to 64% during PTC visits. The average number of visits in the KMC clinic were three per baby; 105 babies had between 4-5 visits and 15% of all the participants were still attending the clinic by one year of age. Many babies were not seen in the clinic after the age of 6 months. Conclusion: Scheduled follow up clinic attendance for low birth weight preterm infants is suboptimal with only one out of four were followed up after one year. There is need to strengthen utilization of available services, community support and devise means to improve the long term follow up.

scholarly journals Regional Supervision of Healthcare Institutions With a Focus on Antimicrobial Resistance

2020 ◽  
Vol 41 (S1) ◽  
pp. s371-s372
Author(s):  
Robbin Westerhof ◽  
Lisanne de Boer
Keyword(s):  
Antimicrobial Resistance ◽  
The Netherlands ◽  
Dental Care ◽  
Information Transfer ◽  
Infection Prevention ◽  
Collaborative Networks ◽  
Diagnostic Tools ◽  
Term Care ◽  
Care Clinic ◽  
Antibiotic Policy

Background: Resistance to antibiotic drugs, also called antimicrobial resistance (AMR) is a serious threat to (public) health. Surveillance reports throughout the world show that formation and spread of highly resistant microorganisms (HRMOs) continues to be substantial. In The Netherlands, 10 regional collaborative networks on AMR have been established among healthcare institutions to mitigate the existing risks concerning HRMO by collaborative actions in antibiotic stewardship and infection prevention. Objective: We sought to determine whether the healthcare institutions in one of the regional collaborative networks in The Netherlands contribute adequately to reducing the risks of formation and/or spread of HRMO. Methods: The Health and Youth Care Inspectorate in The Netherlands visited 37 institutions in the region of Limburg (the southern province). The following healthcare sectors were included: hospitals (n = 5), rehabilitation clinics (n = 2), long-term care facilities (n = 5), homecare institutions (n = 4), mental healthcare institutions (n = 2), dental care clinics (n = 4), general practitioners (GPs; n = 10), municipal health services (n = 2) and healthcare facilities for mentally disabled people (n = 3). In each visit, 5 topics were addressed: antibiotic policy, infection prevention, information transfer, governance and collaboration in the region. Results and Conclusions: In general, the healthcare institutions had an adequate to good score. Good results were seen in antibiotic policy (ie, the use of diagnostic tools to avoid the use of antibiotics); information transfer among GPs and in homecare institutions; and infection prevention in homecare institutions and dental care clinics. Exceptions with inadequate scores were observed in several areas: absence of prescription guidance specifically for antibiotics in various sectors; infection prevention among GPs, and dental care clinics. In 4 cases (ie, 3 GPs and 1 dental care clinic), we stopped using the autoclave because of lack of proof of proper maintenance.Funding: NoneDisclosures: None

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