Quality of Mother-Infant Attachment and Pediatric Health Care Use

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 248-254
Author(s):  
Emily S. Harris ◽  
Donna R. Weston ◽  
Alicia F. Lieberman
Keyword(s):  
Acute Care ◽  
Early Recognition ◽  
Health Care Use ◽  
Pediatric Care ◽  
First Year ◽  
Infant Attachment ◽  
Care Services ◽  
Acute Care Services ◽  
First Year Of Life

The relationship between infant pediatric care use in the first year of life and the quality of mother-infant attachment at 1-year of age was examined. Fifty-six mother and infant pairs were classified by the Ainsworth Strange Situation procedure as securely (n = 17) or anxiously attached (n = 39). Pediatric records for the first 12 months of life were reviewed for frequency and type of visit, diagnoses, treatment, and symptoms prompting the care visit. Anxiously attached infants used acute care services (walk-in and emergency room) significantly earlier and more often than infants with a secure attachment. Use of acute care services began at a mean age of 3.8 months for the anxiously attached infants compared with 6.5 months for the securely attached. Differences in utilization persisted through the year. Mean acute care use in the anxiously attached infants was 3.6 visits compared with 1.9 visits for the securely attached. Acute care use was associated with a variety of common infant illnesses in both groups. In contrast, there was no difference in the use of well-baby care (mean 6 visits). Utilization and attachment status were independent of birth or prenatal difficulties. High cumulative use of pediatric care during the first year of life may identify infant and mother pairs who ho are experiencing strain in their interactions and relationship. Early recognition would provide an opportunity for comprehensive assessment and preventive intervention in the pediatric setting.

Clinical handover practices among healthcare practitioners in acute care services: A qualitative study

2018 ◽  
Vol 28 (1-2) ◽  
pp. 80-88 ◽  
Author(s):  
Gerard Fealy ◽  
Suzanne Donnelly ◽  
Gerardine Doyle ◽  
Maria Brenner ◽  
Mary Hughes ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Acute Care ◽  
Clinical Handover ◽  
Care Services ◽  
Acute Care Services

Factors Associated With Unplanned Acute Care Services for Patients With Newly Diagnosed Hematologic Malignancies

2021 ◽  
pp. 1197-1206
Author(s):  
Kai Zu ◽  
Kristina L. Greenwood ◽  
Joyce C. LaMori ◽  
Besa Smith ◽  
Tyler Smith ◽  
...  
Keyword(s):  
Acute Care ◽  
Predictive Models ◽  
Psychosocial Functioning ◽  
Predictive Accuracy ◽  
Care Utilization ◽  
Medical Complication ◽  
Quality Reporting ◽  
Care Services ◽  
Acute Care Services ◽  
The Impact

PURPOSE This study evaluated risk factors predicting unplanned 30-day acute service utilization among adults subsequent to hospitalization for a new diagnosis of leukemia, lymphoma, or myeloma. This study explored the prevalence of medical complications (aligned with OP-35 measure specifications from the Centers for Medicare & Medicaid Services [CMS] Hospital Outpatient Quality Reporting Program) and the potential impact of psychosocial factors on unplanned acute care utilization. METHODS This study included 933 unique patients admitted to three acute care inpatient facilities within a nonprofit community-based health care system in southern California from 2012 to 2017. Integrated comprehensive data elements from electronic medical records and facility oncology registries were leveraged for univariate statistics, predictive models constructed using multivariable logistic regression, and further exploratory data mining, with predictive accuracy of the models measured with c-statistics. RESULTS The mean age of study participants was 65 years, and 55.1% were male. Specific diagnoses were lymphoma (48.7%), leukemia (35.2%), myeloma (14.0%), and mixed types (2.1%). Approximately one fifth of patients received unplanned acute care services within 30 days postdischarge, and over half of these patients presented with one or more symptoms associated with the CMS medical complication measure. The predictive models, with c-statistics ranging from 0.7 and above for each type of hematologic malignancy, indicated good predictive qualities with the impact of psychosocial functioning on the use of acute care services ( P values < .05), including lack of consult for social work during initial admission (lymphoma or myeloma), history of counseling or use of psychotropic medications (lymphoma), and past substance use (myeloma). CONCLUSION This study provides insights into patient-related factors that may inform a proactive approach to improve health outcomes, such as enhanced care transition, monitoring, and support interventions.

Perceptions of emergency medicine and acute care among a cohort of non-emergency medicine health providers in Myanmar

2019 ◽  
Author(s):  
Corey B. Bills ◽  
Peter Acker ◽  
Tina McGovern ◽  
Rebecca Walker ◽  
Htoo Ohn ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Acute Care ◽  
Emergency Care ◽  
Healthcare Providers ◽  
Unmet Need ◽  
Health Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Care Services ◽  
Acute Care Services

Abstract Background Currently, Myanmar does not have a nationalized emergency care or emergency medical services (EMS) system. The provision of emergency medicine (EM) education to physicians without such training is essential to address this unmet need for high quality emergency care. We queried a group of healthcare providers in Myanmar about their experience, understanding and perceptions regarding the current and future needs for EM training in their country. Methods A 34-question survey was administered to a convenience sample of healthcare workers from two primary metropolitan areas in Myanmar to assess exposure to and understanding of emergency and pre-hospital care in the country. Results 236 of 290 (81% response rate) individuals attending one of two full-day symposia on emergency medicine completed the survey. The majority of respondents were female (n=138, 59%), physicians (n=171, 74%), and working in private practice (n=148, 64%). A majority of respondents (n=133, 57%) spent some to all of their clinical time providing acute and emergency care however 83.5% (n=192) of all surveyed reported little or no past training in emergency care; and those who have received prior emergency medicine training were more likely to care for emergencies (>2 weeks training; p=.052). 81% (n= 184) thought the development of emergency and acute care services should be a public health priority. Conclusions Although this subset of surveyed health practitioners commonly provides acute care, providers in Myanmar may not have adequate training in emergency medicine. Continued efforts to train Myanmar’s existing healthcare workforce in emergency and acute care should be emphasized.

scholarly journals The Integration of Adult Acute Care Surgeons into Pediatric Surgical Care Models Supplements the Workforce without Compromising Quality of Care

2015 ◽  
Vol 81 (9) ◽  
pp. 854-858 ◽  
Author(s):  
Rudy J. Judhan ◽  
Raquel Silhy ◽  
Kristen Statler ◽  
Mija Khan ◽  
Benjamin Dyer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Tertiary Care ◽  
Disease Process ◽  
Pediatric Care ◽  
Care Hospital ◽  
Late Night ◽  
General Surgeons ◽  
The Impact

Acute care of children remains a challenge due to a shortage of pediatric surgeons, particularly in rural areas. In our institutional norm, all cases in patients age six and older are managed by dedicated general surgeons. The provision of care to these children by these surgeons alleviates the impact of such shortages. We conducted a five-year retrospective analysis of all acute care pediatric surgical cases performed in patients aged 6 to 17 years by a dedicated group of adult general surgeons in a rural tertiary care hospital. Demographics, procedure, complications, outcomes, length of stay, and time of consultation/operation were obtained via chart review. Elective, trauma related, or procedures performed by a pediatric surgeon were excluded. Descriptive statistics are reported. A total of 397 cases were performed by six dedicated general surgeons during the study period. Mean age was 11.5 ± 3.1 years. In all, 100 (25.2%) were transferred from outlying facilities and 52.6 per cent of consultations/operations occurred at night (7P–7A), of which 33.2 per cent occurred during late night hours (11P–7A). On weekends, 34.0 per cent occurred. Appendectomy was the most commonly performed operation (n = 357,89.9%), of which 311 were laparoscopic (87.1%). Others included incision/drainage (4.5%), laparoscopic cholecystectomy (2.0%), bowel resection (1.5%), incarcerated hernia (0.5%), small bowel obstruction (0.5%), intraabdominal abscess drainage (0.3%), resection of intussusception (0.3%), Graham patch (0.3%), and resection omental torsion (0.3%). Median length of stay was two days. Complications occurred in 23 patients (5.8%), of which 22(5.5%) were the result of the disease process. These results parallel those published by pediatric surgeons in this age group and for the diagnoses treated. Models integrating dedicated general surgeons into pediatric call rotations can be designed such that quality of pediatric care is maintained while providing relief to an overburdened pediatric surgical workforce.

scholarly journals Valuing Health Status in the First Year of Life: The Infant Health-Related Quality of Life Instrument

2019 ◽  
Vol 22 (6) ◽  
pp. 721-727 ◽  
Author(s):  
Ruslan Jabrayilov ◽  
Karin M. Vermeulen ◽  
Patrick Detzel ◽  
Livia Dainelli ◽  
Antoinette D.I. van Asselt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Infant Health ◽  
First Year ◽  
Health Related Quality ◽  
Life Instrument ◽  
Related Quality ◽  
Health Related ◽  
First Year Of Life

Asthma-like symptoms in the first year of life and health-related quality of life at age 12 months: the Generation R study

2011 ◽  
Vol 21 (3) ◽  
pp. 545-554 ◽  
Author(s):  
Ashna D. Mohangoo ◽  
Harry J. de Koning ◽  
Johan C. de Jongste ◽  
Jeanne M. Landgraf ◽  
Johannes C. van der Wouden ◽  
...  
Keyword(s):  
Quality Of Life ◽  
First Year ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
First Year Of Life

The Cost of Prematurity: Hospital Charges at Birth and Frequency of Rehospitalizations and Acute Care Visits over the First Year of Life

2005 ◽  
Vol 105 (7) ◽  
pp. 56-64 ◽  
Author(s):  
Katherine D. Cuevas ◽  
Debra R. Silver ◽  
Dorothy Brooten ◽  
JoAnne M. Youngblut ◽  
Charles M. Bobo
Keyword(s):  
Acute Care ◽  
Hospital Charges ◽  
First Year ◽  
First Year Of Life ◽  
The Cost

The COAG Reforms and Community Health Services

1995 ◽  
Vol 1 (1) ◽  
pp. 3 ◽  
Author(s):  
Stephen Duckett ◽  
Tracie Hogan ◽  
Jan Southgate
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Acute Care ◽  
Community Health Services ◽  
Community Wellbeing ◽  
Care Services ◽  
Acute Care Services ◽  
English Speaking ◽  
The Impact

Ultimately, the reform directions announced by the Council of Australian Governments (COAG) in April 1995 have the potential to touch all aspects of health care and community wellbeing, and the impact will be felt as much by community health services, and for groups with special needs, such as people from non-English speaking backgrounds, as it will for acute care services.

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