scholarly journals Az epilepsziás betegek ellátásának változása a COVID–19-járvány első veszélyhelyzeti periódusában

2020 ◽  
Vol 161 (46) ◽  
pp. 1939-1943
Author(s):  
Dániel Fabó ◽  
Zoltán Horváth ◽  
Péter Klivényi ◽  
Anita Kamondi
Keyword(s):  
Outpatient Care ◽  
Care Staff ◽  
Great Care ◽  
Multiple Choice Questions ◽  
Expert Opinions ◽  
Personal Doctor ◽  
Outpatient Visits ◽  
Annual Congress ◽  
New Framework ◽  
International League

Összefoglaló. Bevezetés: A COVID–19-járvány világszerte hónapokra átalakította a járóbeteg-ellátás működését is. Magyarországon a 2020. március 11-től 2020. június 17-ig fennálló egészségügyi veszélyhelyzeti rendelkezések szabták meg az új kereteket. Célkitűzés: Az első veszélyhelyzeti periódus második felében, 2020. április 22. és 2020. május 5. között mértük fel az epilepsziaellátásban részt vevő orvosok véleményét, hogy milyen mértékben változott a betegek ellátása, és hogyan élték meg a változásokat személyesen. Módszer: Internetes kérdőíves véleményfelmérés történt, a Magyar Epilepszia Liga 2020. április 16–17-re tervezett, de a COVID–19-járvány miatt elhalasztott XV. kongresszusára regisztrált neurológusok között. Kilenc egyszeres vagy többszörös feleletválasztós kérdés és ’szabad kommentár’ mezők álltak rendelkezésre. Eredmények: A megkeresett 116 neurológus közül 33-an válaszoltak (28%), összesen 30 kommentár került rögzítésre. 73%-uk szerint a változások komoly nehézséget okoztak, 15%-uk gondolta, hogy ennek súlyos következményei lesznek. Új betegek fogadása 53%-ban leállt, 25%-ban nagy nehézségekbe ütközött. A gondozott betegek problémáit 49%-ban a távvizit lehetőségeivel élve meg tudták oldani, de 24%-ban ez nem sikerült. A beteg távollétében lebonyolított vizitek 68%-a dokumentált telefonbeszélgetések formájában zajlott. Az orvosok kétharmada veszélyeztetve érezte magát, hogy elkapja a vírust, ebből 40% úgy érezte, nem kap elegendő védelmet, 6% (2 fő) kapta el a fertőzést. Következtetés: A COVID–19-járvány a leginkább az új szakvélemények kiadását érintette, de a gondozási feladatokat sem mindig lehetett megfelelően megoldani. A károkat jelentősen enyhítette az ellátószemélyzet rugalmassága. A telefonvizitek, szükség esetén, az epileptológiában pótolhatják a személyes orvos-beteg találkozásokat. A járvány visszatérésének veszélye miatt a távvizit-alkalmazások technikai fejlesztése és ezek dokumentálási kérdéseinek megoldása fontos. A járványidőszakban a személyzet védelmére nagy figyelmet kell fordítani a fertőződés elkerülése és az orvosok biztonságérzetének fokozása érdekében. Orv Hetil. 2020; 161(46): 1939–1943. Summary. Introduction: COVID-19 pandemic has transformed the operation of outpatient care worldwide for months. The new framework was set in Hungary by the health emergency regulations that existed from 11. 03. 2020 to 17. 06. 2020. Objective: In the second half of the emergency period, between 22. 04. 2020 and 05. 05. 2020, we surveyed the opinion of physicians involved in epilepsy care about the extent to which patient care had changed and how they experienced the changes in person. Method: An internet questionnaire survey was conducted among neurologists registered for the annual congress of the Hungarian Chapter of the International League Against Epilepsy. Nine single- or multiple-choice questions and ‘free comment’ fields were available. Results: Of 116 neurologists contacted, 33 responded (28%), and a total of 30 comments were recorded. 73% said the changes caused a serious difficulty, 15% thought it would have serious consequences. Reception of new patients was stopped in 53%, and 25% encountered great difficulties. In 49%, the problems of the cared patients could be solved using remote visits, but 24% could not solve them properly. 68% of outpatient visits took the form of documented telephone conversations. Two-thirds of doctors feared catching the virus, 40% of whom felt they were not getting enough protection. 6% caught the infection. Conclusion: The COVID-19 pandemic has mostly affected the issuance of new expert opinions, but care tasks have not always been adequately addressed. The damage was significantly mitigated by the flexibility of the care staff. Telephone visits, if necessary, can replace personal doctor-patient encounters in epileptology. The technical development of remote visit applications and their documentation issues are important. During the pandemic period, great care must be taken to protect staff in order to avoid infection and increase the sense of safety of doctors. Orv Hetil. 2020; 161(46): 1939–1943.

Abstract 03: Outpatient Care Preceding Incident Heart Failure (HF) and Implications for Long-Term Outcomes. The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anna Kucharska-Newton ◽  
Lloyd Chambless ◽  
Ricky Camplain ◽  
Carmen Cuthbertson ◽  
Patricia Chang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Primary Care Physicians ◽  
Fee For Service ◽  
Physician Visits ◽  
Comorbidity Score ◽  
Risk Of Death ◽  
Outpatient Visits ◽  
Outpatient Physician ◽  
One Year ◽  
Aric Study

Hypothesis: We hypothesized that outpatient management of patients at risk for a HF hospitalization is associated with lower mortality following an incident HF hospitalization. Methods: Patterns of outpatient visits prior to incident HF hospitalization were assessed among CMS Medicare beneficiaries with continuous fee-for-service eligibility residing during 2003-2006 in four geographic areas of CVD surveillance conducted by the ARIC Study. Incident HF hospitalization was defined as hospitalization with ICD9 code 428.x with no HF hospitalizations in preceding 2 years. Outpatient visits to primary care physicians, general internists, or cardiologists were identified from Carrier files. A comorbidity score was calculated from ICD9 codes at the time of incident HF hospitalization. Cox proportional hazard models adjusted for age, comorbidity score, gender, and race were used to estimate mortality. Results: Mean age among beneficiaries with observed incident HF hospitalization (n=2006; 90.4% white, 45.1% male) was 79.8 years (SD 7.4). Mean comorbidity score was 3.6 (SD 1.9). Mean number of outpatient physician visits occurring in two years preceding the incident HF hospitalization, was 9.6 (SD 9.0); 19.6% beneficiaries had no observed prior outpatient physician visits. Risk of death within one year of incident HF hospitalization was greater among those with no preceding outpatient physician visits as compared to those with at least one physician visit (adjusted HR=1.81 (95% CI 1.50, 2.18); Figure). Adjustment for the presence of an outpatient visit within 2 weeks following the HF hospitalization attenuated the risk of death (HR=1.56 (1.29, 1.89)). Conclusion: Lack of outpatient care in two years prior to a HF-related hospitalization is associated with increased mortality within one year following hospitalization. Further inquiry is warranted to assess whether the association reflects diversity in causes/manifestations of HF, ambulatory care received in ED settings, or benefits associated with outpatient care.

scholarly journals Perceived enablers of exclusive breastfeeding by teenage mothers in Ghana

2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Angela K. Acheampong ◽  
Makombo Ganga-Limando ◽  
Lydia Aziato
Keyword(s):  
Exclusive Breastfeeding ◽  
Age Groups ◽  
Teenage Mothers ◽  
Care Staff ◽  
Policy Makers ◽  
Expert Opinions ◽  
Contextual Design ◽  
Breastfeeding Education ◽  
History Of

Background: Exclusive breastfeeding for the first 6 months can prevent diseases, boost immunity and improve quality of lives of infants. Ghana implemented programmes aimed at reaching the global target of increasing exclusive breastfeeding for the first 6 months to at least 50% by the year 2025. The country witnessed a decline in the overall rate of exclusive breastfeeding and an increase in the number of teenage mothers. Globally, teenage mothers are less likely to breastfeed than mothers of other age groups. Understanding enablers of exclusive breastfeeding by teenage mothers is important for any intervention aimed at improving exclusive breastfeeding rates and the quality of lives of infants.Method: The study used a qualitative, exploratory, descriptive and contextual design, with focus groups. A total of six group discussions were conducted with 30 pregnant teenagers recruited from six public hospitals.Results: Seven enablers emerged from the analysis of data. These included positive beliefs about the benefits of breast milk, family history of positive exclusive breastfeeding outcomes, support of the intimate partner, approval of closed-family members, expert opinions of antenatal care staff, teenage-oriented breastfeeding education and community-based breastfeeding education.Conclusion: Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana.

scholarly journals Back to the Future: Principles on Resuming Outpatient Services in the COVID-19 Era

2020 ◽  
Vol 163 (4) ◽  
pp. 705-706 ◽  
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Outpatient Services ◽  
Drastic Reduction ◽  
The Public ◽  
Outpatient Visits ◽  
The Future ◽  
Care Systems

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to outpatient care.

Outpatient Care and Morbidity Reduction in Diabetic Foot Ulcers Associated with Chronic Pressure Callus

2001 ◽  
Vol 91 (6) ◽  
pp. 275-279 ◽  
Author(s):  
Ronald A. Sage ◽  
Julie Kate Webster ◽  
Susan Gross Fisher
Keyword(s):  
Diabetic Foot ◽  
Outpatient Care ◽  
Traumatic Event ◽  
Foot Ulcers ◽  
Minor Trauma ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Foot Ulceration ◽  
Outpatient Visits ◽  
Foot Clinic

In a retrospective review of 233 cases of diabetic foot ulceration preceded by minor trauma, 192 ulcerations exhibited focal pressure keratosis as the preceding traumatic event. The frequency of outpatient visits and other foot care interventions were correlated with the occurrence and severity of ulceration. Patients seen more frequently in an outpatient foot clinic had less severe ulcers and were less likely to undergo surgical treatment than those with less frequent visits. (J Am Podiatr Med Assoc 91(6): 275-279, 2001)

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities (Preprint)

2019 ◽  
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

BACKGROUND Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. OBJECTIVE In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. METHODS We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. RESULTS We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. CONCLUSIONS This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities

10.2196/16185 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e16185
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

Background Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. Objective In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. Methods We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. Results We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. Conclusions This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

scholarly journals Prevalence and risk factors of MRSA colonisations: a cross-sectional study among personnel in outpatient care settings in Hamburg, Germany

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021204 ◽  
Author(s):  
Claudia Peters ◽  
Olaf Kleinmüller ◽  
Albert Nienhaus ◽  
Anja Schablon
Keyword(s):  
Risk Factors ◽  
Nursing Staff ◽  
Outpatient Care ◽  
Health Personnel ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Sectional Study ◽  
Outpatient Services ◽  
Cross Sectional

ObjectivesHealthcare workers frequently come into contact with infected individuals and are at a greater risk of infection than the general population due to their occupation. Multidrug-resistant organisms (MDROs) also pose a significant challenge for personnel and medical facilities. Currently, little is known about the occupational risk of methicillin-resistantStaphylococcus aureus(MRSA) in outpatient care settings. Therefore, a cross-sectional study was conducted in Hamburg to investigate MRSA colonisation among outpatient nursing staff.MethodsMRSA screening with nasal swabs was carried out, the known risk factors for colonisation were determined and information on infection control was inquired. Where tests were positive, a control swab was taken; if this confirmed a positive result, decolonisation was offered. A molecular biological examination of the MRSA samples was performed. The occupational MRSA exposure and risk factors were compared with the situation for personnel in inpatient geriatric care.ResultsA total of 39 outpatient services participated in the study and 579 employees were tested. The MRSA prevalence was 1.2% in all and 1.7% in nursing staff. Most of the employees that tested positive had close or known contact with MRSA patients. Health personnel frequently reported personal protective measures and their application. Compared with inpatient care staff, outpatient staff were older and had worked in their profession for a longer time.ConclusionThis study marks the first time that data has been made available on the occupational MRSA risk of outpatient care personnel in Hamburg. The MRSA prevalence is low and provides a good basis for describing the MRSA risk of occupational exposure by health personnel in outpatient care.

scholarly journals Main trends of changes in indicators of emergency outpatient care for adult population of the large industrial city

2017 ◽  
Vol 98 (1) ◽  
pp. 105-110
Author(s):  
I R Iskandarov ◽  
A A Gilmanov
Keyword(s):  
Chronic Diseases ◽  
Acute Exacerbation ◽  
Emergency Care ◽  
Outpatient Care ◽  
Adult Population ◽  
Circulatory System ◽  
Health Organizations ◽  
Outpatient Visits ◽  
Number Of Patients ◽  
Outpatient Settings

Aim. To study major trends of emergency outpatient visits on the example of the city of Naberezhnye Chelny adult population of different categories by age and sex according to the time indices - the month and day of the week.Methods. 3,393,351 outpatient visits of the Naberezhnye Chelny adult population for 2011-2013 were analyzed.Results. The highest attendance rates of adult population to health organizations providing emergency care in outpatient settings were registered in spring (March, April, May) and in autumn (September, October, November) with a peak attendance in April and October. There is a certain pattern of distribution of cases of outpatient visits for acute exacerbation of chronic diseases, and by the day of the week. Thus, a significant number of patients attended health organizations on Monday (26%). In the following days, their number gradually decreased and reached minimum on Saturday and Sunday. During the study period, the number of outpatient visits for acute exacerbation of chronic diseases by adult population on Monday rose by 12.1%. In the structure of emergency outpatient care, proportion of the diseases of respiratory, musculoskeletal and circulatory systems was the highest. During the study period number of visits for diseases of respiratory system increased by 2.4%, circulatory system - by 1.2%, musculoskeletal system - has not changed.Conclusion. The main workload of medical organizations providing emergency care in outpatient settings is unequally distributed by days of the week and months; there is a need for translating outpatient care on a 7-day work schedule to avoid the maximum load on the outpatient clinic on Monday and in the morning hours as a result of the accumulated over the weekend and night hours incidence.

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