scholarly journals Controlling the Queue of Work Items in System of Management of Medical Care Quality in Case of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Alsim Kharisov ◽  
Evgeniya Berseneva ◽  
Aleksey Bereznikov ◽  
Maxim Efimov ◽  
Sergey Shkitin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medical Care ◽  
Pulmonary Disease ◽  
Poor Quality ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Workflow Technology ◽  
Quality Of Medical Care ◽  
Quality Medical Care

Providing Russias population with accessible and quality medical care is made possible by its strict correspondence to the legal requirements. In case there arise violations of legally established requirements in providing medical care, it is named as poor quality medical care, which is subject to juridical liability. Measures in managing the quality of medical care should take into account the timely elimination of violations - depending on the degree of their significance and expediency of delayed elimination. Inadequacy of admitted violations determine the need of controlling the work items queue in the system of the medical care quality management in implementing the Workflow technology in medical organizations. The authors examine the feature of the work items queue control in terms of example of chronic obstructive pulmonary disease.

scholarly journals Readmissions for chronic obstructive pulmonary disease in actual clinical practice

2018 ◽  
Vol 99 (2) ◽  
pp. 314-322
Author(s):  
A F Yakupova ◽  
A R Zinnatullina ◽  
R F Khamitov
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Relative Risk ◽  
Medical Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Treatment Optimization ◽  
Obstructive Pulmonary Disease ◽  
Quality Of Medical Care

Aim. Identification of risk factors for readmissions associated with exacerbation of chronic obstructive pulmonary disease followed by identification of possible quality defects in the provision of medical care to patients in the outpatient and hospital stages. Methods. A retrospective analysis of the medical records of patients with exacerbation of chronic obstructive pulmonary disease admitted twice or more to the therapeutic department of one of the hospitals of Kazan during the period from January 1, 2015 to June 30, 2016. Results. The risk factors for readmissions were found to be the following: male sex (relative risk 2.29; 95% CI 0.78-6.69; р ˂0.05), age over 70 years (relative risk 2.069; 95% CI 1.01-4.2; р ˂0.05), smoking for more than 40 years (relative risk 5.3; 95% CI 1.6-17.5; р ˂0.05), duration of the disease more than 6 years (relative risk 2.4; 95% CI 0.98-6.18; р ˂0.05), presence of three or more concomitant diseases, primarily cardiovascular pathology (relative risk 13.0; 95% CI 1.89-90.14; р ˂0.05). Important reasons for subsequent exacerbations after discharge from the hospital are patients' nonadherence and defects of the provision of medical care in the hospital. Conclusion. The revealed defects of the quality of medical care indicate the need to intensify the implementation of the federal clinical guidelines for chronic obstructive pulmonary disease in actual medical practice; due to the difficulty of modifying the identified risk factors, the main efforts should be directed at treatment optimization with adherence control, as well as full use of the potential for non-drug treatment in the form of guidelines for maintaining physical activity, early smoking quitting and patients' rehabilitation.

Chronic obstructive pulmonary disease: significance of risk factors for frequent exacerbations requiring hospitalization

2021 ◽  
Vol 31 (4) ◽  
pp. 446-455
Author(s):  
A. R. Zinnatullina ◽  
R. F. Khamitov
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Medical Care ◽  
Pulmonary Disease ◽  
Patient Adherence ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Quality Of Medical Care ◽  
Outpatient Settings

Aim. Identification of risk factors for readmissions associated with an exacerbation of chronic obstructive pulmonary disease (COPD) followed by evaluation of quality of the medical care in the outpatient and hospital settings.Methods. A retrospective analysis of the medical records of patients with an exacerbation of chronic obstructive pulmonary disease admitted to the multidisciplinary hospitals in Kazan from January 1, 2015 to December 31, 2018, was.Results. The identified risk factors for readmission were male gender (relative risk (RR) 3.49; 95% confidence interval (CI) 1.45 – 8.43; p < 0.05), age over 70 years (RR 1.21; 95% CI 0.74 – 1.86; p < 0.05), smoking experience more than 40 years (RR 1.6; 95% CI 0.87 – 3.0; p < 0.05), duration of COPD at least 10 years (RR 3.48; 95% CI 2.27 – 5.34; p < 0.05), the presence of three or more concomitant diseases (RR 2.0; 95% CI 1.23 – 3.4; p < 0.05). The most significant reasons for readmissions were nonadherence in the outpatient settings, as well as defects in the therapy that was provided in the hospital and prescribed upon discharge.Conclusion. The identified risk factors are non-modifiable in most cases, so optimizing treatment and monitoring patient adherence are of paramount importance. Also, more attention should be paid to nonpharmacological treatment in the form of maintaining physical activity, early smoking cessation and psychological rehabilitation. The revealed defects of the quality of medical care for patients with severe exacerbations requiring repeated hospitalizations indicate the need to intensify the implementation of the federal clinical guidelines on chronic obstructive pulmonary disease in the real clinical practice.

Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality

2020 ◽  
pp. 1357633X2097040
Author(s):  
Hanadi Y Hamadi ◽  
Dayana Martinez ◽  
Jing Xu ◽  
Geoffrey A Silvera ◽  
Jorge M Mallea ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mortality Rates ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Post Discharge ◽  
Obstructive Pulmonary Disease ◽  
American Hospital ◽  
American Hospital Association ◽  
Copd Mortality

Introduction Much attention has been focused on decreasing chronic obstructive pulmonary disease (COPD) hospital readmissions. The US health system has struggled to meet this goal. The objective of this study was to assess the efficacy of telehealth services on the reduction of hospital readmission and mortality rates for COPD. Methods We used a cross-sectional design to examine the association between hospital risk-adjusted readmission and mortality rates for COPD and hospital use of post-discharge telemonitoring (TM). Data for 777 hospitals were sourced from the Centers for Medicare & Medicaid Services and the American Hospital Association annual surveys. Propensity score matching using the kennel weights method was applied to calculate the weighted probability of being a hospital that offers post-discharge TM services. Results Hospitals with post-discharge TM had about 34% significantly higher odds (adjusted odds ratio (AOR) = 1.34; 95% confidence interval (CI) 1.06–1.70) of 30-day COPD readmission and 33% significantly lower odds (AOR = 0.67; 95% CI 0.50–0.90) of 30-day COPD mortality compared to hospitals without post-discharge TM services. Discussion Overall, hospitals that offer post-discharge TM services have seen an improvement in 30-day COPD mortality rates. However, those same hospitals have also experienced a significant increase in 30-day COPD readmissions. TM can potentially decrease mortality in patients recently admitted for acute exacerbation of COPD. The results provide further evidence that readmissions present a problematic assessment of health-care quality, as the need for readmission may or may not be directly related to the quality of care received while in hospital.

Palliative Care in End-Stage Chronic Obstructive Pulmonary Disease

2018 ◽  
Author(s):  
Linh My Thi Nguyen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Poor Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
End Stage

Patients with end-stage chronic obstructive pulmonary disease (COPD) experience high symptom burden due to severe dyspnea, fatigue, anxiety, depression, disability, and social isolation, resulting in poor quality of life. The caregiving burden for the family is also severe. Despite high symptom burden, because of limited access and difficulty with prognostication, the quality of care for patients with end-stage COPD who receive palliative care compares poorly to the care received by patients with cancer, and the proportion of COPD patients who receive palliative care is much lower than that of cancer patients. Therefore, patients with COPD receive less palliative care and die following more aggressive treatments at the end of life compared to patients with lung cancer, despite having the same preferences for palliative care. This chapter discusses the key issues related to end-stage COPD, including symptom assessment, management, and hospice eligibility.

scholarly journals Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease

2015 ◽  
Vol 3 (3) ◽  
pp. 89-92 ◽  
Author(s):  
Pan-wen Tian ◽  
Fu-qiang Wen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Poor Quality ◽  
High Rate ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mucus Hypersecretion ◽  
Phosphodiesterase 4 Inhibitors ◽  
Airway Mucus

Abstract Airway mucus hypersecretion is one of the most important features of chronic obstructive pulmonary disease (COPD). Airway mucus hypersecretion in COPD patients results in outcomes such as rapid decline of lung function, poor quality of life, and high rate of acute exacerbation, hospitalization and mortality. Nonpharmacologic treatments for airway mucus hypersecretion in COPD include smoking cessation and physical rehabilitation. Pharmacologic therapies include expectorants, mucolytics, methylxanthines, beta-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics. Novel drugs with promising prospects are currently under clinical trials.

scholarly journals What is the Cost to Employers of Direct Medical Care for Chronic Obstructive Pulmonary Disease?

2006 ◽  
Vol 3 (4) ◽  
pp. 203-209 ◽  
Author(s):  
Tursynbek Nurmagambetov ◽  
Adam Atherly ◽  
Seymour Williams ◽  
Fernando Holguin ◽  
David M. Mannino ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medical Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Cost ◽  
Direct Medical Care

Health-Care Quality Standards in Chronic Obstructive Pulmonary Disease

2009 ◽  
Vol 45 (4) ◽  
pp. 196-203 ◽  
Author(s):  
Juan José Soler-Cataluña ◽  
Myriam Calle ◽  
Borja G. Cosío ◽  
José María Marín ◽  
Eduard Monsó ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Health Care Quality ◽  
Quality Standards ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease
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