scholarly journals Hospital Admission Rates for a Racially Diverse Low-Income Cohort of Patients With Diabetes: The Urban Diabetes Study

2006 ◽  
Vol 96 (7) ◽  
pp. 1260-1264 ◽  
Author(s):  
Jessica M. Robbins ◽  
David A. Webb
Keyword(s):  
Hospital Admission ◽  
Low Income ◽  
Racially Diverse ◽  
Admission Rates ◽  
Patients With Diabetes

A retrospective evaluation of unplanned hospital admission rates for women with ovarian cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18129-e18129
Author(s):  
Shayan M Dioun ◽  
Eirwen Murray Miller ◽  
Joan Tymon-Rosario ◽  
Dennis Yi-Shin Kuo ◽  
Nicole Suzanne Nevadunsky
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Hospital Admission ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Care Model ◽  
Metabolic Disturbances ◽  
Racially Diverse ◽  
Admission Rates ◽  
Oncology Care

e18129 Background: Unplanned admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates 10-35% in women with ovarian cancer receiving chemotherapy. It is unclear whether the Oncology Care Model is sustainable based on these admission rates. We sought to evaluate the rate and risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, all patients with epithelial ovarian cancer who received chemotherapy at our institution from 2005-2016 were identified. Charts were retrospectively reviewed for clinicopathologic data. Categorical variables were compared with chi-squared and continuous variables with the student t-test. Results: 222 evaluable patients were identified. 37 (17%) patients had unplanned admissions following initial chemotherapy. Indications for admission included neutropenic fever (9), abdominal pain (15), metabolic disturbances (2), infection (3), and other (8). The median number of days from chemotherapy to admission was 8 (IQR 7-18.5). No significant differences were seen in race, medical co-morbidities, age, or BMI in admitted patients. Stage and primary neoadjuvant chemotherapy were predictive of admission. Conclusions: Unplanned hospital admission rates following initial chemotherapy in our racially diverse patient population are consistent with previously reported rates. Though age and medical co-morbidities did not predict admission, stage and primary neoadjuvant chemotherapy were predictive of subsequent admission. The Oncology Care Model may not account for hospital admission rates of this magnitude and further investigation is needed to identify predictors of hospitalization and poor outcomes. [Table: see text]

scholarly journals Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes

2015 ◽  
Vol 98 (11) ◽  
pp. 1360-1366 ◽  
Author(s):  
M.T. Chao ◽  
M.A. Handley ◽  
J. Quan ◽  
U. Sarkar ◽  
N. Ratanawongsa ◽  
...  
Keyword(s):  
Low Income ◽  
Safety Net ◽  
Racially Diverse ◽  
Complementary Health Approaches ◽  
Patients With Diabetes

scholarly journals 1683. Hospital Admission Patterns in Adult Patients with Complicated Urinary Tract Infections (cUTIs): Identification of Potentially Avoidable Hospital Admissions Across United States (US) Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S825-S826
Author(s):  
Thomas Lodise ◽  
Teena Chopra ◽  
Brian Nathanson ◽  
Katherine Sulham
Keyword(s):  
Hospital Admission ◽  
Hospital Admissions ◽  
Panel Member ◽  
Inclusion Criteria ◽  
Independent Contractor ◽  
Healthcare Database ◽  
Admission Rates ◽  
Comorbidity Index ◽  
Multi Center Study ◽  
Tract Infections

Abstract Background There is an increase in hospital admissions for cUTI in the US despite apparent reductions in the severity of admissions. However, there are scant data on cUTI hospital admission rates from the emergency department (ED) stratified by age, infection severity, and presence of comorbidities. This study described US hospitalization patterns among adults who present to the ED with a cUTI. We sought to quantify the proportion of admissions that were potentially avoidable based on presence of sepsis and associated symtpoms as well as Charlston Comorbidity Index (CCI) scores. Methods A retrospective multi-center study using data from the Premier Healthcare Database (2013-18) was performed. Inclusion criteria: (1) age ≥ 18 years, (2) primary cUTI ED/inpatient discharge diagnosis, (3) positive blood or urine culture between index ED service days -5 to +2. Transfers from acute care facilities were excluded. Based on ICD-9/10 diagnosis codes present on admission, incidence of hospital admissions were stratified by age (≥ 65 years vs. < 65 years), presence of sepsis (S), sepsis symptoms but no sepsis codes (SS) (e.g., fever, tachycardia, tachypnea, leukocytosis, etc.), and CCI. Results 187,789 patients met inclusion criteria. The mean (SD) age was 59.7 (21.9), 40.4% were male, 29.4% had sepsis, 16.7% had at least 1 SS symptom (but no S), and 53.9% had no evidence of S or SS. The median [IQR] CCI was 1 [0, 3]. 119,668 out of 187,789 (63.7%) were admitted to hospital. Among inpatients, median [IQR] length of stay (LOS) and total costs were 5 [3, 7] days and $7,956 [$4,834, $13,960] USD. Incidence of hospital admissions by age, presence of S/SS, and CCI score are shown in the Table. 18.9% of admissions (22,644/119,668) occurred in patients with no S/SS and a CCI ≤ 2. Their median [IQR] LOS and total costs were 3 [2, 5] days and $5,575 [$3,607, $9,133]. Incidence of Hospital Admission by Age, Charlson comorbidity index (CCI), Presence of Sepsis (S), and Presence of Sepsis Symptoms (SS) Conclusion Nearly 1 in 5 cUTI hospital admissions may be avoidable. Given the resources associated with the management of inpatients with cUTIs, these findings highlight the critical need for healthcare systems to develop well-defined criteria for hospital admission based on presence of comorbid conditions and infection severity. Preventing avoidable hospital admissions has the potential to save the healthcare system substantial costs. Disclosures Thomas Lodise, PharmD, PhD, Paratek Pharmaceuticals, Inc. (Consultant) Teena Chopra, MD, MPH, Spero Therapeutics (Consultant, Advisor or Review Panel member) Brian Nathanson, PhD, Spero Therapeutics (Independent Contractor) Katherine Sulham, MPH, Spero Therapeutics (Independent Contractor)

scholarly journals Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison

2021 ◽  
pp. 135581962110127
Author(s):  
Irina Lut ◽  
Kate Lewis ◽  
Linda Wijlaars ◽  
Ruth Gilbert ◽  
Tiffany Fitzpatrick ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Underlying Disease ◽  
Primary Diagnosis ◽  
Care Quality ◽  
Attendance Rates ◽  
Admission Rates ◽  
Primary Care Quality ◽  
Hospital Administrative

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.

scholarly journals MyCare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial, clinical outcomes and hospital admission rates for adults with severe mental illness

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040610
Author(s):  
Renée O'Donnell ◽  
Melissa Savaglio ◽  
Debra Fast ◽  
Ash Vincent ◽  
Dave Vicary ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Community Based ◽  
Admission Rates ◽  
Mental Health Support ◽  
Health Support

IntroductionPeople with serious mental illness (SMI) often fail to receive adequate treatment. To provide a higher level of support, mental health systems have been reformed substantially to integrate mental healthcare into the community. MyCare is one such community-based mental health model of care. This paper describes the study protocol of a controlled trial examining the effect of MyCare on psychosocial and clinical outcomes and hospital admission and duration rates for adults with SMI.Methods and analysisThis is a multisite non-randomised controlled trial with a 3, 6 and 12-month follow-up period. The study participants will be adults (18–64 years of age) with SMI recruited from Hobart, Launceston and the North-West of Tasmania. The treatment group will include adults who receive both the MyCare intervention and standard mental health support; the control group will include adults who receive only standard mental health support. The primary outcome includes psychosocial and clinical functioning and the secondary outcome will examine hospital admission rates and duration of stay. Mixed-effects models will be used to examine outcome improvements between intake and follow-up. This trial will generate the evidence needed to evaluate the effect of a community mental health support programme delivered in Tasmania, Australia. If MyCare results in sustained positive outcomes for adults with SMI, it could potentially be scaled up more broadly across Australia, addressing the inequity and lack of comprehensive treatment that many individuals with SMI experience.Ethics and disseminationThis study has been approved by the Tasmanian Health and Medical Human Research Ethics Committee. The findings will be disseminated to participants and staff who delivered the intervention, submitted for publication in a peer-reviewed journal and shared at academic conferences.Trial registration numberACTRN12620000673943.

scholarly journals Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme

BMJ ◽  
2020 ◽  
pp. m4571 ◽  
Author(s):  
Caroline Fyfe ◽  
Lucy Telfar ◽  
Barnard ◽  
Philippa Howden-Chapman ◽  
Jeroen Douwes
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Confidence Interval ◽  
Hospital Admission ◽  
Retrospective Cohort ◽  
Rate Ratio ◽  
Hospital Admissions ◽  
Relative Rate ◽  
Intervention Programme ◽  
Admission Rates

Abstract Objectives To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. Design A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. Participants 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. Main outcome measure A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. Results 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). Conclusion This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.

Budesonide reduces hospital admission rates in preschool children with acute wheezing

2017 ◽  
Vol 52 (6) ◽  
pp. 720-728 ◽  
Author(s):  
Cem Hasan Razi ◽  
Nazlı Cörüt ◽  
Nesibe Andıran
Keyword(s):  
Preschool Children ◽  
Hospital Admission ◽  
Admission Rates

Measuring Attitudes and Health Beliefs Among Mexican Americans With Diabetes

1994 ◽  
Vol 20 (3) ◽  
pp. 221-227 ◽  
Author(s):  
Terri Schwab ◽  
Julie Meyer ◽  
Rosa Merrell
Keyword(s):  
Health Beliefs ◽  
Low Income ◽  
Cultural Sensitivity ◽  
Mexican Americans ◽  
Mexican American ◽  
Health Belief ◽  
Important Variable ◽  
Patients With Diabetes ◽  
Health Related ◽  
Belief Model

Adherence to the treatment regimen for patients with diabetes is of major concern to healthcare practitioners, particularly when dealing with the high-risk, low-income, Mexican-American population. Assessing the attitudes and beliefs of this group is vital for planning effective and realistic intervention strategies. Therefore, we designed a culturally sensitive instrument to measure health beliefs and attitudes of low-income Mexican Americans with diabetes. The Health Belief Model (HBM) was used as a basis for this study because it is well accepted as a predictor of health-related behaviors. However, we found that the HBM was not an effective tool for assessing the health beliefs or attitudes of this patient population even after rigorous efforts to operationalize the HBM and after conducting extensive statistical analyses. Only two of the five subscales of the traditional HBM, barriers and benefits, were reliable. Scales to measure acculturation and fatalism were added to increase the cultural sensitivity of the tool. These added components were found to be an important variable in interpreting the results for low-income Mexican-American patients.

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