scholarly journals The Impact of a Hospitalist Model in Perioperative Care of Elective Joint Replacement Patients: a 17 years-experience Report

2020 ◽  
Author(s):  
Matteo Carlo Ferrari ◽  
Elena Azzolini ◽  
Giuseppe Strangio ◽  
Salvatore Badalamenti ◽  
Michele Lagioia
Keyword(s):  
Customer Satisfaction ◽  
Joint Replacement ◽  
Indirect Costs ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Joint Infections ◽  
Co Morbidity ◽  
Tertiary Teaching ◽  
Prosthetic Joint Infections ◽  
The Impact

Abstract Background Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The aim of this report is to describe a 17-year experience of a hospitalist model in peri-operative co-management in more than 25,000 elective joint replacement patients. Methods A retrospective observational study about surgical co-management with hospitalists in a tertiary teaching referral hospital in Milan in relation to hospital lengths of stay (LOS), 30-days readmission rate, incidence of prosthetic joint infections (PJI) and patient related co-morbidities, number of medico-legal disputes and related costs, and medical customer satisfaction. Results Over a 17-year period LOS has been reduced from 10 to 5 days; readmission rates for total hip arthroplasty are 1.7% vs 3.7% (Italy) at 30 days; total infection rates for total knee arthroplasty are recorded at 0.8% vs 1.4% (Italy); obesity, diabetes, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) and/or smoking result as the main co-morbidity in PJI; there have been only 113 medico-legal disputes out of approximately 19,000 surgeries and we report 95% overall medical customer satisfaction. Conclusions This is the first paper outside the US to highlight the impact of the hospitalists on patient satisfaction and the translation of the obtained benefits into savings. The evolution of the hospitalist model in surgical settings shows promising results in terms of patients’ safety and cut of health-related direct and indirect costs.

scholarly journals The Impact of a Hospitalist Model in Perioperative Care of Elective Joint Replacement Patients: a 17 years-experience Report

2020 ◽  
Author(s):  
Matteo Carlo Ferrari ◽  
Elena Azzolini ◽  
Giuseppe Strangio ◽  
Salvatore Badalamenti ◽  
Michele Lagioia
Keyword(s):  
Customer Satisfaction ◽  
Joint Replacement ◽  
Indirect Costs ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Joint Infections ◽  
Co Morbidity ◽  
Tertiary Teaching ◽  
Prosthetic Joint Infections ◽  
The Impact

Abstract Background: Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The aim of this report is to describe a 17-year experience of a hospitalist model in peri-operative co-management in more than 25000 elective joint replacement patients.Methods: A retrospective observational study about surgical co-management with hospitalists in a tertiary teaching referral hospital in Milan in relation to hospital lengths of stay (LOS), 30-days readmission rate, incidence of prosthetic joint infections (PJI) and patient related co-morbidities, number of medico-legal disputes and related costs, and medical customer satisfaction. Results: Over a 17-year period LOS has been reduced from 10 to 5 days; readmission rates at 30 days for total hip arthroplasty are 1.7% vs 3.7% (Italy), whereas for total knee arthroplasty are 0.8% vs 1.4% (Italy); total infection rates (PJI) are recorded at 0.7% vs 1.4% (Italy); obesity, diabetes, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) and/or smoking result as the main co-morbidity in PJI; there have been only 113 medico-legal disputes out of approximately 19000 surgeries and we report 95% overall medical customer satisfaction.Conclusions: This is the first paper outside the US to highlight the impact of the hospitalists on patient satisfaction and the translation of the obtained benefits into savings. The evolution of the hospitalist model in surgical settings shows promising results in terms of patients’ safety and cut of health-related direct and indirect costs.

Hazards for Construction Workers

2017 ◽  
Author(s):  
Gavin H. West ◽  
Laura S. Welch
Keyword(s):  
Heavy Metals ◽  
Prevention And Control ◽  
Respiratory Diseases ◽  
Noise Exposure ◽  
Engineered Nanomaterials ◽  
Construction Workers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
And Control ◽  
The Impact

This chapter describes the hazards for construction workers, with a particular focus on injuries as well as exposures to hazardous chemicals and dusts. A section describes hazardous exposures to lead and other heavy metals. Another section describes noise exposure. The impact of musculoskeletal disorders among construction workers is then discussed. A section on respiratory diseases focuses on asbestosis, silicosis, chronic obstructive pulmonary disease, and asthma. Exposures known to cause dermatitis and cancer are reviewed. There is a discussion of engineered nanomaterials as a potential emerging hazard. Various approaches to prevention and control, including regulations and health services, are described.

scholarly journals The Impact of the COVID-19 Pandemic on Self-Reported Management of Chronic Conditions

2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Hyllore Imeri ◽  
Erin Holmes ◽  
Shane Desselle ◽  
Meagen Rosenthal ◽  
Marie Barnard
Keyword(s):  
Locus Of Control ◽  
Chronic Conditions ◽  
Online Survey ◽  
Health Locus Of Control ◽  
Patient Activation ◽  
Survey Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control–Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.

scholarly journals ‘I’m fine!’: Assertions of lack of support need among patients with chronic obstructive pulmonary disease: A mixed-methods study

2021 ◽  
pp. 174239532110003
Author(s):  
A Carole Gardener ◽  
Caroline Moore ◽  
Morag Farquhar ◽  
Gail Ewing ◽  
Efthalia Massou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mixed Method ◽  
Self Report ◽  
Design Stage ◽  
Chronic Obstructive ◽  
Support Needs ◽  
Obstructive Pulmonary Disease ◽  
Stage 1 ◽  
The Impact

Objectives To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow their support needs and the impact on care. Methods Two stage mixed-method design. Stage 1 involved sub-analyses of data from a mixed-method population-based longitudinal study exploring the needs of patients with advanced COPD. Using adapted criteria from mental health research, we identified 21 patients who disavowed their needs from the 235 patient cohort. Qualitative interview transcripts and self-report measures were analysed to compare these patients with the remaining cohort. In stage 2 focus groups (n = 2) with primary healthcare practitioners (n = 9) explored the implications of Stage 1 findings. Results Patients who disavowed their support needs described non-compliance with symptom management and avoidance of future care planning (qualitative data). Analysis of self-report measures of mental and physical health found this group reported fewer needs than the remaining sample yet wanted more GP contact. The link between risk factors and healthcare professional involvement present in the rest of the sample was missing for these patients. Focus group data suggested practitioners found these patients challenging. Discussion This study identified patients with COPD who disavow their support needs, but who also desire more GP contact. GPs report finding these patients challenging to engage.

scholarly journals The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status

2013 ◽  
Vol 37 (4) ◽  
pp. 654-663 ◽  
Author(s):  
Kristen E. Holm ◽  
Melissa R. Plaufcan ◽  
Dee W. Ford ◽  
Robert A. Sandhaus ◽  
Matthew Strand ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Relationship Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease - a randomised clinical trial

2014 ◽  
Vol 23 (21-22) ◽  
pp. 3124-3137 ◽  
Author(s):  
Christina Emme ◽  
Erik L Mortensen ◽  
Susan Rydahl-Hansen ◽  
Birte Østergaard ◽  
Anna Svarre Jakobsen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Pulmonary Disease ◽  
Self Efficacy ◽  
Randomised Clinical Trial ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Abstract 15226: The Impact of Chronic Obstructive Pulmonary Disease on In-hospital Outcomes Following Left Ventricular Assist Device Implantation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bertrand Ebner ◽  
Jennifer Maning ◽  
Louis Vincent ◽  
Jelani Grant ◽  
neal olarte ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Left Ventricular Assist Device ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Assist Device ◽  
Hospital Outcomes ◽  
Ventricular Assist ◽  
Obstructive Pulmonary Disease ◽  
Left Ventricular Assist ◽  
The Impact

Background: Chronic obstructive pulmonary disease (COPD) is well-known cause of ventricular dysfunction. However, in the setting of patients with advanced heart failure undergoing left ventricular assist device (LVAD) implantation, there is paucity data on COPD influence on in-hospital outcomes. Methods: This retrospective cohort study based on the Nationwide Inpatient Sample included all patients above 18 years all who underwent LVAD implantation from 2011 to 2017. All data was weight as recommended by Healthcare Cost and Utilization Project.Multivariate logistic regression was used to evaluate the impact of COPD on in-hospital outcomes. Results: A total of 25,503 patients underwent LVAD implantation, of those 13.8% had a pre-existing diagnosis of COPD. Individuals with COPD were older (median 62 vs. 58 years, p<0.001), more commonly male (82% vs. 76.4%, p<0.001). Patient with COPD had a greater burden of comorbidities confirmed by significant higher rate of hypertension, diabetes, atrial tachyarrhythmias, dyslipidemia, prior stroke, coronary and peripheral artery diseases, pulmonary hypertension, and chronic kidney disease (p<0.001 for all). No significant difference was found in in-hospital stroke, infections, short-term percutaneous mechanical circulatory support, implant related complications, and LVAD thrombosis. There was a significant higher rate of inpatient acute kidney injury, major bleeding, cardiac complications, thromboembolism, and cardiac arrest in patients without COPD (p<0.05 for all outcomes). Compared to patients without COPD, individuals with COPD had a lower mortality (6.2% vs. 12.4%; OR 0.59; C.I. 0.512-0.685; p<0.05). Conclusion: Patients with COPD undergoing LVAD implantation have higher comorbidities, however, it is not associated with increase in-hospital all-cause mortality.Further studies are needed to analyze the differences found between these two groups in more detail.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

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