scholarly journals Impact of the COVID-19 Outbreak on Emergency Resources – An Observational Multicenter Study Including All Hospitals in a Major Urban Center of the Rhein Ruhr Metropolitan Region

2020 ◽  
Author(s):  
Sebastian Bergrath ◽  
Tobias Strapatsas ◽  
Michael Tuemen ◽  
Thorsten Reith ◽  
Marc Deussen ◽  
...  
Keyword(s):  
Data Analysis ◽  
Multicenter Study ◽  
Social Life ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Urban Center ◽  
Medical Specialties ◽  
Work Related ◽  
Ed Visits ◽  
The Impact

Abstract Background: The outbreak of the coronavirus disease 2019 (COVID-19) caused by the severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) led to severe disruption in social life and economics. The present study should analyze the impact of the local COVID-19 epidemic on emergency resources for all hospitals in a major urban center (Moenchengladbach, Germany). Methods: An observational multicenter study was performed involving all four acute care hospitals. Systemic parameters department (ED) parameters from week 4 to 24 in 2020 were compared to the corresponding period in 2019 for each hospital and in a summative data analysis using a logistic regression model. Outcomes: ED visits, ED to hospital admission, ED to Intensive Care Unit (ICU) admission, medical specialties of admitted patients, work related accidents. Results: In week 9/2020 the first SARS-CoV-2 positive patients were detected in our region. All hospitals decided to minimize elective admissions to ensure operational capability for COVID-19 patients. The summative number of ED visits dropped from 34,659 to 28,008. Numbers decreased from week 8 on between 38% and 48% per week per hospital at the maximum and began to rise again from week 16 on. The pooled data analysis showed statistically significant decreases in outpatient ED visits (20,152 vs. 16,477, p=<0.001), hospital admissions of ED patients (14,507 vs. 11,531, p=<0.001), and work-related accidents (2,290 vs. 1,468, p=<0.001). The decrease in admissions from ED to ICU did not reach statistical significance (2,093 vs. 1,566, p=0.255). The decline in ED cases was mainly caused by a decrease in non-trauma and non-surgical patients. Conclusion: The regional COVID-19 outbreak led to significantly reduced ED contacts after the first COVID-19 cases appeared. Even the admissions to the hospitals and the number of ED to ICU-admissions decreased, which is potentially dangerous, because the ratio of emergency outpatients vs. inpatients remained stable. Therefore, one can assume that patients with severe medical problems did not seek ED care in many cases. The decline of patients was earlier than in other German hospitals and in contrast to the findings in the U.S. and Italy where ED visits and hospital admissions in medical disciplines increased.

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

scholarly journals The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature

2021 ◽  
Author(s):  
Matthijs D. Kruizinga ◽  
Daphne Peeters ◽  
Mirjam van Veen ◽  
Marlies van Houten ◽  
Jantien Wieringa ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hospital Admissions ◽  
Clinical Care ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Care Utilization ◽  
Admission Data ◽  
Multicenter Analysis ◽  
Ed Visits ◽  
The Impact

AbstractThe coronavirus disease 2019 pandemic has enormous impact on society and healthcare. Countries imposed lockdowns, which were followed by a reduction in care utilization. The aims of this study were to quantify the effects of lockdown on pediatric care in the Netherlands, to elucidate the cause of the observed reduction in pediatric emergency department (ED) visits and hospital admissions, and to summarize the literature regarding the effects of lockdown on pediatric care worldwide. ED visits and hospital admission data of 8 general hospitals in the Netherlands between January 2016 and June 2020 were summarized per diagnosis group (communicable infections, noncommunicable infections, (probable) infection-related, and noninfectious). The effects of lockdown were quantified with a linear mixed effects model. A literature review regarding the effect of lockdowns on pediatric clinical care was performed. In total, 126,198 ED visits and 47,648 admissions were registered in the study period. The estimated reduction in general pediatric care was 59% and 56% for ED visits and admissions, respectively. The largest reduction was observed for communicable infections (ED visits: 76%; admissions: 77%), whereas the reduction in noninfectious diagnoses was smaller (ED visits 36%; admissions: 37%). Similar reductions were reported worldwide, with decreases of 30–89% for ED visits and 19–73% for admissions.Conclusion: Pediatric ED utilization and hospitalization during lockdown were decreased in the Netherlands and other countries, which can largely be attributed to a decrease in communicable infectious diseases. Care utilization for other conditions was decreased as well, which may indicate that care avoidance during a pandemic is significant. What is Known:• The COVID-19 pandemic had enormous impact on society.• Countries imposed lockdowns to curb transmission rates, which were followed by a reduction in care utilization worldwide. What is New:• The Dutch lockdown caused a significant decrease in pediatric ED utilization and hospitalization, especially in ED visits and hospital admissions because of infections that were not caused by SARS-CoV-2.• Care utilization for noninfectious diagnoses was decreased as well, which may indicate that pediatric care avoidance during a pandemic is significant.

Mobile Business Effects on Employees' Social Life

2021 ◽  
Vol 13 (2) ◽  
pp. 1
Author(s):  
Husam Alfahl
Keyword(s):  
Social Life ◽  
Structural Equation ◽  
Equation Modeling ◽  
Work Family Conflict ◽  
Negative Effects ◽  
Mobile Business ◽  
Business Services ◽  
Work Related ◽  
The Social ◽  
The Impact

The use of mobile devices and smartphones is increasingly becoming a critical part of many people’s lifestyle. Such usage can vary from playing games to accomplishing work-related tasks. Being able to use organizations’ persuasive technologies via mobile business services or to achieve work-related tasks ubiquitously at any time means that such devices provide a valuable service, especially for employees who are working online. This paper explores the impact of mBusiness on the social life of employees. In the research, structural equation modeling was applied to validate the research model. Employees in Saudi organizations were surveyed to test the research hypotheses. The research results confirmed that there are some negative effects of using mBusiness technologies on the social life of employees. Based on the analysis, the findings revealed that addiction to mBusiness technologies significantly increases the perceived work overload, which also significantly increases work-family conflict. The paper concludes with some implications of this research.

Analyzing the Performance and Efficiency of IT-Compliant Audit Module Using Clustering Methods

2020 ◽  
pp. 351-376 ◽  
Author(s):  
Soobia Saeed ◽  
N. Z. Jhanjhi ◽  
Mehmood Naqvi ◽  
Mamoona Humayun ◽  
Vasaki Ponnusamy
Keyword(s):  
Data Analysis ◽  
Service Quality ◽  
Statistical Significance ◽  
Human Beings ◽  
Clustering Methods ◽  
Minimum Period ◽  
The Impact

Human beings have a knack for errors. Counter-effective actions rendered to specify and rectify such errors in a minimum period of time are required when effectiveness and swift advancement depends on the capability of acknowledging the faults and errors and repair quickly. The software as audit module application in IT complaint is in review in this commentary as is another significant instrument created in the field of data analysis that digs deep into quickly and successfully assessing the imprecisions or grievances identified by the users in a certain company. The target of this study is to evaluate the statistical significance in relationship between client reporting attitude and client reliability and to evaluate the impact of strong responsiveness on client reliability, to measure the statistically noteworthy effect of client grievance conduct on service quality, and to test the impact of service quality on client dedication.

Financial development and self-employment

2020 ◽  
Vol 19 (3) ◽  
pp. 339-357
Author(s):  
Papar Kananurak ◽  
Aeggarchat Sirisankanan
Keyword(s):  
Data Analysis ◽  
Panel Data ◽  
Financial Development ◽  
Panel Data Analysis ◽  
Statistical Significance ◽  
Random Effect Model ◽  
Direct Examination ◽  
Content Type ◽  
Self Employment ◽  
The Impact

Purpose There are several different factors that can influence self-employment. However, there is little evidence stemming from direct examination of the impact of financial development (FD) on self-employment. This study aims to formulate empirical specification models to examine the effect of FD on self-employment. Design/methodology/approach Panel data analysis of 136 sample countries was performed during the period from 2000 to 2017. This study initially implemented the new financial index developed by the International Monetary Fund (IMF) to examine the impact of FD on self-employment. Panel data analysis including the pooled model, fixed effect and random effect model has been carried out. Findings The empirical results show that the financial institutions index has a negative significant impact on self-employment by a considerable magnitude, whereas the financial markets index does not show any statistical significance. The results also find that the government effectiveness index is negative and statistically significant on self-employment. Originality/value There are several different factors which can influence self-employment. Nevertheless, there is little evidence for the direct examination of the impact of FD on self-employment. This study investigated the impact of FD on self-employment by using the new FD index created by the IMF. The finding may help policymakers to implement FD along with other institutional policies to control self-employment.

scholarly journals Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas

2018 ◽  
Vol 46 (8) ◽  
pp. 3172-3182 ◽  
Author(s):  
Vijay Agusala ◽  
Priyanka Vij ◽  
Veena Agusala ◽  
Vivekanand Dasari ◽  
Bhargavi Kola
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Parental Education ◽  
Pediatric Patients ◽  
Hospital Admissions ◽  
Care Utilization ◽  
Asthma Education ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Objective It is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state. Methods This prospective study investigated an interactive asthma education intervention in pediatric patients aged 2–18 years and their caregivers. Change in parental/caregiver knowledge about their child’s asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered. Results The study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control. Conclusion Asthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.

scholarly journals MP03: Clearing the air: A retrospective cohort study of cannabis-related harms in urban Alberta emergency departments following legalization

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S43-S43
Author(s):  
M. Yeung ◽  
C. Weaver ◽  
E. Lang ◽  
R. Saah-Haines ◽  
K. Janz
Keyword(s):  
Emergency Departments ◽  
Hospital Admissions ◽  
Population Increase ◽  
Relative Risk Ratio ◽  
Poison Control ◽  
Absolute Level ◽  
Study Objective ◽  
Level Change ◽  
Ed Visits ◽  
The Impact

Introduction: Non-medical cannabis recently became legal on October 18th, 2018 to Canadian adults. The impact of legalization on Emergency Departments (EDs) has been identified as a major concern. The study objective was to identify changes in cannabis-related ED visits and changes in co-existing diagnoses associated with cannabis-related ED visits pre- and post-legalization for the entire urban population of Alberta. Urban Alberta was defined as Calgary and Edmonton, inclusive of Sherwood Park and St. Albert given the proximity of some Edmontonians to their EDs) encompassing 12 adult EDs and 2 pediatric EDs. Methods: Retrospective data was collected from the National Ambulatory Care Reporting System, and from the HealthLink and the Alberta Poison and Drug Information Service (PADIS) public telehealth call databases. An interrupted time-series analysis was completed via segmented regression calculation in addition to incident rate and relative risk ratio calculation for the pre- and post-legalization periods to identify both differences among the entire urban Alberta population and differences among individuals presenting to the ED. Data was collected from October 1st, 2013 up to July 31st, 2019 for ED visits and was adjusted for natural population increase using quarterly reports from the Government of Alberta. Results: The sample included 11 770 pre-legalization cannabis-related visits, and 2962 post-legalization visits. Volumes of ED visits for cannabis-related harms were found to increase post-legalization within urban EDs (IRR 1.45, 95% CI 1.39, 1.51; absolute level change: 43.48 visits per month in urban Alberta, 95% CI 26.52, 60.43), and for PADIS calls (IRR 1.87, 95% CI 1.55, 2.37; absolute level change: 4.02 calls per month in Alberta, 95% CI 0.11, 7.94). The increase in visits to EDs equates to an increase of 2.72 visits per month, per ED. Lastly, increases were observed for cannabinoid hyperemesis (RR 1.23, 95% CI 1.10, 1.36), unintentional ingestion (RR 1.48, 95% CI 1.34, 1.62), and in individuals leaving the ED pre-treatment (RR 1.28, 95% CI 1.08, 1.49). Decreases were observed for coingestant use (RR 0.77, 95% CI 0.73, 0.81) and hospital admissions (RR 0.88, 95% CI 0.80, 0.96). Conclusion: Overall, national legalization of cannabis appears to be correlated with a small increase in cannabis-related ED visits and poison control calls. Post-legalization, fewer patients are being admitted, though cannabinoid hyperemesis appears to be on the rise.

scholarly journals 3247 Implementing an Interdisciplinary, Student-Run Consult Service for Homeless Patients: The Critical Role of Community Partnerships

2019 ◽  
Vol 3 (s1) ◽  
pp. 91-91
Author(s):  
Frances Loretta Gill
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Community Partnerships ◽  
Care Utilization ◽  
Consult Service ◽  
Utilization Patterns ◽  
Ed Visits ◽  
Hospital Days ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: Elucidate the unique challenges associated with hospital discharge planning for patients experiencing homelessness. Assess the impact of robust community partnerships and strong referral pathways on participating patients’ health care utilization patterns in an interdisciplinary, student-run hospital consult service for patients experiencing homelessness. Identify factors (both patient-level and intervention-level) that are associated with successful warm hand-offs to outside social agencies at discharge. METHODS/STUDY POPULATION: To assess the impact of participation in HHL on patients’ health care utilization, we conducted a medical records review using the hospital’s electronic medical record system comparing patients’ health care utilization patterns during the nine months pre- and post- HHL intervention. Utilization metrics included number of ED visits and hospital admissions, number of hospital days, 30-day hospital readmissions, total hospital costs, and follow-up appointment attendance rates, as well as percentage of warm hand-offs to community-based organizations upon discharge. Additionally, we collected data regarding patient demographics, duration of homelessness, and characteristics of homelessness (primarily sheltered versus primarily unsheltered, street homeless versus couch surfing, etc) and intervention outcome data (i.e. percentage of warm hand-offs). This study was reviewed and approved by the Tulane University Institutional Review Board and the University Medical Center Research Review Committee. RESULTS/ANTICIPATED RESULTS: For the first 41 patients who have been enrolled in HHL, participation in HHL is associated with a statistically significant decrease in hospital admissions by 49.4% (p < 0.01) and hospital days by 47.7% (p < 0.01). However, the intervention is associated with a slight, although not statistically significant, increase in emergency department visits. Additionally, we have successfully accomplished warm hand-offs at discharge for 71% percent of these patients. Over the next year, many more patients will be enrolled in HHL, which will permit a more finely grained assessment to determine which aspects of the HHL intervention are most successful in facilitating warm hand-offs and decreased health care utilization amongst patients experiencing homelessness. DISCUSSION/SIGNIFICANCE OF IMPACT: Providing care to patients experiencing homelessness involves working within complex social problems that cannot be adequately addressed in a hospital setting. This is best accomplished with an interdisciplinary team that extends the care continuum beyond hospital walls. The HHL program coordinators believe that ED visits amongst HHL patients and percentage of warm hand-offs are closely related outcomes. If we are able to facilitate a higher percentage of warm hand-offs to supportive social service agencies, we may be able to decrease patient reliance on the emergency department as a source of health care, meals, and warmth. Identifying the factors associated with successful warm hand-offs upon discharge from the hospital may assist us in building on the HHL program’s initial successes to further decrease health care utilization while offering increased interdisciplinary educational opportunities for medical students.

scholarly journals The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252441
Author(s):  
Elissa Rennert-May ◽  
Jenine Leal ◽  
Nguyen Xuan Thanh ◽  
Eddy Lang ◽  
Shawn Dowling ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Population Based ◽  
Emergency Department Visits ◽  
System Capacity ◽  
Population Based Study ◽  
Health Measures ◽  
Ed Visits ◽  
The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

scholarly journals Occupational injuries in Canadian youth: an analysis of 22 years of surveillance data collected from the Canadian Hospitals Injury Reporting and Prevention Program

2016 ◽  
Vol 36 (5) ◽  
pp. 89-98 ◽  
Author(s):  
B. Pratt ◽  
J. Cheesman ◽  
C. Breslin ◽  
M. T. Do
Keyword(s):  
Prevention Program ◽  
Hospital Admissions ◽  
Occupational Injuries ◽  
Specific Information ◽  
Eye Injuries ◽  
Work Related ◽  
Occupation Group ◽  
Ed Visits ◽  
Injury Reporting ◽  
Job Group

Introduction Inexperience, inadequate training and differential hazard exposure may contribute to a higher risk of injury in young workers. This study describes features of work-related injuries in young Canadians to identify areas for potential occupational injury prevention strategies. Methods We analyzed records for youth aged 10–17 presenting to Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) emergency departments (EDs) from 1991–2012. We classified work-related injuries into job groups corresponding to National Occupational Classification for Statistics 2006 codes and conducted descriptive analyses to assess injury profiles by job group. Age- and sex-adjusted proportionate injury ratios (PIRs) and 95% confidence intervals (CIs) were calculated to compare the nature of injuries between occupational and non-occupational events overall and by job group. Results Of the 6046 injuries (0.72% of events in this age group) that occurred during work, 63.9% were among males. Youth in food and beverage occupations (54.6% males) made up 35.4% of work-related ED visits and 10.2% of work-related hospital admissions, while primary industry workers (76.4% males) made up 4.8% of workrelated ED visits and 24.6% of work-related hospital admissions. PIRs were significantly elevated for burns (9.77, 95% CI: 8.94–10.67), crushing/amputations (6.72, 95% CI: 5.79–7.80), electrical injuries (6.04, 95% CI: 3.64–10.00), bites (5.09, 95% CI: 4.47– 5.79), open wounds (2.68, 95% CI: 2.59–2.78) and eye injuries (2.50, 95% CI: 2.20–2.83) in occupational versus non-occupational events. These were largely driven by high proportional incidence of injury types unique to job groups. Conclusion Our findings provide occupation group-specific information on common injury types that can be used to support targeted approaches to reduce incidence of youth injury in the workplace.

Sign in / Sign up

Export Citation Format

Share Document