SEASON OF BIRTH AND THE RISK OF INFECTION AMONG LESS THAN FIVE YEAR-OLD CHILDREN - A STUDY OF HOSPITAL ADMISSIONS AND SMS-REPORTED SYMPTOMS AT HOME

2017 ◽  
Author(s):  
Karina Christensen
Keyword(s):  
Hospital Admissions ◽  
Season Of Birth ◽  
Risk Of Infection ◽  
At Home

scholarly journals Educational Needs of Mothers about using Oral Rehydration Salt (ORS) at Home During Acute Diarrhea in Children under 5 at Urmia Population Research Center

2020 ◽  
Vol 2 (3) ◽  
pp. 1-6
Author(s):  
Baratali Rezapour
Keyword(s):  
Acute Diarrhea ◽  
Hospital Admissions ◽  
Health Workers ◽  
Oral Rehydration Therapy ◽  
Educational Needs ◽  
Oral Rehydration Salt ◽  
Low Literacy ◽  
Oral Rehydration ◽  
Children Under 5 ◽  
At Home

Preventable factors such as infectious diseases (pneumonia, diarrhea, and malaria), malnutrition and neonatal complications are still the leading cause of child mortality worldwide 1 In 2013, it is estimated that 6.3 million babies born worldwide died before the age of 5, and approximately 9.2% of these deaths were due to diarrheal diseases 2, 3 in simple, accessible ways, and effective treatment can reduce diarrhea-related mortality and make hospital admissions unnecessary, and the role of mothers is the most important 4. Since the presentation of Oral Rehydration Therapy (ORT) in 1979, mortality has reduced. Diarrhea has had a steady downward trend 5. If mothers who have children under 5 years of age, used correctly ORS, they could easily resolve the problem of dehydration in acute diarrhea 6. Mothers didn’t use correctly ORS because of their Low literacy and lack of knowledge and wrong attitude about ORT7. Some health care workers provide mothers’ required equipments, regardless of their educational needs, and mothers may not use ORS. In this study, health workers identified mothers' educational needs and subsequently they trained them about using ORS at home in acute diarrhea in children under 5 years of age

scholarly journals Effect of Seasonal Variation on Clinical Outcome in Patients with Chronic Conditions: Analysis of the Commonwealth Scientific and Industrial Research Organization (CSIRO) National Telehealth Trial (Preprint)

2017 ◽  
Author(s):  
Ahmadreza Argha ◽  
Andrey Savkin ◽  
Siaw-Teng Liaw ◽  
Branko George Celler
Keyword(s):  
Seasonal Variation ◽  
Length Of Stay ◽  
Clinical Outcome ◽  
Seasonal Variations ◽  
Chronic Conditions ◽  
Hospital Admissions ◽  
Australian Capital Territory ◽  
Home Telemonitoring ◽  
The Impact ◽  
At Home

BACKGROUND Seasonal variation has an impact on the hospitalization rate of patients with a range of cardiovascular diseases, including myocardial infarction and angina. This paper presents findings on the influence of seasonal variation on the results of a recently completed national trial of home telemonitoring of patients with chronic conditions, carried out at five locations along the east coast of Australia. OBJECTIVE The aim is to evaluate the effect of the seasonal timing of hospital admission and length of stay on clinical outcome of a home telemonitoring trial involving patients (age: mean 72.2, SD 9.4 years) with chronic conditions (chronic obstructive pulmonary disease coronary artery disease, hypertensive diseases, congestive heart failure, diabetes, or asthma) and to explore methods of minimizing the influence of seasonal variations in the analysis of the effect of at-home telemonitoring on the number of hospital admissions and length of stay (LOS). METHODS Patients were selected from a hospital list of eligible patients living with a range of chronic conditions. Each test patient was case matched with at least one control patient. A total of 114 test patients and 173 control patients were available in this trial. However, of the 287 patients, we only considered patients who had one or more admissions in the years from 2010 to 2012. Three different groups were analyzed separately because of substantially different climates: (1) Queensland, (2) Australian Capital Territory and Victoria, and (3) Tasmania. Time series data were analyzed using linear regression for a period of 3 years before the intervention to obtain an average seasonal variation pattern. A novel method that can reduce the impact of seasonal variation on the rate of hospitalization and LOS was used in the analysis of the outcome variables of the at-home telemonitoring trial. RESULTS Test patients were monitored for a mean 481 (SD 77) days with 87% (53/61) of patients monitored for more than 12 months. Trends in seasonal variations were obtained from 3 years’ of hospitalization data before intervention for the Queensland, Tasmania, and Australian Capital Territory and Victoria subgroups, respectively. The maximum deviation from baseline trends for LOS was 101.7% (SD 42.2%), 60.6% (SD 36.4%), and 158.3% (SD 68.1%). However, by synchronizing outcomes to the start date of intervention, the impact of seasonal variations was minimized to a maximum of 9.5% (SD 7.7%), thus improving the accuracy of the clinical outcomes reported. CONCLUSIONS Seasonal variations have a significant effect on the rate of hospital admission and LOS in patients with chronic conditions. However, the impact of seasonal variation on clinical outcomes (rate of admissions, number of hospital admissions, and LOS) of at-home telemonitoring can be attenuated by synchronizing the analysis of outcomes to the commencement dates for the telemonitoring of vital signs. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12613000635763; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364030&isReview=true (Archived by WebCite at http://www.webcitation.org/ 6xLPv9QDb)

Algorithms for Individual Prediction of COVID-19 infection and Hospitalization among Symptomatic patients based on health data (Preprint)

2021 ◽  
Author(s):  
Rossella Murtas ◽  
Nuccia Morici ◽  
Chiara Cogliati ◽  
Massimo Puoti ◽  
Barbara Omazzi ◽  
...  
Keyword(s):  
High Risk ◽  
Prediction Models ◽  
Hospital Admissions ◽  
Health Data ◽  
Low Risk ◽  
Risk Prediction Models ◽  
Predictive Algorithms ◽  
Medium Risk ◽  
Risk Patients ◽  
At Home

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has generated a huge strain on the health care system worldwide. The metropolitan area of Milan, Italy was one of the most hit area in the world. OBJECTIVE Robust risk prediction models are needed to stratify individual patient risk for public health purposes METHODS Two predictive algorithms were implemented in order to foresee the probability of being a COVID-19 patient and the risk of being hospitalized. The predictive model for COVID-19 positivity was developed in 61.956 symptomatic patients, whereas the model for COVID-19 hospitalization was developed in 36.834 COVID-19 positive patients. Exposures considered were age, gender, comorbidities and symptoms associated with COVID-19 (vomiting, cough, fever, diarrhoea, myalgia, asthenia, headache, anosmia, ageusia, and dyspnoea). RESULTS The predictive models showed a good fit for predicting COVID-19 disease [AUC 72.6% (95% CI 71.6%-73.5%)] and hospitalization [AUC 79.8% (95% CI 78.6%-81%)]. Using these results, 118,804 patients with COVID-19 from October 25 to December 11, 2020 were stratified into low, medium and high risk for COVID-19 severity. Among the overall population, 67.030 (56%) were classified as low-risk, 43.886 (37%) medium-risk, and 7.888 (7%) high-risk, with 89% of the overall population being assisted at home, 9% hospitalized, and 2% dead. Among those assisted at home, most people (60%) were classified as low risk, whereas only 4% were classified at high risk. According to ordinal logistic regression, the OR of being hospitalised or dead was 5.0 (95% CI 4.6-5.4) in high-risk patients and 2.7 (95% CI 2.6-2.9) in medium-risk patients, as compared to low-risk patients. CONCLUSIONS A simple monitoring system, based on primary care datasets with linkage to COVID-19 testing results, hospital admissions data and death records may assist in proper planning and allocation of patients and resources during the ongoing COVID-19 pandemic.

Abstract 16125: Impact of COVID-19 on Echocardiography Volume at a Large Academic Medical Center

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Merilyn S Varghese ◽  
Jordan B Strom ◽  
Sarah Fostello ◽  
Warren J Manning
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Hospital Systems ◽  
The Impact ◽  
At Home

Introduction: COVID-19 has significantly impacted hospital systems worldwide. The impact of statewide stay-at-home mandates on echocardiography volumes is unclear. Methods: We queried our institutional echocardiography database from 6/1/2018 to 6/13/2020 to examine rates of transthoracic (TTE), stress (SE), and transesophageal echocardiograms (TEE) prior to and following the COVID-19 Massachusetts stay-at-home order on March 15, 2020. Results: Among 36,377 total studies performed during the study period, mean weekly study volume dropped from 332 + 3 TTEs/week, 30 + 1 SEs/week, and 21 + 1 TEEs/week prior to the stay-at-home order (6/1/2018-3/15/2020) to 158 + 13 TTEs/week, 8 + 2 SEs/week, and 8 + 1 TEEs/week after (% change, -52%, -73%, and -62% respectively, all p < 0.001 when comparing volume prior to March 15 versus after). Weekly TTEs correlated strongly with hospital admissions throughout the study period (r = 0.93, 95% CI 0.89-0.95, p < 0.001) ( Figure ). Outpatient TTEs declined more than inpatient TTEs (% change, -74% vs. -39%, p <0.001). As of 3 weeks following the cessation of the stay-at-home order, TTE, SE, and TEE weekly volumes have increased to 73%, 66%, and 81% of pre-pandemic levels, respectively. Conclusions: Echocardiography volumes fell precipitously following the Massachusetts stay-at-home order, strongly paralleling declines in overall hospitalizations. Outpatient TTEs declined more than inpatient TTEs. Despite lifting of the order, echocardiography volumes remain substantially below pre-pandemic levels. The impact of the decreased use of echocardiographic services on patient outcomes remains to be determined.

scholarly journals Ambulance staff and end-of-life hospital admissions: A qualitative interview study

2018 ◽  
Vol 32 (9) ◽  
pp. 1465-1473 ◽  
Author(s):  
Sarah Hoare ◽  
Michael P Kelly ◽  
Larissa Prothero ◽  
Stephen Barclay
Keyword(s):  
End Of Life ◽  
Hospital Admissions ◽  
Qualitative Interviews ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Policy Problem ◽  
Dying Patients ◽  
Qualitative Interview Study ◽  
At Home

Background: Hospital admissions for end-of-life patients, particularly those who die shortly after being admitted, are recognised to be an international policy problem. How patients come to be transferred to hospital for care, and the central role of decisions made by ambulance staff in facilitating transfer, are under-explored. Aim: To understand the role of ambulance staff in the admission to hospital of patients close to the end of life. Design: Qualitative interviews, using particular patient cases as a basis for discussion, analysed thematically. Participants/setting: Ambulance staff ( n = 6) and other healthcare staff (total staff n = 30), involved in the transfer of patients (the case-patients) aged more than 65 years to a large English hospital who died within 3 days of admission with either cancer, chronic obstructive pulmonary disease or dementia. Results: Ambulance interviewees were broadly positive about enabling people to die at home, provided they could be sure that they would not benefit from treatment available in hospital. Barriers for non-conveyance included difficulties arranging care particularly out-of-hours, limited available patient information and service emphasis on emergency care. Conclusion: Ambulance interviewees fulfilled an important role in the admission of end-of-life patients to hospital, frequently having to decide whether to leave a patient at home or to instigate transfer to hospital. Their difficulty in facilitating non-hospital care at the end of life challenges the negative view of near end-of-life hospital admissions as failures. Hospital provision was sought for dying patients in need of care which was inaccessible in the community.

Simultaneous care in Italy’s Veneto Region Health District 8: Integrated assistance to provide better outcomes in end-of-life care.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19595-e19595
Author(s):  
Fabio Girardi ◽  
Paola Paiusco ◽  
Paolo Manente ◽  
Michela Bortolin ◽  
Maria Grazia Ruggeri ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Hospital Admissions ◽  
Palliative Care Unit ◽  
Health District ◽  
Care Plan ◽  
Veneto Region ◽  
Time Period ◽  
Number Of Patients ◽  
At Home

e19595 Background: The number of cancer patients requiring active treatment and palliation for symptoms relief is progressively increasing, due to the possibility to significantly prolong survival even in persons affected by metastatic disease. Italian Board of Health, within the National Oncological Plan 2010-2012, gave “simultaneous care” the recognition as the most qualified model to ensure the best result regarding life expectation, quality of life, adherence to therapies. Methods: In Italy’s veneto region health district 8 a unit dedicated to palliative care works in cooperation with oncology clinic, medical wards, general practitioner, social services; periodical meetings are scheduled to review all the requests; each patient is given a multidimensional evaluation, to assess the care needs. The Unit is able to provide a daily home-care, with total parenteral nutrition if needed, management of infusional devices, invasive procedures such as paracentesis, in order to minimize the number of intervening hospital admissions. We considered the percentage of patients who received a simultaneous care approach between 2008 and 2010, the number of patients who died at home or in a hospice, the average time-period of care, the number of elapsing hospital admissions. Results: In 2008 268 new patients received assistance by the Palliative Care Unit, 273 new patients in 2009 and 434 new patients in 2010; 82 (31,3%), 70 (25,6%) and 111 (25,6%) were affected by advanced cancer, respectively; in 2008 208 patients out of 262 (79,4%) died at home or in a hospice, in 2009 224 patients out of 273 (82,1%), in 2010 376 patients out of 434 (86,7%); in 2008 the average time-period of care was 93 days (calculated as the ratio between the total number of days of assistance to patients as a whole and the number of patients), 88 days in 2009; in 2008 the average number of intervening hospital admissions was 0,26 (calculated as the ratio between the number of admissions and the number of patients), 0,28 in 2009. Conclusions: Our data show that the earlier the patient affected by advanced cancer is evaluated by Palliative care Unit, the higher is the likelihood to develop an adequate home- or hospice-base care plan.

Comparing costs of home- versus hospital-based treatment of infections in adults in a specialist cystic fibrosis center

2005 ◽  
Vol 21 (4) ◽  
pp. 506-510 ◽  
Author(s):  
Rachel A. Elliott ◽  
Judith Thornton ◽  
A. Kevin Webb ◽  
Mary Dodd ◽  
Mary P. Tully
Keyword(s):  
Cystic Fibrosis ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Alternative Methods ◽  
Factors Affecting ◽  
Intention To Treat ◽  
Home Based ◽  
Clinical Records ◽  
Mean Cost ◽  
At Home

Objectives: This study aimed to produce valid patient-based UK National Health Service (NHS) costs for adults with cystic fibrosis to identify differences between hospital- and home-based treatments for infections.Methods: A costing study was carried out in adults with cystic fibrosis (CF) in the United Kingdom, who required intravenous antibiotic treatments for respiratory infections, administered either at home or in the hospital. The perspective was that of the NHS hospital trust. Data were collected retrospectively for each patient for 1 year using clinical records. Data were collected for 116 adults with CF between 2000 and 2001, when 42,382 treatment days (454 courses) of intravenous antibiotics were administered; 213 courses with intention-to-treat at home and 241 courses with intention-to-treat in the hospital. The mean length of a course was 15.3 days.Results: Patients who had >60 percent of courses at home over 1 year had a mean cost of £13,528, compared with £22,609 for patients who had >60 percent of courses in the hospital, and a mean cost of £19,927 for patients who had an equal mix of home and hospital care (p = .0001).Conclusions: The key cost-generating events in CF respiratory infections are hospital admissions. Future studies assessing costs should concentrate on factors affecting admissions, length of stay, staff input, and alternative methods of home-care provision, rather than marginal effects, such as using different antibiotics.

High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study

2016 ◽  
Vol 42 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Sawako Kato ◽  
Bengt Lindholm ◽  
Yukio Yuzawa ◽  
Yoshinari Tsuruta ◽  
Kana Nakauchi ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Hospital Admissions ◽  
Ferritin Level ◽  
Nutrition Status ◽  
Rank Test ◽  
Risk Of Infection ◽  
Dialysis Patients ◽  
Clinical Biomarkers ◽  
Kaplan Meier ◽  
Increased Risk

Aims: The aim of the study was to clarify the relationship between serum ferritin and infectious risks. Methods: We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. Results: Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. Conclusion: Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.

scholarly journals 'I Thought It Was Just a Pimple': A Study Examining the Parents of Pacific Children's Understanding and Management of Skin Infections in the Home

2021 ◽  
Author(s):  
◽  
Elaine Ete-Rasch
Keyword(s):  
Hospital Admissions ◽  
Qualitative Content Analysis ◽  
Wound Care ◽  
Signs And Symptoms ◽  
Relevant Information ◽  
Structure Interview ◽  
Skin Infections ◽  
Preventative Measures ◽  
Semi Structure Interview ◽  
At Home

<p>Hospital admissions of young children due to serious skin infections have increased throughout the Greater Wellington Region over the years. Pacific children make up a high proportion of these hospital admissions. While the literature suggests that these admissions are highly preventable through proper care and management of skin sores at home, little is known about parents' knowledge and practices at home when a child is known to have a skin sore. This descriptive exploratory study explored the management of skin sores and wound care in the homes of 11 Pacific children from the Greater Wellington region prior to being admitted with skin infections. Mothers of 11 children who were aged between three months and 15 years were interviewed using a semi-structure interview schedule that was designed to understand parents' knowledge, understanding and perceptions of wound care, how the early signs of infections were recognised and where and when to seek medical help. The availability of first aid kits and their utilisation by families in their homes as simple preventative measures were also explored. The interviews were transcribed and a descriptive qualitative content analysis process undertaken. Overall the study found that parents engaged in active roles in an effort to maintain and sustain the wellbeing of their children once the signs and symptoms of skin infections were identified. The key findings are categorised under four main themes, 1) Parents in action; 2) The search for healing and cure; 3) Household activities; and 4) Health information for parents. Implications and recommendations for health professionals centre on the need for improved information for parents and for a review of practice surrounding skin infections in primary health care settings. Relevant information on skin infections on children to be addressed in the Well Child Tamariki Ora booklet is also recommended.</p>

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