scholarly journals Differences in Dementia Care Between Swedish-Born and Foreign-Born from Countries with Different Country Level Socioeconomic Position: A Nationwide Register-Based Study

2021 ◽  
pp. 1-9
Author(s):  
Emma Lindgren ◽  
Josephine Sörenson ◽  
Carina Wattmo ◽  
Ingemar Kreholt ◽  
Katarina Nägga
Keyword(s):  
Socioeconomic Position ◽  
Acetylcholinesterase Inhibitors ◽  
Dementia Care ◽  
Minority Ethnic Group ◽  
Foreign Born ◽  
Health Care Outcomes ◽  
Country Level ◽  
Dementia Registry ◽  
Care Outcomes ◽  
The Impact

Background: With a growing elderly population worldwide, the prevalence of dementia is rapidly increasing. Studies from high income countries have shown that belonging to a minority ethnic group increases the risk of health disadvantages. Objective: The aim of the present registry-based study was to identify potential differences in diagnostics, treatment, and care of individuals with dementia focusing on foreign-born in Sweden and the impact of country level socioeconomic position (SEP). Methods: The study was based on a large dataset from the Swedish Dementia Registry (SveDem) and the Swedish Tax Agency’s population registry. Data on demographic variables, cognitive tests, clinical assessments, medication, diagnosis, and interventions initiated at diagnosis were collected. Country level SEP was determined by country of birth as classified by World Bank Country and Lending groups. Results: Of 57,982 patients with dementia registered in SveDem, 7,171 (12.4%) were foreign-born. The foreign-born were significantly younger at diagnosis (p <  0.001), had a lower MMSE score (p <  0.001), lower odds of receiving a specific dementia diagnosis (p <  0.001), lower use of acetylcholinesterase inhibitors (p <  0.001), and overall a higher use of neuroleptics compared with the Swedish-born group. The lower SEP, the greater differences to Swedish-born were seen in many of the examined variables. Conclusion: There were significant differences in dementia diagnostics, treatment, and care between foreign-born and Swedish-born, a lower SEP indicating greater differences. Further research should focus on various socioeconomic aspects and health care outcomes for a more profound analysis of equity in dementia care.

Introduction to Public Health in Pharmacy

2018 ◽  
Keyword(s):  
Public Health ◽  
Population Health ◽  
Pharmacy Practice ◽  
The United States ◽  
Pharmacy Education ◽  
Health Care Outcomes ◽  
Disease States ◽  
Care Outcomes ◽  
The Impact

The need for texts that blend the areas of pharmacy and public health has continued to expand. Introduction to Public Health in Pharmacy (second edition), builds upon the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes report, which emphasizes public health in the domains of Foundational Knowledge and Essentials of Pharmacy Practice and Care, focusing on both patient and population health care outcomes. This second edition has (a) a strong pharmacy-relevant emphasis on the foundations of public health in pharmacy and (b) an increased emphasis on the impact of pharmacy on disease states important in public health and pharmacy in the United States and internationally. This text can be adopted for pharmacy and public health courses but would also be a valuable resource to those teaching therapeutics, patient care, disease prevention, and community engagement. In addition, it is an invaluable resource and handbook for practitioners. The focus is on the role of pharmacy in population health.

The impact of a dedicated patent ductus arteriosus ligation team on neonatal health-care outcomes

2016 ◽  
Vol 36 (6) ◽  
pp. 463-468 ◽  
Author(s):  
M H F Resende ◽  
K More ◽  
D Nicholls ◽  
J Ting ◽  
A Jain ◽  
...  
Keyword(s):  
Health Care ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Neonatal Health ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
The Impact ◽  
Patent Ductus

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals Analysis of Frailty in Geriatric Patients as a Prognostic Factor in Endovascular Treated Patients with Large Vessel Occlusion Strokes

2021 ◽  
Vol 10 (10) ◽  
pp. 2171
Author(s):  
Marlena Schnieder ◽  
Mathias Bähr ◽  
Mareike Kirsch ◽  
Ilko Maier ◽  
Daniel Behme ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Health Care Outcomes ◽  
Increased Risk ◽  
Observational Cohort ◽  
Care Outcomes ◽  
The Impact ◽  
Retrospective Observational Cohort Study

Frailty is associated with an increased risk of adverse health-care outcomes in elderly patients. The Hospital Frailty Risk Score (HFRS) has been developed and proven to be capable of identifying patients which are at high risk of adverse outcomes. We aimed to investigate whether frail patients also face adverse outcomes after experiencing an endovascular treated large vessel occlusion stroke (LVOS). In this retrospective observational cohort study, we analyzed patients ≥ 65 years that were admitted during 2015–2019 with LVOS and endovascular treatment. Primary outcomes were mortality and the modified Rankin Scale (mRS) after three months. Regression models were used to determine the impact of frailty. A total of 318 patients were included in the cohort. The median HFRS was 1.6 (IQR 4.8). A total of 238 (75.1%) patients fulfilled the criteria for a low-frailty risk with a HFRS < 5.72 (22.7%) for moderate-frailty risk with an HFRS from 5–15 and 7 (2.2%) patients for a high-frailty risk. Multivariate regression analyses revealed that the HFRS was associated with an increased mortality after 90 days (CI (95%) 1.001 to 1.236; OR 1.112) and a worse mRS (CI (95%) 1.004 to 1.270; OR 1.129). We identified frailty as an impact factor on functional outcome and mortality in patients undergoing thrombectomy in LVOS.

Return on investment in healthcare leadership development programs

2018 ◽  
Vol 31 (1) ◽  
pp. 77-97 ◽  
Author(s):  
Maya M. Jeyaraman ◽  
Sheikh Muhammad Zeeshan Qadar ◽  
Aleksandra Wierzbowski ◽  
Farnaz Farshidfar ◽  
Justin Lys ◽  
...  
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Development Programs ◽  
Leadership Development Programs ◽  
Content Type ◽  
Health Care Outcomes ◽  
Leadership Quality ◽  
Care Outcomes ◽  
Evaluative Instrument ◽  
The Impact

Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review

10.2196/30432 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e30432
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

Background The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. Objective A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. Methods Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. Results Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. Conclusions The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

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