scholarly journals Hospital Admissions for Neurodegenerative Diseases during the First Wave of the COVID-19 Pandemic: A Nationwide Cross-sectional Study from Germany

2021 ◽  
Vol 11 (9) ◽  
pp. 1219
Author(s):  
Raphael Scherbaum ◽  
Eun Hae Kwon ◽  
Daniel Richter ◽  
Dirk Bartig ◽  
Ralf Gold ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Hospital Admissions ◽  
Late Phase ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Administrative Claims ◽  
Sectional Study ◽  
Cross Sectional ◽  
Relative Change ◽  
Peak Phase

(1) Background: The COVID-19 pandemic impacts healthcare utilization across all care settings and health conditions. The objective of this study was to determine changes in hospital admissions for neurodegenerative diseases (NDD) during the first COVID-19 wave in Germany; (2) Methods: This cross-sectional study used nationwide administrative claims data covering 1468 hospitals. The primary outcome was the year-to-year relative change in case numbers during a four-month study period (16 January–15 May 2020 vs. 2019) during the first pandemic wave. Secondary outcomes included year-to-year relative changes during a four-week peak phase (16 March–15 April) and changes between differential phases of the wave. The analyzed NDD comprised progressive supranuclear palsy (PSP), multiple system atrophy (MSA), Parkinson’s disease, amyotrophic lateral sclerosis (ALS) and Huntington’s disease; (3) Results: Hospital admissions for any reason decreased by 16.7% in 2020 during the study period and by 36.6% during the peak phase, whereas admissions for NDD decreased by 27.6% and 65.0%, respectively. PSP cases decreased during the study period (−34.7%) and the peak phase (−68.1%) and stayed reduced in a late phase with falling COVID-19 numbers. MSA and ALS cases increased strongest after the peak, with ALS cases being comparatively weakly reduced during the study period (−17.3%) and peak phase (−51.7%); (4) Conclusions: Inpatient care utilization for NDD changed differentially during the first wave of the COVID-19 pandemic in Germany and showed a greater reduction than overall and general neurological admissions. Mitigating long-term health deterioration of this vulnerable subgroup is important to reduce morbidity and mortality in the future.

scholarly journals Health Care Utilization and Symptom Severity in Ghanaian Children – a Cross-Sectional Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e80598 ◽  
Author(s):  
Ralf Krumkamp ◽  
Nimako Sarpong ◽  
Benno Kreuels ◽  
Lutz Ehlkes ◽  
Wibke Loag ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Symptom Severity ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions.

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023216 ◽  
Author(s):  
Amy GL Nuttall ◽  
Katie M Paton ◽  
Alison M Kemp
Keyword(s):  
Head Injury ◽  
Hospital Admissions ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Initial Assessment ◽  
Clear Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Level Of Consciousness

ObjectiveTo evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.DesignCross sectional study.SettingUK hospital admissions: September 2009–February 2010.Patients<15 years with head injury.InterventionsGCS and/or AVPU at injury scene and in emergency departments (ED).Main outcomeMeasures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type.ResultsLevel of consciousness was recorded in 91% (5168/5700) in ED (43%: GCS/30.5%: GCS+AVPU/17.3%: AVPU) and 66.1% (1190/1801) prehospital (33%: GCS/26%GCS+AVPU/7%: AVPU). Failure to record level of consciousness and the use of AVPU were greatest for infants. Correlation between AVPU and median GCS in 1147 children <5 years: A=15, V=14, P=8, U=3, for 1163 children ≥5 years: A=15, V=13, P=11, U=3. There was no significant difference in the proportion of infants who had a CT whether AVPU=V/P/U or GCS<15. However diagnostic yield of intracranial injury or depressed fracture was significantly greater for V/P/U than GCS<15 :7/7: 100% (95% CI 64.6% to 100%) versus 5/17: 29.4% (95% CI 13.3% to 53.1%). For children >1 year significantly more had a CT scan when GCS<14 was recorded than ‘V/P/U only’ and the diagnostic yield was greater. Prehospital GCS and GCS in the ED were the same for 77.4% (705/911).ConclusionThere was a clear correlation between Alert and GCS=15 and between Unresponsive and GCS=3 but a wider range of GCS scores for responsive to Pain or Voice that varied with age. AVPU was valuable at initial assessment of infants and did not adversely affect the proportion of infants who had head CT or the diagnostic yield.

scholarly journals Antenatal care among women in Chitwan district of Nepal: A cross-sectional study

2021 ◽  
Vol 9 (01) ◽  
pp. 74-86
Author(s):  
Sharmila Pokharel ◽  
Ram Krishna Maharjan
Keyword(s):  
Antenatal Care ◽  
Educational Level ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Care Utilization ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Care Community

Antenatal care is one of the most effective measures to reduce maternal mortality in Lower Middle-income Countries. The study aims to assess the utilization of antenatal care and related factors by breastfeeding mothers in Chitwan district of Nepal. A cross-sectional study was carried out in Bharatpur municipality in April 2020, among all women of the reproductive age group (15-49) who have had a birth child in the last 12 months before the survey date. A census sampling technique was used to select respondents. The vaccination period was two weeks. All the mothers who came to the vaccine center to vaccinate their children were the respondents of this study. The data were collected by using an interview schedule. The collected data were managed using SPSS Version 20. The study found that 84.31 percent of respondents attended more than four antenatal care utilization. The educational level of the respondents and the occupation of their partners were linked to the use of antenatal care. The number of pregnancies, the number of live births, the place of delivery, and the educational level and occupations of the birth attendees were also significantly linked to the use of antenatal care. Community mobilization and intensive use of community health workers are essential factors to improve the use of antenatal care.

scholarly journals Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in German: a cross-sectional study

2020 ◽  
Author(s):  
Bernhard Michalowsky ◽  
Wolfgang Hoffmann ◽  
Jens Bohlken ◽  
Karel Kostev
Keyword(s):  
Hospital Admissions ◽  
Healthcare Services ◽  
Routine Care ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Long Term Effects ◽  
Older Population ◽  
Cross Sectional

Abstract Background There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown. Objectives We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. Design Cross-sectional observational study. Setting 1,095 general practitioners (GPs) and 960 specialist practices in Germany. Subjects 2.45 million older patients aged 65 or older. Methods The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019. Results Physician consultations decrease slightly in February (−2%), increase before the imposed lockdown in March (+9%) and decline in April (−18%) and May (−14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (−39 versus −6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (−17 to −26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. Conclusion The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.

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