scholarly journals Current status and issues of medical demand in Japan

2020 ◽  
pp. 1
Keyword(s):  
Medical Care ◽  
Hospital Stay ◽  
Statistical Data ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Current Status ◽  
Current State ◽  
Important Measure ◽  
Number Of Patients

The purpose of this study is to analyze the transition of population and the number of patients in Japan based on official statistical data, and to examine the current state and issues of medical care. In Japan's medical care, it will be an important measure to improve the quality and shorten the length of hospital stay by clarifying, sharing and coordinating service functions to meet the ongoing demand for the elderly.

PP88 Economic Impact Of New Diagnostic Tools In Severe Sepsis

2019 ◽  
Vol 35 (S1) ◽  
pp. 55-55
Author(s):  
Kurt Neeser ◽  
Ilse-Barbara Oelze ◽  
Elvira Müller
Keyword(s):  
Severe Sepsis ◽  
Hospital Stay ◽  
Economic Impact ◽  
Length Of Hospital Stay ◽  
Current Status ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Treatment Scenario ◽  
Number Of Patients ◽  
The Impact

IntroductionConstantly rising healthcare costs and the increasing incidence of antimicrobial resistance represent a growing burden on public health, affecting patients, physicians, payers, and health authorities. This analysis assessed the economic impact of improved diagnostic accuracy among septic patients.MethodsA cost-consequence model was developed to evaluate two different scenarios for the treatment of severe sepsis: scenario one represents the current status of diagnostic performance used for an antimicrobial treatment; scenario two is based on the assumption that a more accelerated diagnostic process results in 15 percent more patients being treated with an efficient antimicrobial drug early in their therapy. Data for the average patient-related cost for diagnostics (EUR 1,182) and overall cost (EUR 12,090), length of hospital stay (average 18.7 days), and number of patients affected annually (n = 771) were derived from the German Diagnosis-Related Group Catalog for 2017. Further, the impact of optimal versus inadequate therapeutic approaches on length of hospital stay (38% decrease), hospitalization cost (40% decrease), and mortality rate (28% decrease) were derived from published sources.ResultsBy using more efficient tests to enable earlier detection of sepsis in patients who otherwise would not receive appropriate treatment, 36 additional patients were appropriately treated. The overall annual length of hospital stay can be shortened by 319 days and the number of sepsis-related deaths reduced by three. The overall annual costs in scenarios 1 and 2 amounted to EUR 11.4 and EUR 11.2 million, respectively. The main savings resulted from reduced expenses for hospital stay, drugs, readmissions, and progression to septic shock.ConclusionsIncreasing cost pressure and the rise in multi-resistant germs are a burden, which will increase over the next decade. The present analysis showed that a willingness to intervene early and stop detrimental developments, and to invest in effective technologies, can promote affordable health care.

Triage in Mass-Casualty Events: The Haitian Experience

2011 ◽  
Vol 26 (5) ◽  
pp. 386-390 ◽  
Author(s):  
Ofer Merin ◽  
Ian N. Miskin ◽  
Guy Lin ◽  
Itay Wiser ◽  
Yitshak Kreiss
Keyword(s):  
Medical Care ◽  
Hospital Stay ◽  
Total Mortality ◽  
Length Of Hospital Stay ◽  
Mass Casualty ◽  
Limited Resources ◽  
Medical Attention ◽  
Field Hospital ◽  
Local Conditions ◽  
Number Of Patients

AbstractIntroduction: Mass-casualty triage is implemented when available resources are insufficient to meet the needs of all patients in a disaster situation. The basic principle is to do the maximum good for the most casualties with the least amount of resources. There are limited data to support the applicability of this principle in massive disasters such as the January 2010 earthquake in Haiti, in which the number of patients seeking medical attention overwhelmed the local resources.Objective: To analyze the application of a triage system developed for use in a mass-casualty setting with limited resources. The system was designed to admit only those patients who had medical conditions requiring urgent treatment that were within the capabilities of the hospital and had a good chance of survival after discharge. Priority was given to those whose treatment could be administered within a short hospital stay.Method: A retrospective, observational review of computerized registration forms of Haitian earthquake victims who sought medical care at a 72-bed field hospital within four to 14 days after the event. An analysis of the efficacy of the triage protocol that was used followed, using length of hospital stay to measure consumption of resources.Results: A total of 1,111 patients were triaged for treatment in the field hospital within 14 days of the earthquake. The median length of stay for all patients for whom data was available was 16 hours (mean = 29.7 hours). The majority of patients (n = 620, 65%) were discharged within 24 hours. Two hundred five patients underwent surgery and were discharged within a median of 39 hours (mean = 52.6 hours); of these, 124 (62%) were discharged within 48 hours. The total mortality of the treated patients was 1.5% (n = 17).Conclusions: Currently accepted triage principles for the most part are appropriate for efficiently providing medical care in a disaster area with extremely limited resources, but require extensive adaptation to local conditions.

scholarly journals Risk factors for high length of hospital stay and in-hospital mortality in hip fractures in the elderly

2021 ◽  
Vol 65 (5) ◽  
pp. 322-330
Author(s):  
J. Salvador Marín ◽  
F.J. Ferrández Martínez ◽  
C. Fuster Such ◽  
J.M. Seguí Ripoll ◽  
D. Orozco Beltrán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
High Length

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals A comparative study of the fracture union between long and short proximal femoral intramedullary nails antirotation in the treatment of intertrochanteric femur fractures in the elderly: a multicentric analysis

2019 ◽  
Vol 5 (2) ◽  
pp. 288
Author(s):  
B. Hari Krishnan ◽  
S. K. Rai ◽  
Rohit Vikas ◽  
Manoj Kashid ◽  
Pramod Mahender
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Intraoperative Blood Loss ◽  
Fracture Union ◽  
Femur Fractures

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the fracture union of long vs. short proximal femoral intramedullary nail antirotation (PFNA) in the treatment of intertrochanteric fractures in elderly patients who was more than 60 years old.</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis of 170 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted. There were 64 males (37.6%) and 106 females (62.3%) with the age of 60–90 (mean age 75) years. The general demographic data of patients, operation time, intraoperative blood loss, length of hospital stay, blood transfusion rate, anterior thigh pain, postoperative complications like periprosthetic fractures, infections were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> The short nail group also had a significantly shorter operation time (41.5±15.3 minutes vs. 62.5±25.3 minutes, p=0.002) and lower rate of postoperative transfusion (31.3% vs. 58.7%, p=0.041). However the length of hospital stay showed no significant differences. After surgery in short group there were 03 cases of periprosthetic fracture with a total incidence of 03%, however there were none in long nail group. At the end of the follow-up, all patients achieved bony union. The average fracture union time of the long nail group was (8.5±3.2) months, and the short nail group was (7.8±4.7) months, revealing no significant differences (p=0.09).</p><p class="abstract"><strong>Conclusions:</strong> Both the proximal femoral intramedullary long and short nail fixation has a good result in the form of fracture union in treating intertrochanteric femur fractures in the elderly. They showed no significant difference in terms of fracture union, hospital stay, and postoperative complications. The incidence of periprosthetic fractures and anterior thigh pain was slightly high in short nail group. In short intramedullary nailing group there was obvious decrease in the intraoperative blood loss, operation time and postoperative blood transfusion.</p>

scholarly journals A retrospective study on the effect of Vitamin C in the management of dengue fever in three different states of India

2019 ◽  
Vol 10 (4) ◽  
pp. 2670-2673 ◽  
Author(s):  
Kothai Ramalingam ◽  
Christina S Varghese ◽  
Chinchu Elias ◽  
Gigi M Mathew ◽  
Arul Balasubramanian
Keyword(s):  
Retrospective Study ◽  
Vitamin C ◽  
Hospital Stay ◽  
Dengue Fever ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Madhya Pradesh ◽  
Percentage Increase ◽  
Number Of Patients

The objective of the study was to analyze the effect of vitamin C in the management of Dengue fever in the tertiary care hospitals of selected three states of India (Tamil Nadu, Kerala, and Madhya Pradesh). This retrospective study was carried out for a period of 6 months from November 2017 to April 2018, in which 200 patients were selected by considering the inclusion and exclusion criteria. It included 100 patients who were administered with Vitamin C and another 100 patients who were not given Vitamin C. All data were entered into the prepared PROFORMA. Mainly the increase in platelet counts and the duration of the hospital stay for both categories of patients were studied. Majority of dengue cases were in Tamil Nadu, followed by Kerala and then Madhya Pradesh depending upon the seasonal variations. Occurrence in male patients (58.5%) were more than female patients (41.5%). The most commonly affected age group ranges from 0-15 years (35.5%). Among the various types of dengue fever, a large number of patients had common dengue fever (87.5%). The 100 patients who were treated with vitamin C were mostly administered by oral routes. It was seen that the patients who were administered with Vitamin C had a greater percentage increase in their platelet count and a shorter duration of hospital stay. Study indicates that there exists an association between Vitamin C intake and length of hospital stay.

POST OPERATIVE LESS COMPLICATIONS IN ROBOTIC DONOR NEPHRECTOMY WITH MINIMAL HOSPITAL STAY

2021 ◽  
pp. 74-76
Author(s):  
Vinay Mahendra ◽  
Palash Saha ◽  
J.B. Roy ◽  
Tridibesh Mandal ◽  
Debarshi Jana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Donor Nephrectomy ◽  
Postoperative Blood Loss ◽  
Minimally Invasive Surgical ◽  
Number Of Patients ◽  
Widespread Acceptance ◽  
Pain Duration ◽  
Group 2

Introduction: Minimally invasive surgical procedures have gained widespread acceptance in the eld of living kidney donation over the last decade. Ratner et al. were the rst to describe laparoscopic donor nephrectomy (LDN). Since then, compared to open donor nephrectomy, LDN has demonstrated several improvements in terms of decreased postoperative pain, decreased length of hospital stay (LOS), rapid patient rehabilitation, reduced postoperative blood loss, and superior cosmetic results. Aims And Objective: The aim of this study is to study less complication in robotic Donor nephrectomy with Respect to clinical outcome which include pordoprade pain, time and minimal stay in hospital. Materials And Methods: This study had been conducted on patients admitted for Robotic Donor Nephrectomy. This study done at Apollo Gleneagles Hospital, Kolkata. Prospective study was carried out in cases performed between which includes number of patients. All patients were older then 20years for this study. Result And Analysis: It was found that 49 (96.1%) patients had under vein group1, and 2(3.9%) patient had under vein group 2. 43 (84.3%) patients had under artery group1, and 8(15.7%) patient had under artery group 2. 1(2.0%) patient had acute graft rejection. 41 (80.4%) patients had Left site, and 10(19.6%) patient had Right site. Conclusion:Robotic donor Nephrotomy performed by the vinei Robot the use 7 Robot allows Minimum blood loss, Minimum OT time in their better result our study proven the ruperiority 7 then method and add then there were less complication. Pastopade pain Duration of hospital stay was less and return to regular life earlier so therefore Robot arrited Donor Nephrotomy is the method I choice for Renal tramplant Surgery.

Transfusions and long-term functional outcomes in traumatic brain injury

2010 ◽  
Vol 113 (3) ◽  
pp. 539-546 ◽  
Author(s):  
Matthew A. Warner ◽  
Terence O'Keeffe ◽  
Premal Bhavsar ◽  
Rashmi Shringer ◽  
Carol Moore ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Glucose Level ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Number Of Patients ◽  
Transfusion Volume ◽  
Gcs Score

Object In this paper, the authors' goal was to examine the relationship between transfusion and long-term functional outcomes in moderately anemic patients (lowest hematocrit [HCT] level 21–30%) with traumatic brain injury (TBI). While evidence suggests that transfusions are associated with poor hospital outcomes, no study has examined transfusions and long-term functional outcomes in this population. The preferred transfusion threshold remains controversial. Methods The authors performed a retrospective review of patients who were admitted with TBI between September 2005 and November 2007, extracting data such as HCT level, status of red blood cell transfusion, admission Glasgow Coma Scale (GCS) score, serum glucose, and length of hospital stay. Outcome measures assessed at 6 months were Glasgow Outcome Scale-Extended score, Functional Status Examination score, and patient death. A multivariate generalized linear model controlling for confounding variables was used to assess the association between transfusion and outcome. Results During the study period, 292 patients were identified, and 139 (47.6%) met the criteria for moderate anemia. Roughly half (54.7%) underwent transfusions. Univariate analyses showed significant correlations between outcome score and patient age, admission GCS score, head Abbreviated Injury Scale score, number of days with an HCT level < 30%, highest glucose level, number of days with a glucose level > 200 mg/dl, length of hospital stay, number of patients receiving a transfusion, and transfusion volume. In multivariate analysis, admission GCS score, receiving a transfusion, and transfusion volume were the only variables associated with outcome (F = 2.458, p = 0.007; F = 11.694, p = 0.001; and F = 1.991, p = 0.020, respectively). There was no association between transfusion and death. Conclusions Transfusions may contribute to poor long-term functional outcomes in anemic patients with TBI. Transfusion strategies should be aimed at patients with symptomatic anemia or physiological compromise, and transfusion volume should be minimized.

scholarly journals Study comparing the stroke unit outcome and conventional ward treatment: a randomized study in Joinville, Brazil

2003 ◽  
Vol 61 (2A) ◽  
pp. 188-193 ◽  
Author(s):  
Norberto L. Cabral ◽  
Carla Moro ◽  
Giana R. Silva ◽  
Rosana Herminia Scola ◽  
Lineu César Werneck
Keyword(s):  
Hospital Stay ◽  
Stroke Unit ◽  
Survival Curve ◽  
Clinical Status ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
General Ward ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

BACKGROUND AND PURPOSE: To assess the impact of a stroke unit (SU) on acute phase treatment when compared to a conventional general ward treatment (GW). METHOD: Seventy-four patients with acute stroke were randomized between a SU and conventional general ward (GW). We compared both groups regarding the length of hospital stay, lethality and functional and clinical status within 6 months, using the Scandinavian scale and Barthel index. RESULTS: Thirty-five and thirty-nine patients were allocated at SU and GW, respectively. Lethality on the 10th day at SU and GW achieved 8.5% and 12.8% respectively (p= 0.41), whereas 30-days mortality rates achieved 14.2% and 28.2% (p= 0.24), 17.4% and 28.7% on the 3rd month (p= 0.39), and 25.7% and 30.7% on the 6th month (p= 0.41). Thirty-day survival curve achieved 1.8 log rank (p= 0.17), with a trend for lower lethality in the SU. In order to save one death in 6 months in SU, NNT (the number need to treat) was 20; to get one more home independent patient NNT was 15. No significant difference was found between the length of hospital stay and morbidity. CONCLUSION: No significant benefit was found in SU patients compared to GW group. However,an evident benefit in absolute numbers was observed in lethality, survival curve and NNT in thirty days period after stroke. Further collaborative studies or incresead number of patients are required to define the role of SU.

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