scholarly journals Completeness of Prenatal Records in Community Hospital Charts

2018 ◽  
Author(s):  
Nedra W ◽  
Laura B. Strange ◽  
Sara M. Kennedy ◽  
Katrina D. Burson ◽  
Gina L. Kilpatrick
Keyword(s):  
Intensive Care ◽  
Medical Care ◽  
Medical Records ◽  
Laboratory Tests ◽  
Community Hospital ◽  
Medical Condition ◽  
Medical Conditions ◽  
Community Hospitals ◽  
Newborn Intensive Care ◽  
Common Laboratory

We describe the completeness of prenatal data in maternal delivery records and the prevalence of selected medical conditions and complications among patients delivering at community hospitals around Atlanta, Georgia. Medical charts for 199 maternal-infant dyads (99 infants in normal newborn nurseries and 104 infants in newborn intensive care nurseries) were identified by medical records staff at 9 hospitals and abstracted on site. Ninety-eight percent of hospital charts included prenatal records, but over 20 percent were missing results for common laboratory tests and prenatal procedures. Forty-nine percent of women had a pre-existing medical condition, 64 percent had a prenatal complication, and 63 percent had a labor or delivery complication. Missing prenatal information limits the usefulness of these records for research and may result in unnecessary tests or procedures or inappropriate medical care.

Neonatal Hotline Telephone Network

PEDIATRICS ◽  
1979 ◽  
Vol 64 (4) ◽  
pp. 419-424
Author(s):  
Paul H. Perlstein ◽  
Neil K. Edwards ◽  
James M. Sutherland
Keyword(s):  
Intensive Care ◽  
Community Hospital ◽  
Care Center ◽  
Care Facility ◽  
Telephone Network ◽  
Community Hospitals ◽  
Newborn Intensive Care

By simplifying the process by which telephone contacts are made, improved communications were established between a university-affiliated newborn intensive care center and some of the community hospital nurseries that it serves as a regional resource. Initiation of the improved system of communications was associated with a significant improvement in the survival of infants transferred from the community hospitals to the regional care facility.

The changing role of GP clinicians working in community hospitals.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696713
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Helen Tucker ◽  
Angela Ellis-Paine ◽  
Jon Glasby
Keyword(s):  
Medical Care ◽  
Local Community ◽  
Community Hospital ◽  
Clinical Care ◽  
Hospital Setting ◽  
Community Hospitals ◽  
Recruitment Challenges ◽  
Acute Hospitals ◽  
Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

Back Transport of Neonates: Improved Efficiency of Tertiary Nursery Bed Utilization

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 918-922 ◽  
Author(s):  
August L. Jung ◽  
Carl L. Bose
Keyword(s):  
Intensive Care ◽  
Community Hospitals ◽  
Oxygen Supplementation ◽  
Newborn Intensive Care Unit ◽  
Level Ii ◽  
Hospital Beds ◽  
Critically Ill Neonates ◽  
Newborn Intensive Care ◽  
Level I ◽  
Full Occupancy

Neonatal back transport is defined as the return of previously critically ill neonates from Level III newborn intensive care units to Level II and Level I nurseries for intermediate and/or convalescing care. During 1980, 172 infants (65% of eligible infants) were back transported from a Level III nursery to both Level I and Level II community hospitals. Infants who were returned to Level II hospitals tended to be smaller at the time of transfer, were less frequently nipple fed, and more frequently required oxygen supplementation compared with infants returned to Level I hospitals. Back transport permitted physicians to defer 3,892 days of hospitalization for these infants to community hospitals, an equivalent savings of approximately ten hospital beds at full occupancy. This resulted in a 44% reduction in the need for services in the newborn intensive care unit. Back transport is an efficient means of dealing with overcrowding of Level III nurseries.

scholarly journals Medication Changes and Diagnosis of New Chronic Illnesses in COVID-19 Intensive Care Unit Survivors

2022 ◽  
pp. 106002802110633
Author(s):  
Rima A. Mohammad ◽  
Cynthia T. Nguyen ◽  
Patrick G. Costello ◽  
Janelle O. Poyant ◽  
Siu Yan Amy Yeung ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Medical Condition ◽  
Hospital Length Of Stay ◽  
Medical Conditions ◽  
Medication Change ◽  
The Impact ◽  
Medication Changes

Background Currently, there is limited literature on the impact of the COVID-19 infection on medications and medical conditions in COVID-19 intensive care unit (ICU) survivors. Our study is, to our knowledge, the first multicenter study to describe the prevalence of new medical conditions and medication changes at hospital discharge in COVID-19 ICU survivors. Objective To determine the number of medical conditions and medications at hospital admission compared to at hospital discharge in COVID-19 ICU survivors. Methods Retrospective multicenter observational study (7 ICUs) evaluated new medical conditions and medication changes at hospital discharge in patients with COVID-19 infection admitted to an ICU between March 1, 2020, to March 1, 2021. Patient and hospital characteristics, baseline and hospital discharge medication and medical conditions, ICU and hospital length of stay, and Charlson comorbidity index were collected. Descriptive statistics were used to describe patient characteristics and number and type of medical conditions and medications. Paired t-test was used to compare number of medical conditions and medications from hospital discharge to admission. Results Of the 973 COVID-19 ICU survivors, 67.4% had at least one new medical condition and 88.2% had at least one medication change. Median number of medical conditions (increased from 3 to 4, P < .0001) and medications (increased from 5 to 8, P < .0001) increased from admission to discharge. Most common new medical conditions at discharge were pulmonary disorders, venous thromboembolism, psychiatric disorders, infection, and diabetes. Most common therapeutic categories associated with medication change were cardiology, gastroenterology, pain, hematology, and endocrinology. Conclusion and Relevance Our study found that the number of medical conditions and medications increased from hospital admission to discharge. Our results provide additional data to help guide providers on using targeted approaches to manage medications and diseases in COVID-19 ICU survivors after hospital discharge.

Back Transporting Infants From Neonatal Intensive Care Units to Community Hospitals for Recovery Care: Effect on Total Hospital Charges

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 22-26
Author(s):  
Ciaran S. Phibbs ◽  
Lynn Mortensen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Small Sample ◽  
Hospital Charges ◽  
Neonatal Intensive Care Units ◽  
Community Hospitals

Many neonates are referred to neonatal intensive care units (NICUs) for specialized care far from their parents' residence. This distance can add to the stress of the parents and reduce the contact of the parents with their newborn. Small studies have found that back transporting these neonates to hospitals closer to their homes is safe and cost-effective. Despite these findings, the reluctance of many insurers to pay for back transports prevents or delays many back transports. Insurers may not consider the findings of the previous studies to be conclusive, given that the comparisons were between small numbers of neonates back transported and neonates who remained in tertiary care, and the potential for differences in severity of illness between the groups is significant. In this study the effect on hospital charges of back transports was examined by comparing the charges for care in community hospitals with what these charges would have been in a tertiary care center. The advantage of this method is that it avoids case-mix differences between the groups and thus minimizes the potential for small-sample bias. Data were collected for all back transports from a NICU to non-tertiary care centers (n = 90) for a 9-month period. We were able to obtain the itemized bills for the care at community hospitals for 42 of these patients. Each bill was recalculated using the charges for the NICU to determine potential for savings. The average charges for recovery care were about $6200 lower at the community hospital than they would have been at the NICU. When the charges for the back transport are subtracted (mean = $1603), the average net savings are $4,600. These savings are even larger ($6163) for neonates who stayed at the community hospital for more than 7 days.

scholarly journals Clinical presentation of paediatric patients with COVID-19 admitted to a single paediatric intensive care unit (PICU) in Iran

2020 ◽  
Vol 4 (1) ◽  
pp. e000715
Author(s):  
Amir Saeed ◽  
Eslam Shorafa ◽  
Anahita Sanaeidashti ◽  
Mohammad Rahim Kadivar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Clinical Presentation ◽  
Medical Condition ◽  
Paediatric Intensive Care ◽  
Chronic Medical Condition ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Paediatric Patients

ObjectivesTo describe the clinical characteristics of paediatric patients admitted to a single paediatric intensive care unit (PICU) in Iran with COVID-19.MethodsA cross-sectional study of paediatric patients who were admitted to a COVID-19-dedicated PICU from 16 March 2020 to 21 April 2020 with COVID-19.ResultsSix children had confirmed COVID-19 and four had suspected COVID-19. Six had pre-existing chronic medical conditions. Nine had respiratory failure and needed ventilation. Five children, of whom four had chronic medical conditions, died. Four had cardiac arrhythmias. Clinical presentation included fever and cough.ConclusionCOVID-19 can be fatal in paediatric patients, especially in those with a chronic medical condition.

scholarly journals Use of medical care biases associations between Parkinson disease and other medical conditions

Neurology ◽  
2018 ◽  
Vol 90 (24) ◽  
pp. e2155-e2165 ◽  
Author(s):  
Anat Gross ◽  
Brad A. Racette ◽  
Alejandra Camacho-Soto ◽  
Umber Dube ◽  
Susan Searles Nielsen
Keyword(s):  
Parkinson Disease ◽  
Medical Care ◽  
Medical Condition ◽  
Population Based ◽  
Medical Conditions ◽  
Medicare Beneficiaries ◽  
Level Indicator ◽  
Individual Level ◽  
The Individual ◽  
Control Study

ObjectiveTo examine how use of medical care biases the well-established associations between Parkinson disease (PD) and smoking, smoking-related cancers, and selected positively associated comorbidities.MethodsWe conducted a population-based, case-control study of 89,790 incident PD cases and 118,095 randomly selected controls, all Medicare beneficiaries aged 66 to 90 years. We ascertained PD and other medical conditions using ICD-9-CM codes from comprehensive claims data for the 5 years before PD diagnosis/reference. We used logistic regression to estimate age-, sex-, and race-adjusted odds ratios (ORs) between PD and each other medical condition of interest. We then examined the effect of also adjusting for selected geographic- or individual-level indicators of use of care.ResultsModels without adjustment for use of care and those that adjusted for geographic-level indicators produced similar ORs. However, adjustment for individual-level indicators consistently decreased ORs: Relative to ORs without adjustment for use of care, all ORs were between 8% and 58% lower, depending on the medical condition and the individual-level indicator of use of care added to the model. ORs decreased regardless of whether the established association is known to be positive or inverse. Most notably, smoking and smoking-related cancers were positively associated with PD without adjustment for use of care, but appropriately became inversely associated with PD with adjustment for use of care.ConclusionUse of care should be considered when evaluating associations between PD and other medical conditions to ensure that positive associations are not attributable to bias and that inverse associations are not masked.

scholarly journals Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009–2017

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Cornelia Adlhoch ◽  
Joana Gomes Dias ◽  
Isabelle Bonmarin ◽  
Bruno Hubert ◽  
Amparo Larrauri ◽  
...  
Keyword(s):  
Public Health ◽  
European Union ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Influenza A ◽  
Medical Condition ◽  
Fatal Outcome ◽  
Health Concern ◽  
Medical Conditions ◽  
Risk Of Death

Abstract Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.

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