scholarly journals The Economic impact of Lower Extremity Amputations in Diabetics. A retrospective study from A Tertiary Care Hospital of Faisalabad, Pakistan

2020 ◽  
Vol 1 (1) ◽  
pp. 18-22
Author(s):  
Muhammad Labeeq ◽  
Muhammad Ahsan Tariq ◽  
Samra Atta Tung ◽  
Muhammad Asfand Yar ◽  
Waleed Rehman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Economic Burden ◽  
Diabetic Foot ◽  
Treatment Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
The Mean

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well.

scholarly journals A study on waiting time and out-patient satisfaction at Gujarat medical education research society hospital, Valsad, Gujarat, India

2017 ◽  
Vol 4 (3) ◽  
pp. 857
Author(s):  
Ravikant Patel ◽  
Hinaben R. Patel
Keyword(s):  
Medical Education ◽  
Patient Satisfaction ◽  
Waiting Time ◽  
Treatment Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Research Society ◽  
Care Hospital ◽  
The Mean

Background: Gujarat Medical Education Research society started GMERS medical college and tertiary care Hospital in Valsad since last 4 years. As civil Hospital is converted in to tertiary care hospital and many of the departments running in different buildings so, searching the concern OPDs is difficult for patients, waiting time and patients satisfaction is important to avail the services. Patient satisfaction is one of the important goals of any health system, but it is difficult to measure the satisfaction. Aims & objectives were (1) to study the waiting time at various Out Patient Department (OPDs). and various investigation; (2) To study the accessibility of various department of hospital;  (3) To study the patient satisfaction on hospital process, behavior of hospital staff and treatment cost.Methods: This was a cross sectional observational study conducted in G.M.E.R.S. Hospital-Valsad for the period of 2 months and total 135 patients were interviewed availing the OPD Services.Results: The mean age of patient attending the OPD was 30.31±15.65 years and majority of them are female patient (54.07%). Hospital staff (48.89%) was main source of guidance for searching the OPDs for consulting the doctor. 54.07% patient registered 20 min after standing in queue. The mean waiting time was 12.16±2.35 min. 94.07% and 98.52% patients were satisfied with treatment cost and behavior of staff respectively.Conclusions: Many patients face the difficulties in finding the various departments. On an average 12 minutes of waiting time outside the various O.P.Ds. They were also satisfied with the treatment cost and behaviour of hospital staff.

scholarly journals UNSTABLE ANGINA

2010 ◽  
Vol 23 (10) ◽  
pp. 1276-1280
Author(s):  
Shazia Alam ◽  
Syed Baqir Syum Naqvi ◽  
Maqsood Ahmed ◽  
Syed Baqir Syum Naqvi
Keyword(s):  
Unstable Angina ◽  
Conservative Management ◽  
Treatment Cost ◽  
Tertiary Care ◽  
Cost Of Care ◽  
Total Direct Cost ◽  
Care Hospital ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
The Cost

Objective: To determine the direct treatment cost of unstable angina (UA) withlow molecular weight heparin (LMWH) in conservative management. Study design: Prospectivestudy. Settings: Government cardiovascular hospital and private tertiary care hospital, Karachi.Study period: One year. Method: All 487 patients with either sex having cardiac history ofischemic heart disease, presenting chest pain diagnosed to have unstable angina admitted inhospital for 2-8 days were recruited and entered in study. The current prospective study wasdesigned to analyze the direct treatment cost of UA with LMWH. Data was collected throughproforma and results were analyzed by SPSS version 20. Results: Results were represented interms of percentages, frequencies and means of cost contribution of LMWH. All costs valuesconverted from Pakistani currency (PKR) into US dollars ($) as per exchange rate of 2014. Lessnumber of prescriptions found for fondaparinux (24.85%) than enoxaparin (70%). The estimatedmean of drug cost particularly observed in three treatment groups of patients who receivedenoxaparin, fondaparinux and dalteparin was $36, $ 15 and $ 47 correspondingly. Moreover,4 days total direct cost of enoxaparin and fondaparinux was $191, $ 84 and 6 days treatmentcosts $ 149 with dalteparin to treat a single case of UA. It has been found that fondaparinuxsignificantly lowers the cost of care in comparison to enoxaparin and dalteparin. Conclusion:Current analysis concluded that in the treatment of unstable angina, fondaparinux found to bea dominant strategy that simultaneously lowers the cost of care in conservative management.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital

2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Hospital ◽  
Barrier Method ◽  
Unintended Pregnancies ◽  
Attitude And Practice ◽  
Complete Knowledge ◽  
The Mean ◽  
Medical Healthcare

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer

2021 ◽  
Vol 44 (4) ◽  
pp. E11-16
Author(s):  
Muzammil H. Syed ◽  
Mohammed Al-Omran ◽  
Jean Jacob-Brassard ◽  
Joel G. Ray ◽  
Mohamad A. Hussain ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Hospital ◽  
Reference Standard ◽  
Diagnostic Coding ◽  
Icd 10

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.

scholarly journals Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

2020 ◽  
Vol 27 (4) ◽  
pp. E202043
Author(s):  
Aamir Hussain Hela ◽  
Haseeb Mohammad Khandwaw ◽  
Rahul Kumar ◽  
Mir Adnan Samad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Bile Duct ◽  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
The Mean

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

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