scholarly journals Hospital Closure and Insights into Patient Dispersion

2015 ◽  
Vol 06 (01) ◽  
pp. 185-199 ◽  
Author(s):  
N. Garg ◽  
G. Husk ◽  
T. Nguyen ◽  
A. Onyile ◽  
S. Echezona ◽  
...  

SummaryBackground: Hospital closures are becoming increasingly common in the United States. Patients who received care at the closing hospitals must travel to different, often farther hospitals for care, and nearby remaining hospitals may have difficulty coping with a sudden influx of patients.Objectives: Our objectives are to analyze the dispersion patterns of patients from a closing hospital and to correlate that with distance from the closing hospital for three specific visit types: emergency, inpatient, and ambulatory.Methods: In this study, we used data from a health information exchange to track patients from Saint Vincent’s Medical Center, a hospital in New York City that closed in 2010, to determine where they received emergency, inpatient, and ambulatory care following the closure.Results: We found that patients went to the next nearest hospital for their emergency and inpatient care, but ambulatory encounters did not correlate with distance.Discussion: It is likely that patients followed their ambulatory providers as they transitioned to another hospital system. Additional work should be done to determine predictors of impact on nearby hospitals when another hospital in the community closes in order to better prepare for patient dispersion.Citation: Garg N, Husk G, Nguyen T, Onyile A, Echezona S, Kuperman G, Shapiro JS. Hospital closure and insights into patient dispersion: the closure of Saint Vincent’s Catholic Medical Center in New York City. Appl Clin Inf 2015; 6: 185–199http://dx.doi.org/10.4338/ACI-2014-10-RA-0090

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237392
Author(s):  
Eugenie Poirot ◽  
Carrie W. Mills ◽  
Andrew D. Fair ◽  
Krishika A. Graham ◽  
Emily Martinez ◽  
...  

2020 ◽  
Vol 35 (10) ◽  
pp. 963-970 ◽  
Author(s):  
Sudham Chand ◽  
Sumit Kapoor ◽  
Deborah Orsi ◽  
Melissa J. Fazzari ◽  
Tristan G. Tanner ◽  
...  

Background: The first confirmed case of novel coronavirus (2019-nCoV) infection in the United States was reported from the state of Washington in January, 2020. By March, 2020, New York City had become the epicenter of the outbreak in the United States. Methods: We tracked all patients with confirmed coronavirus-19 (COVID-19) infection admitted to intensive care units (ICU) at Montefiore Medical Center (Bronx, NY). Data were obtained through manual review of electronic medical records. Patients had at least 30 days of follow-up. Results: Our first 300 ICU patients were admitted March 10 through April 11, 2020. The majority (60.7%) of patients were men. Acute respiratory distress syndrome (ARDS) was documented in 91.7% of patients; 91.3% required mechanical ventilation. Prone positioning was employed in 58% of patients and neuromuscular blockade in 47.8% of mechanically-ventilated patients. Neither intervention was associated with decreased mortality. Vasopressors were required in 77.7% of patients. Acute kidney injury (AKI) was present on admission in 40.7% of patients, and developed subsequently in 36.0%; 50.9% of patients with AKI received renal replacement therapy (RRT). Overall 30-day mortality rate was 52.3%, and 55.8% among patients receiving mechanical ventilation. In univariate analysis, higher mortality rate was associated with increasing age, male sex, hypertension, obesity, smoking, number of comorbidities, AKI on presentation, and need for vasopressor support. A representative multivariable model for 30-day mortality is also presented, containing patient age, gender, body mass index, and AKI at admission. As of May 11, 2020, 2 patients (0.7%) remained hospitalized. Conclusions: Mortality in critical illness associated with COVID-19 is high. The majority of patients develop ARDS requiring mechanical ventilation, vasopressor-dependent shock, and AKI. The variation in mortality rates reported to date likely reflects differences in the severity of illness of the evaluated populations.


2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Lauren Schreibstein ◽  
Remle Newton-Dame ◽  
Katharine H. McVeigh ◽  
Sharon E. Perlman ◽  
Lorna E. Thorpe ◽  
...  

The New York City Department of Health has been developing two public health surveillance systems for chronic diseases. The first is the NYC Macroscope, which is built on a distributed query network of 740 New York City ambulatory practices all using proprietary software from one EHR vendor. The second model, Query Health, still in its initial phase, accesses data collected by a Health Information Exchange. This study compares these two models for potential disease surveillance and public health application.


1997 ◽  
Vol 7 (2) ◽  
pp. 195-223
Author(s):  
Lillian Taiz

Forty-eight hours after they landed in New York City in 1880, a small contingent of the Salvation Army held their first public meeting at the infamous Harry Hill's Variety Theater. The enterprising Hill, alerted to the group's arrival from Britain by newspaper reports, contacted their leader, Commissioner George Scott Railton, and offered to pay the group to “do a turn” for “an hour or two on … Sunday evening.” In nineteenth-century New York City, Harry Hill's was one of the best known concert saloons, and reformers considered him “among the disreputable classes” of that city. His saloon, they said, was “nothing more than one of the many gates to hell.”


Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.


1984 ◽  
Vol 55 (1) ◽  
pp. 231-240 ◽  
Author(s):  
Avraham Shama ◽  
Joseph Wisenblit

This paper describes the relation between values and behavior of a new life style, that of voluntary simplicity which is characterized by low consumption, self-sufficiency, and ecological responsibility. Also, specific hypotheses regarding the motivation for voluntary simplicity and adoption in two areas of the United States were tested. Analysis shows (a) values of voluntary simplicity and behaviors are consistent, (b) the motivation for voluntary simplicity includes personal preference and economic hardship, and (c) adoption of voluntary simplicity is different in the Denver and New York City metropolitan areas.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Caitlin Gruer ◽  
Kim Hopper ◽  
Rachel Clark Smith ◽  
Erin Kelly ◽  
Andrew Maroko ◽  
...  

Abstract Background There has been increasing recognition that certain vulnerable populations in the United States of America struggle to meet their menstruation-related needs, including people experiencing homelessness. Media and policy attention on this subject has focused on the provision of free menstrual products to vulnerable populations, including a New York City legislative bill, which guarantees access to menstrual products for Department of Homeless Services shelter residents (Intros 1123-A). Methods This qualitative study explored the challenges people experiencing homelessness in New York City face in accessing menstrual products. Data collection was conducted from June to August 2019 and included: Semi-structured key informant interviews with staff from relevant government agencies and homeless service providers (n = 15), and semi-structured in-depth interviews with individuals with experience living on the street and in shelters (n = 22). Data were analysed using thematic analysis. Results Key themes that emerged included: (1) insufficient and inconsistent access to menstrual products; (2) systemic challenges to providing menstrual products; and (3) creative solutions to promote access to menstrual products. Both shelter- and street-living individuals reported significant barriers to accessing menstrual products. While both populations struggle, those in shelters were more likely to be able to purchase menstrual products or access free products at their shelter, while those living on the streets were more likely to have to resort to panhandling, theft, or using makeshift materials in place of menstrual products. Across both populations, individuals described barriers to accessing free products at shelters and service providers, primarily due to distribution systems that rely on gatekeepers to provide a few pads or tampons at a time, sometimes of inadequate quality and only upon request. Shelters and service providers also described challenges providing these products, including inconsistent supply. Conclusion These findings highlight the critical importance of expanding and improving initiatives seeking to provide access to menstrual products for vulnerable populations. Despite policy level efforts to support menstrual product access, individuals experiencing homelessness in New York City, whether living in shelters or on the street, are often not able to access the menstrual products that they need to manage their monthly menstrual flow.


2008 ◽  
Vol 9 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Robin C. Fenley ◽  
Sarah J. Bober ◽  
Mebane E. Powell ◽  
Jacquelin Berman ◽  
Barbara N. Altman

This article reports on the first 2 years of an ongoing project that examined the efficacy of a 10-hour dementia training provided to entry-level personal care aide (PCA) trainees from the Hispanic, White, African American, and Asian communities in New York City. Participants were enrolled in a 90-hour PCA training program offered by the New York City Department for the Aging and were either recipients of public assistance, displaced employees from September 11, or recent immigrants to the United States from China. Classes were conducted in Spanish, English, and Mandarin/Cantonese. An 11-item Knowledge of Alzheimer’s Disease instrument was developed for the purposes of this project and administered before and after the dementia training and at 3 months following graduation. All groups, regardless of language, showed a significant increase in knowledge of Alzheimer’s disease at the conclusion of the training and retention of this knowledge at 3 months follow-up. Age was strongly correlated with an increase in knowledge, while gender and education were not.


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