Epidemiological comparison of stroke patients before and after Cincinatti Scale implementation

Introduction: Stroke is an obstruction or rupture of cerebral arteries that leads to brain damage. The Cincinnati Prehospital Stroke Scale (CPSS) aims to identify early stroke signs. Objectives: To epidemiologically compare stroke victims in Brazil before and after CPSS implementation. Design and setting: A cross-sectional study in Brazil. Methods: Data collected was published by the Health Ministry through DATASUS. A ten-year period was selected before and after the Cincinnati Scale (2010) implementation in Brazil. The data collected were mortality rate, lethality and average length of stay. Results: The average stroke mortality rate from 2000 to 2009 was 16.99, while from 2011 to 2020 it was 15.10, representing a 12,5% reduction. However, comparing these same periods, the average lethality rate increased by 4.92%. The median of stay averages before the implementation of the CPSS is 7.15 days, whereas the one afterwards is 7.45. Conclusions: The CPSS aims to identify stroke by evaluating weakness, speech and facial drop. A significant reduction in mortality has been noted since the implementation of the protocol, which may suggest its effectiveness in early stroke detection. Before the scale, the treatment was possibly late, leading to worse prognosis. Thus, the average stay increase between the evaluated periods could be explained by premature deaths.

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Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; a case study in Iran

10.21203/rs.3.rs-38410/v1 ◽

2020 ◽

Author(s):

Mohammad Ranjbar ◽

Hassan Jafari ◽

Mohammad Baziyar ◽

Mohsen Pakdaman ◽

Vahid Pirasteh

Keyword(s):

Performance Indicators ◽

Average Length ◽

Interrupted Time Series ◽

Cross Sectional Study ◽

Public Hospitals ◽

Health Coverage ◽

Monthly Basis ◽

Cross Sectional ◽

Average Length Of Stay ◽

Before And After

Abstract Introduction: Health systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. Methods: The present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. Findings: The implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).Conclusion: Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; A Case Study in Iran

10.21203/rs.3.rs-81488/v1 ◽

2020 ◽

Author(s):

Mohammad Ranjbar ◽

Hassan Jafari ◽

Mohammad Baziyar ◽

Mohsen Pakdaman ◽

Vahid Pirasteh

Keyword(s):

Performance Indicators ◽

Average Length ◽

Interrupted Time Series ◽

Cross Sectional Study ◽

Public Hospitals ◽

Health Coverage ◽

Monthly Basis ◽

Cross Sectional ◽

Average Length Of Stay ◽

Before And After

Abstract IntroductionHealth systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. MethodsThe present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. FindingsThe implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).ConclusionBased on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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SCHIZOPHRENIA AND EPILEPSY: WHAT LINKS BETWEEN? ARRAZI HOSPITAL EXPERIENCE ABOUT 56 CASES

International Journal of Advanced Research ◽

10.21474/ijar01/13263 ◽

2021 ◽

Vol 9 (08) ◽

pp. 293-299

Author(s):

S. Benzahra ◽

◽

A. Karara ◽

H. Nafiaa ◽

A. Ouanass ◽

...

Keyword(s):

Psychotic Disorders ◽

Age Of Onset ◽

Average Length ◽

Cross Sectional Study ◽

Cross Sectional ◽

Average Length Of Stay ◽

Management Algorithm ◽

History Of ◽

Generalized Epilepsy ◽

Patients With Epilepsy

Background: Given the higher incidence of psychotic disorders in patients with epilepsy, several neurologists and psychiatrists have attempted to explain this controversial comorbidity. Thus, several hypotheses have been put forward but no link has been established with certainty until today. Objectives: The aim of our work is to draw up a socio-demographic and psychopathological profile of patients with schizophrenia-epilepsy comorbidity as well as to assess the risk of suicide, the management, the reasons for admission and the length of hospitalization. Methodology: we conducted a retrospective cross-sectional study on medical records of patients with schizophrenia and epilepsy who were hospitalized at the Ar-Razi University Psychiatric Hospital in SalÃ© between January 01, 2017 and March 31, 2021. Results: Our study included 56 patients. The average age was 33 + / - 9.83, 55% male. 50% of patients had attempted suicide in the past and 25% had a history of depressive episode, 41.1% had substance use disorder and 26.8% had a family history of psychosis. 85.7% of our patients developed schizophrenia from pre-existing epilepsy the time to onset of schizophrenia compared to epilepsy was 11.08 years +/- 7.71. The mean age of onset of schizophrenia is 23.3 years with a mean duration of progression of 9.18 years, 55.4% of patients were on monotherapy and 8.9% had resistant schizophrenia on clozapine. The average age of onset of epilepsy is 14.73 years, with generalized epilepsy in 84% of cases. The average length of stay is 42 days. The reasons for admission were as follows: hetero-aggression 78.6%, delusional verbalization 85.7% and suicide attempt 23.2%. The majority of our patients have been treated with atypical antipsychotics: Risperidone 30.4%, Amisulpride 21.4% and Aripiprazole 12.5%. Conclusion: The co-occurrence of schizophrenia epilepsy suggests the existence of possible common etiopathogenic factors. The management of this comorbidity requires a multidisciplinary collaboration between neurologist and psychiatrist, in order to confirm the diagnosis, establish a good therapeutic approach and propose a management algorithm taking into account the two pathologies.

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The epidemiological study of migraine and other headache syndromes in southern Brazil: hospitalizations and average length of stay in 2020.

10.5327/1516-3180.042 ◽

2021 ◽

Author(s):

Júlia Maria Orsini Zava ◽

Tais Lorrane Mendes Silva ◽

Gabriela Biazi Barbosa ◽

Fabio Rosnei da Silva ◽

Gabriela Dias Silva Dutra Macedo

Keyword(s):

Average Length ◽

Length Of Hospital Stay ◽

Epidemiological Survey ◽

Cross Sectional Study ◽

Age Group ◽

Southern Brazil ◽

Cross Sectional ◽

Southern States ◽

Average Length Of Stay ◽

Using Data

Introduction: Migraine is one of the most common headaches and a frequent population complaint, presenting different symptoms and intensities. Objective: The objective is to carry out an epidemiological survey and the average length of hospital stay in the southern states of Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study. Design and setting: Is a carried out using data collected from DATASUS, during 2020 year in southern Brazil. Results: In the proposed period, there were 2,662 hospitalizations, with the state of PR the largest number (1,760). As for the average hospitalization, the RS stands out with 4 days, SC presents 2.8 and PR with 2.3. Regarding the age group, in PR it is between 40-49 years old, SC between 30-39 and in RS 50-59. As for gender, the prevalence is higher among women, with 63.11% of the total. Conclusion:The data are in agreement with the literature, confirming that women are more affected, being justified by numerous factors, from hormonal variations to different responses to the perception of stress and pain. The high average length of hospitalizations indicates the need to develop policies to discuss the issue, providing adequate prophylaxis and therapy, reducing the number of the cases, the intensity of crises and hospitalizations.

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Investigating the effect of health transformation plan on the public hospitals performance indicators; a case study from Iran

BMC Health Services Research ◽

10.1186/s12913-021-07164-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mohammad Ranjbar ◽

Mohammad Bazyar ◽

Hassan Jafari ◽

Mohsen Pakdaman ◽

Vahid Pirasteh

Keyword(s):

Performance Indicators ◽

Average Length ◽

Interrupted Time Series ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

Average Length Of Stay ◽

Hospitalization Rates ◽

Research Findings ◽

Yazd City

Abstract Background Health systems need constant changes and reforms in their structure to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in Yazd city, Iran. Methods This cross-sectional study was carried out in all public hospitals in city of Yazd. Six performance indicators were examined monthly and in two time periods of 12 months before and 12 months after the implementation of Health Transformation Plan (HTP). The data was analyzed by SPSS software program version 22, using the paired T-test, and the Interrupted Time Series (ITS) model. Findings Findings showed that the performance indicators of the studied hospitals have improved after the implementation of the HTP. According to the ITS model, the implementation of HTP did not have a significant effect on the level and trend of the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators. However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates. Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy rate, but did not have a significant effect on the trend of this indicator. Conclusion Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which showed the effect of this plan on the performance of hospitals. However, not all indicators were statistically significant as the findings sub-section revealed.

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Epidemiological profile of TBI in children under 10 years old before and after the implementation of the child seat law in Brazil

10.5327/1516-3180.243 ◽

2021 ◽

Author(s):

Rebeca Menezes de Oliveira Lima ◽

Brenda Luiza de Sousa Sanches ◽

Guilherme Ribeiro Soare ◽

Tauá Vieira Bahia

Keyword(s):

Traumatic Brain Injury ◽

Mortality Rate ◽

Traffic Accidents ◽

Ecological Study ◽

Average Length ◽

Car Seat ◽

Average Length Of Stay ◽

Before And After ◽

The Law ◽

Epidemiological Profile

Background: The Car Seat Law (2008) aims to minimize the impacts of traffic accidents on children under 10 years old, including the Traumatic Brain Injury (TBI). Objectives: To compare the epidemiological profile of TBI in children under 10 years old before and after the implementation of the Child Seat Law in Brazil. Design and setting: Ecological study in Brazil. Methods: Data was collected from the Ministry of Health, through DATASUS. The decade prior (1998- 2007) and subsequent (2009-2018) to the implementation of the Law were analyzed. The data collected included children of 10 years or less, average length of stay, hospitalizations, deaths, and mortality. Results: The average mortality between 1998-2007 was 2.31, while between 2009-2018 was 1.59, reducing 30.8%. There was also a reduction of 11% in the average stay averages, which went from 3.6 to 3.2 days. There was a 30.7% decrease in the lethality rate, from 2.3 to 1.6. The median of hospitalizations before the Law was 14,230, while afterwards it was 12,851. Conclusion: There was a significant decrease in the average mortality rate, lethality rate and average stay averages since the Law. This may suggest the Law’s effectiveness in protecting children under 10 years of age.

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Intrabases divergences in the mHealth era: a drug interaction investigation in an infectious-diseases hospital setting

Research Society and Development ◽

10.33448/rsd-v10i14.17156 ◽

2021 ◽

Vol 10 (14) ◽

pp. e559101417156

Author(s):

Roberta Souza ◽

Pedro Ivo da Silva ◽

Paulo César Cascao ◽

Clarissa Alencar Sousa ◽

Angela Ferreira Lopes

Keyword(s):

Drug Interaction ◽

Average Length ◽

Anatomical Therapeutic Chemical ◽

Hospital Setting ◽

Cross Sectional Study ◽

Healthcare Applications ◽

Cross Sectional ◽

Average Length Of Stay ◽

Reference Hospital ◽

Aid Decision

Introduction: Information on potential drug interactions (PDI) are obtained from databases available on the web or through mobile healthcare applications (mHealth), and can prevent unfavorable clinical outcomes for patients. This study compared PDI information available in Micromedex® drug interaction checker, its web version and its mHealth app. Method: A cross-sectional study realized based on a retrospective review of drug prescriptions in a reference hospital in infectology in the Midwest Region of Brazil, 2018. We selected all prescriptions containing two or more drugs. Drugs were classified according to the first level of the Anatomical Therapeutic Chemical (ATC) classification, according to the route of administration and the number of drugs prescribed. PDIs were classified according to the severity system and four-level evidence classification system. Results: This study selected 72 patients, predominantly male, median age of 38 years, average length of stay of 15.8 days, and most diagnosed with HIV/AIDS. The most frequently prescribed anatomical groups according to ATC were digestive system and metabolism (22.1%) and general anti-infectives for systemic use (21.6%). The average number of drugs per prescription was 10.8 (SD±6.7). The Micromedex® mHealth app found 381 PDIs while its web version detected 502 PDIs, with an average of 5.3 and 7.0 and frequency of 61.1% and 72.2%, respectively. According to the severity classification in mHealth and web versions, the following stood out, respectively: 221 and 321 severe; 139 and 149 moderate. The majority (>65%) of identified PDIs had their documentation classified as reasonable. Conclusion: Digital tools although they aid decision-making, are not unanimous and consistent in detecting such interactions.

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Epidemiology And Mortality Of Burn Injury In Ciptomangunkusumo Hospital, Jakarta: A 5 Year Retrospective Study

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v6i1.270 ◽

2020 ◽

Vol 6 (1) ◽

pp. 234-242

Author(s):

Aditya Wardhana ◽

Gammaditya Adhibarata Winarno

Keyword(s):

Mortality Rate ◽

Length Of Stay ◽

Burn Injury ◽

Average Length ◽

Demographic Data ◽

Cross Sectional Study ◽

Inhalation Injury ◽

Payment Method ◽

Cross Sectional ◽

Burn Unit

Background : Burns is a significant cause of morbidity and mortality worldwide. Particularly in low- and middle-income countries (LMICs), burns account for an estimated 180.000 deaths every year. Burn-related mortality rates are exceptionally high in South-East Asia (11.6 deaths per 100 000 population per year) compare with much lower rates of 1.0 deaths per 100.000 people per year in high-income countries. This study aims to investigate the demographic data, etiology, and outcome of the patients treated in burn unit Ciptomangunkusumo Hospital, Jakarta, Indonesia. Method: This is a retrospective cross-sectional study, collecting epidemiologic data from the medical record through Electronic Health Record. A total of 709 patients admitted to burn unit between 2013-2017 were reviewed based on age, sex, total burn surface area (TBSA), burn grade, inhalation injury, etiology, length of stay, outcome, and payment method. Inclusion criteria are patients that were admitted to burn unit of Ciptomangunkusumo Hospital between 2013-2017, while there are no exclusion criteria in this study. Result : Admission of patients between 2013-2017 has inclined throughout the year, from 97 in 2013 to 166 in 2017. Average patient admission per year, reaching 141,8±26,761. Jakarta, and its suburb Bogor, Depok, Tangerang, and Bekasi, has dominated the proportion of referring hospital with 538(75.9%) The most amount of payment method is NHI (JKN/BPJS) with 534(75.3%) population. A total of 465 were male, and 244 were female, with a ratio of 1.9:1. The highest incidence in terms of age group is 16-35 years old (269, with the average age of patients, is 29±19. The highest incidence of burn injury is caused by a stove gas explosion with 253(35.7%), followed by flame 189(26.7%). There are 63 out of 709 patients with inhalation injury, where the incidence rate is 8.9%. Patients admitted to the Ciptomangunkusumo burn unit has an average length of stay of 15 days hospitalization. The most frequent population of extent, staying >14 days is 21-30% TBSA (88). The mortality rate in the Ciptomangunkusumo burn unit is 25.8% (183), with the highest number of death came from TBSA >40% (136). Conclusion: A total of 709 patients were admitted to the Ciptomangunkusumo burn unit in Jakarta, Indonesia, over 5 years, with an average of 141 patients per year and an increase of 171% from 2013 to 2017. Most patients were diagnosed with >40% TBSA and 2nd-3rd grade burn injury. An average of 15 days of hospitalization for patients leading up to 25.8% mortality rate, they are with septic shock as the most common condition causing death in the burn unit.

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Comparison of Factors Associated with the Neonatal Mortality Rate in Fars Province before and after Implementing the Health Section Evolution: A Retrospective Cross-Sectional Study

Evidence Based Health Policy Management and Economics ◽

10.18502/jebhpme.v5i1.5645 ◽

2021 ◽

Author(s):

Khalil Alimohammadzadeh ◽

Farshad Falahati ◽

Hassan Karami ◽

Hamidreza Parsa ◽

Maryam Shirvani Shiri ◽

...

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Neonatal Mortality ◽

Cross Sectional Study ◽

P Value ◽

Fars Province ◽

Neonatal Mortality Rate ◽

Cross Sectional ◽

Factors Associated ◽

Before And After

Background: The neonatal period or the first 28 days after birth is a critical and vulnerable time for a child period, and the mortality rate is high due to the severe problems which might happen during this period. The goal of this study was to compare the risk factors associated with the neonatal mortality rate (NMR) before and after the implementation of the health sector evolution plan (HSEP) in Fars Province, Iran. Methods: This study was a retrospective cross-sectional study. This research was conducted using the census method, and 275951 newborns’ files were studied. Variables are expressed as percentage and frequency. The chi-square test and Fisher tests was used to measure the significance level of variables. A multivariate logistic regression model was also used to estimate the odds ratio of neonatal mortality and risk factors associated with neonatal mortality. All statistical tests were performed bilaterally with P-value < 0.05 considered as significant. All tests were conducted using the software SPSS19. Results: After HSEP, risk factors of pregnancy and delivery complications were significantly reduced, and abnormalities were significantly increased (P-value < 0.001). Using multivariate logistic regression analysis, the risk of death is nine times more in gestational age below 37 weeks compared to gestational age over 37 weeks. The chances of neonatal mortality among neonates weighing less than 1000 grams are much more, and it is about 140 times more than normal weight (over 2500 grams). There was not a significant relationship between the chance of neonatal mortality and the implementation of HSEP (P-value > 0.05). Conclusion: Neonates with abnormal weight and premature neonates had the highest chance of death. Therefore, the prevention of preterm labor and low-birth-weight infants are essential factors in reducing neonatal mortality. This study suggests that improved health service quality is determinative to decrease neonatal mortality rate.

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Internalizing Behavior During the Transition from Childhood to Adolescence

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000025 ◽

2010 ◽

Vol 26 (3) ◽

pp. 187-193 ◽

Cited By ~ 5

Author(s):

Marc Vierhaus ◽

Arnold Lohaus ◽

Indra Shah

Keyword(s):

Research Design ◽

Internalizing Symptoms ◽

Fourth Graders ◽

Cross Sectional Study ◽

Second Graders ◽

Internalizing Behavior ◽

Longitudinal Assessment ◽

Sectional Study ◽

Cross Sectional ◽

The One

This investigation focuses on the question whether assessments of the development of internalizing behavior from childhood to adolescence are affected by the kind of research design (longitudinal versus cross-sectional). Two longitudinal samples of 432 second-graders and 366 fourth graders participated in a longitudinal study with subsequent measurements taken 1, 2, and 3 years later. A third sample consisting of 849 children covering the same range of grades participated in a cross-sectional study. The results show that the development of internalizing symptoms in girls – but not in boys – varies systematically with the research design. In girls, there is a decrease of internalizing symptoms (especially between the first two timepoints) in the longitudinal assessment, which may reflect, for example, the influence of strain during the first testing situation. Both longitudinal trajectories converge to a common trajectory from grade 2 to grade 7 when controlling for this “novelty-distress effect.” Moreover, when we control this effect, the slight but significant decrease characterizing the common trajectory becomes similar to the one obtained in the cross-sectional study. Therefore, trajectories based on longitudinal assessments may suggest more changes with regard to internalizing symptoms over time than actually take place, while trajectories based on cross-sectional data may be characterized by an increased level of internalizing symptoms. Theoretical and practical implications of these results are discussed.

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