Journal articles on the topic 'Hospital patients'
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Purnamasidhi, Cokorda. "Hematological profile of Patients in Udayana University General Hospital." International Journal of Medical Reviews and Case Reports 4, Reports in Microbiology, Infecti (2020): 1. http://dx.doi.org/10.5455/ijmrcr.hematological-profile-patients.
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Duke, Graeme J., Frank Shann, Cameron I. Knott, Felix Oberender, David V. Pilcher, Owen Roodenburg, and John D. Santamaria. "Hospital-acquired complications in critically ill patients." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 285–91. http://dx.doi.org/10.51893/2021.3.oa5.
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BACKGROUND: The national hospital-acquired complications (HAC) system has been promoted as a method to identify health care errors that may be mitigated by clinical interventions. OBJECTIVES: To quantify the rate of HAC in multiday stay adults admitted to major hospitals. DESIGN: Retrospective observational analysis of 5-year (July 2014 – June 2019) administrative dataset abstracted from medical records. SETTING: All 47 hospitals with on-site intensive care units (ICUs) in the State of Victoria. PARTICIPANTS: All adults (aged ≥ 18 years) stratified into planned or unplanned, surgical or medical, ICU or other ward, and by hospital peer group (tertiary referral, metropolitan, regional). MAIN OUTCOME MEASURES: HAC rates in ICU compared with ward, and mixed-effects regression estimates of the association between HAC and i) risk of clinical deterioration, and ii) admission hospital site (intraclass correlation coefficient [ICC] > 0.3). RESULTS: 211 120 adult ICU separations with mean hospital mortality of 7.3% (95% CI, 7.2–7.4%) reported 110 132 (42.6%) HAC events (commonly, delirium, infection, arrhythmia and respiratory failure) in 62 945 records (29.8%). Higher HAC rates were reported in elective (cardiac [50.3%] and non-cardiac [40.6%]) surgical subgroups compared with emergency medical subgroup (23.9%), and in tertiary (35.4%) compared with non-tertiary (22.7%) hospitals. HAC was strongly associated with on-admission patient characteristics (P < 0.001), but was weakly associated with hospital site (ICC, 0.08; 95% CI, 0.05–0.11). CONCLUSIONS: Critically ill patients have a high burden of HAC events, which appear to be associated with patient admission characteristics. HAC may an indicator of hospital admission complexity rather than hospital-acquired complications.
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Connelly, Patricia. "A Hospital-within-a-hospital: Good for Hospitals, Good for Patients." Indiana Health Law Review 13, no. 2 (October 11, 2016): 546. http://dx.doi.org/10.18060/3911.0026.
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Mamik, Mamik, Sunarti Sunarti, and Sri Rahayu. "The Delivery of Service in Forming the Image of the Hospital and Patients Satisfaction to Gain Patients Loyality in Kajuruhan Kepanjen Hospital Malang Regency." GATR Global Journal of Business Social Sciences Review 3, no. 1 (January 10, 2015): 56–64. http://dx.doi.org/10.35609/gjbssr.2015.3.1(8).
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Objective - KajuruhanKepanjen Hospital Malang Regency is the only hospital possessed by Malang Regency. The competition among hospitals is getting tighter along with the appearance of private hospitals. The success of hospitals is caused mainly by the delivery of service, especially the service, tolls, and personals because hospitals as service industries have given good services for their patients so that the patients will be loyal Methodology/Technique - Data collecting method is by a field observation, i.e. distributing the questionnaires and interviewing 210 respondents (patients of KajuruhanKepanjen Hospital Malang Regency). Then the data was processed and analyzed by using Structural Equation Modeling (SEM) method, with AMOS software. Findings - The result of data analysis shows that the delivery of service has positive and significant influence to the image of the hospital but it does not have significant influence to patient's satisfaction. The image of KajuruhanKepanjen Hospital Malang Regency has positive and significant influence to patient's satisfaction and loyalty. Patient's satisfaction has positive and significant influence to patients loyalty. Type of Paper - Empirical Keywords: Delivery of Service, Image, Satisfaction, Loyalty.
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Ramadan, Omar I., Paul R. Rosenbaum, Joseph G. Reiter, Siddharth Jain, Alexander S. Hill, Sean Hashemi, Rachel R. Kelz, Lee A. Fleisher, and Jeffrey H. Silber. "Impact of Hospital Affiliation With a Flagship Hospital System on Surgical Outcomes." Annals of Surgery 279, no. 4 (October 17, 2023): 631–39. http://dx.doi.org/10.1097/sla.0000000000006132.
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Objective: To compare general surgery outcomes at flagship systems, flagship hospitals, and flagship hospital affiliates versus matched controls. Summary Background Data: It is unknown whether flagship hospitals perform better than flagship hospital affiliates for surgical patients. Methods: Using Medicare claims for 2018 to 2019, we matched patients undergoing inpatient general surgery in flagship system hospitals to controls who underwent the same procedure at hospitals outside the system but within the same region. We defined a “flagship hospital” within each region as the major teaching hospital with the highest patient volume that is also part of a hospital system; its system was labeled a “flagship system.” We performed 4 main comparisons: patients treated at any flagship system hospital versus hospitals outside the flagship system; flagship hospitals versus hospitals outside the flagship system; flagship hospital affiliates versus hospitals outside the flagship system; and flagship hospitals versus affiliate hospitals. Our primary outcome was 30-day mortality. Results: We formed 32,228 closely matched pairs across 35 regions. Patients at flagship system hospitals (32,228 pairs) had lower 30-day mortality than matched control patients [3.79% vs. 4.36%, difference=−0.57% (−0.86%, −0.28%), P<0.001]. Similarly, patients at flagship hospitals (15,571/32,228 pairs) had lower mortality than control patients. However, patients at flagship hospital affiliates (16,657/32,228 pairs) had similar mortality to matched controls. Flagship hospitals had lower mortality than affiliate hospitals [difference-in-differences=−1.05% (−1.62%, −0.47%), P<0.001]. Conclusions: Patients treated at flagship hospitals had significantly lower mortality rates than those treated at flagship hospital affiliates. Hence, flagship system affiliation does not alone imply better surgical outcomes.
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Siti Latifah Hanum, Destanul Aulia, and Kintoko Rochadi. "Patient Decision Making in the Choice of a Referral Hospital in Hospital of Subulussalam City in 2018." Britain International of Exact Sciences (BIoEx) Journal 2, no. 1 (February 9, 2020): 368–76. http://dx.doi.org/10.33258/bioex.v2i1.166.
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The choice of referral hospital from Hospital of Subulussalam City based on a preliminary survey is varies. Inpatients are referred to Class A hospitals are on average 65%, Class B hospitals are 30%, and Class C hospitals are 5%, while outpatients are referred to Class A hospitals are on average 49%, Class B hospitals are 28%, class C hospitals are 23%. This type of research is qualitative with a phenomenological approach obtained by conducting in-depth interviews with 13 informants consisting of 3 specialist doctors, 3 general practitioners, 3 patients, 3 patient's family and 1 BPJS verifier in Hospital of Subulussalam City. The study was conducted from February to October 2018. The results showed that during the referral hospital decision-making process there was an interaction between the doctor, the patient and the patient's family, the final decision was on the patient and bearing down the consequences if the hospital's choice was not recommended by the doctor. The determinants of decision making for referral hospitals consist of perceived quality in the form of referral hospitals accepting patients referred from Hospital of Subulussalam City, emergency conditions for patients by choosing the closest hospital, facilities in the form of supporting tests and complete medical devices and additional facilities, the availability of specialist doctors and subspecialty according to the patient's condition, geographical constraints due to the long distance to the referral hospital, references from doctors to patients and vice versa, learning in the form of doctor and patient experience in the previous referral process, not all doctors consider peer relations to be a determinant of choosing a referral hospital due to the BPJS system, social factors in the form of a family in the area of a referral hospital, the same religion and culture as a patient in a referral hospital area make the patient feel comfortable. Suggestions in this study is the management of Hospital of Subulussalam City to confirm and coordinate the referral hospital and make a referral MOU.
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Schneider, Rita, and Christoph Reiners. "GERMAN HOSPITAL DATABASE—ALLOCATION OF PATIENTS TO APPROPRIATE HOSPITALS." Health Physics 98, no. 6 (June 2010): 799–803. http://dx.doi.org/10.1097/hp.0b013e3181d267bc.
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Upton, Mark W. M., G. Harm Boer, and Alastair J. Neale. "Patients or clients? – a hospital survey." Psychiatric Bulletin 18, no. 3 (March 1994): 142–43. http://dx.doi.org/10.1192/pb.18.3.142.
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The use of the term client, rather than patient, has become frequent in psychiatric hospitals. There is little evidence to justify this change, so this study surveyed the views of the in-patients in a community based psychiatric hospital to establish the term they prefer. It concludes that a dear majority of people admitted to a psychiatric hospital think of themselves as patients, not clients.
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Thanh Hai, Phan, Nguyen Thanh Cuong, Van Chien Nguyen, and Mai Thi Thuong. "Sustainable business development of private hospitals in Vietnam: Determinants of patient satisfaction, patient loyalty and revisit intention." Problems and Perspectives in Management 19, no. 4 (October 13, 2021): 63–76. http://dx.doi.org/10.21511/ppm.19(4).2021.06.
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The role of private hospitals is increasingly important in Vietnam. The study aims to determine associations between service quality and hospital brand image with satisfaction and patient loyalty, revisit intention at private hospitals in Vietnam. Quantitative cross-sectional data were collected from 268 patients in DaNang city, Vietnam. Scales to measure hospital service quality, hospital brand image, patient satisfaction, loyalty, and patient revisit intention were developed. The methods used to test the hypotheses of the study include exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM). One notable finding in this study provides practical evidence on the relationship of hospital service quality and hospital brand image with patient satisfaction and loyalty. In addition, service quality has a direct influence on patient satisfaction and revisit intention as the indicator of patient loyalty. Meanwhile, hospital brand image has a direct influence on patient loyalty, although it did not influence patient satisfaction. Results of this study help providing the basis for the marketing and customer care programs of private hospitals in DaNang city, Vietnam.
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Botkin, E. S. "Patients in a hospital." Russian Pulmonology 26, no. 1 (April 19, 2016): 116–20. http://dx.doi.org/10.18093/0869-0189-2016-26-1-116-120.
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Holmes, Susan. "Undernutrition in hospital patients." Nursing Standard 17, no. 19 (January 22, 2003): 45–52. http://dx.doi.org/10.7748/ns2003.01.17.19.45.c3333.
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Fu, Chih-Yuan, Francesco Bajani, Leah Tatebe, Caroline Butler, Frederic Starr, Andrew Dennis, Matthew Kaminsky, et al. "Right hospital, right patients." Journal of Trauma and Acute Care Surgery 86, no. 6 (June 2019): 961–66. http://dx.doi.org/10.1097/ta.0000000000002245.
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Góth, L., and M. Vitai. "Hypocatalasemia in hospital patients." Clinical Chemistry 42, no. 2 (February 1, 1996): 341–42. http://dx.doi.org/10.1093/clinchem/42.2.341.
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Magennis, P., and A. Begley. "Hospital patients who smoke." BMJ 306, no. 6877 (February 27, 1993): 585. http://dx.doi.org/10.1136/bmj.306.6877.585-c.
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McMillen, Paula S., and Dale Elizabeth Pehrsson. "Bibliotherapy for Hospital Patients." Journal of Hospital Librarianship 4, no. 1 (March 24, 2004): 73–81. http://dx.doi.org/10.1300/j186v04n01_07.
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Appleby, J. "Patients choosing their hospital." BMJ 326, no. 7386 (February 22, 2003): 407–8. http://dx.doi.org/10.1136/bmj.326.7386.407.
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Roos, Noralou P. "Linking Patients to Hospital." Medical Care 31, supplement (May 1993): YS6—YS15. http://dx.doi.org/10.1097/00005650-199305001-00003.
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WACHTER, KERRI. "Acinetobacter Hits Hospital Patients." Internal Medicine News 39, no. 2 (January 2006): 1–7. http://dx.doi.org/10.1016/s1097-8690(06)72661-0.
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Scanlon, Dennis P., Richard C. Lindrooth, and Jon B. Christianson. "Steering Patients to Safer Hospitals? The Effect of a Tiered Hospital Network on Hospital Admissions." Health Services Research 43, no. 5p2 (October 2008): 1849–68. http://dx.doi.org/10.1111/j.1475-6773.2008.00889.x.
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Lesmana Putra, Pandu, and Ascobat Gani. "Systematic Review: Relationship between Hospital Marketing Mix and Patient Visits and Hospital Selection." Journal of World Science 3, no. 1 (January 31, 2024): 126–32. http://dx.doi.org/10.58344/jws.v3i1.542.
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This study aims to determine the relationship between hospital marketing mix, patient visits, and hospital selection. The study method uses the PRISMA method. Inclusion criteria were journals published from 2018 to 2022, focusing on marketing mix and hospitals. Journal searches were carried out using the keywords "Marketing Mix", "Hospital", and "Patient". Article searches were conducted in the Scopus, ScienceDirect, Proquest, Garuda, and Google Scholar databases. The research results found six articles that met the requirements to be included in the study for review. Four articles were conducted from the patient's perspective, and two were written from the perspective of hospital staff. The seven aspects of the marketing mix can influence patients to choose hospital services that implement marketing strategies. Elements of the marketing mix that have a relationship can differ from hospital to hospital. Hospitals need to plan a specific marketing strategy that focuses on patients so that patients want to choose to use the hospital's service facilities. The implications of this study are highly relevant for practitioners in the fields of hospital management and health marketing. The finding that the hospital marketing mix can influence patient choices provides a deeper understanding of the importance of appropriate marketing strategies in increasing patient visits and hospital competitiveness.
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Sriram, Shyamkumar, and Rakchanok Noochpoung. "Determinants of hospital waiting time for outpatient care in India: how demographic characteristics, hospital ownership, and ambulance arrival affect waiting tim." International Journal Of Community Medicine And Public Health 5, no. 7 (June 22, 2018): 2692. http://dx.doi.org/10.18203/2394-6040.ijcmph20182601.
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Background: Waiting time in hospital outpatient clinics affects patient satisfaction, access to care, health outcomes, trust, willingness to return and hospital revenue. Only a few studies have explored length and variability of waiting times among patients. This study is an attempt to understand factors affecting waiting time experienced by patients in outpatient clinics.Methods: For this study, data were collected in 2012 from 830 patients seeking care from outpatient clinics located in 30 randomly selected hospitals in the district of Nellore, India. Linear regression and logistic regression models have been used to identify the effect of various determinants on hospital waiting times.Results: The average waiting time in government hospitals was 20.3 minutes compared to 15.5 minutes in private hospitals and 39.71 minutes in voluntary hospitals. Waiting time of men was about six minutes lower than women. After controlling for other patient related and hospital related factors, median wait time was 19% lower for male patients compared to females. Length of waiting declines with patient's age. Patients arriving by ambulance waited 64% less that patients not arriving by ambulance but this pattern was not valid for public hospitals.Conclusions: Significant gender bias was present in all facility-types implying that policy and legal interventions would be required. For-profit hospitals had lower waiting time of patients to ensure higher demand for their services by the economically better-off sections of the population. The results highlight the importance of lowering the waiting time in public sector hospitals, especially for patients arriving in ambulances.
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O, Faour Martín. "Elderly Patients with Pertrochanteric Hip Fracture: In Hospital Care." Journal of Orthopaedics & Bone Disorders 3, no. 4 (2019): 1–8. http://dx.doi.org/10.23880/jobd-16000190.
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Objective: To evaluate the improvement in the care of elderly patients hospitalized due to pertrochanteric hip fractures. Methods: A comparative study of two cohorts of patients admitted due to pertrochanteric hip fractu re before (2010) and after the application of in hospital management protocols (2018). The intervention consisted in the implementation of multidisciplinary measures during hospitalization based on current scientific evidence. An evaluation of the clinical results was performed, as well as the health care impact. Results: The characteristics of patients admitted for hip fracture in 2010 (216 patients) and 2018 (205 patients) were similar in age, sex, Barthel index and the Charlson abbreviated index. In 2018 patients had more comorbidity. A significant reduction of preoperative stay and overall stay in the cohort of 2018 was achieved. Detection of delirium, malnutrition and anaemia was higher in 2018, and a reduced incidence of infection and a better function al efficiency was achieved in this period. Conclusion: The introduction of measures for the improvement of the pertrochanteric hip fracture management reduces hospitalization with consequent cost reduction. Unification of criteria among professionals may b e an opportunity for better clinical results and reduction of complications.
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Norton, Robert L., Edward A. Bartkus, Keith W. Neely, John A. Schriver, and Jerris R. Hedges. "Compliance with Closest Hospital Transport Protocol." Prehospital and Disaster Medicine 7, no. 3 (September 1992): 243–49. http://dx.doi.org/10.1017/s1049023x00039571.
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AbstractHypothesis:Paramedics accurately estimate the closest trauma hospital for ground transport.Population:Ground ambulance scene transports of trauma system patients to six participating trauma hospitals in Multnomah County, Oregon from 1 January 1986 to 1 January 1987 were studied. Transports involving multiple patients or pediatric patients were excluded.Methods:A retrospective analysis was performed on consecutive patient transports to be taken to the closest trauma hospital as required by protocol. The availability of each hospital to receive trauma patients was monitored continuously by a central communications facility. Paramedics were provided hospital availability data at the time of patient system entry. When several hospitals were available, the paramedics were required by protocol to select the “closest” hospital. Subsequently, the vector distance from the trauma site to each of the available hospitals was measured using a grid map. This method was validated by odometer measurement (r2 = 0.924). Chisquare analysis was used to analyze hospital bypasses to specific hospitals.Results:Of the 1193 eligible patients entered into the trauma system, 160 (13%; 95% CI = 11–15%) transports bypassed the closest available hospital for a receiving hospital ≥1 mile more distant. There were 11 (1%; 0–2%) patients transported to a hospital more than five miles more distant. Of the 132 patients with a trauma score (TS) <12, 15 (11%; 6–18%) were taken to a hospital one mile or further beyond the closest hospital. None (0%; 0–2%) were transported more than five miles past the closest hospital. Of the six hospitals, three were bypassed more than one mile significantly more often then they received bypass patients. One hospital received such patients four times more than it was bypassed (p <.001).Conclusion:While paramedics generally can identify the closest hospital for trauma patient transport, some systematic hospital bypass errors occur. If a community wants assurance of an equitable patient distribution among participating trauma hospitals and assignment of the closest geographic hospital for injured patients, then map vector distance determination to identify the closest available hospital should supplement paramedic dispatching.
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Xu, Jing, Sinyoung Park, Jie Xu, Hanadi Hamadi, Mei Zhao, and Koichiro Otani. "Factors Impacting Patients’ Willingness to Recommend: A Structural Equation Modeling Approach." Journal of Patient Experience 9 (January 2022): 237437352210775. http://dx.doi.org/10.1177/23743735221077538.
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Patient ratings of inpatient stay have been the focus of prior research since better patient satisfaction results in a financial benefit to hospitals and are associated with better patient health care outcomes. However, studies that simultaneously account for within- and between-hospital effects are uncommon. We constructed a multilevel structural equation model to identify predictors of patients’ willingness to recommend a hospital at both within-hospital and between-hospital levels. We used data from 60 U.S. general medical and surgical hospitals and 12,115 patients. Multilevel structural equation modeling reported that patient ratings on the overall quality of care significantly affect the willingness to recommend within hospitals. Also, patients’ perspectives on the hospital environment and nursing are the significant factors that predict the patient ratings on the overall quality of care. Overall patient satisfaction significantly predicts the willingness to recommend at the between-hospital level, whereas hospital size and location have marginal impacts.
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Hussain, Irshad, Abdul Rauf, Omar Ishtiaq, Qamar-ul Islam, Faisal Aziz Khan, and Shahzad Ali. "Comparison of Frequency of Pseudo-Exfoliation Syndrome in Patients Undergoing Cataract Surgery in Different Regional Hospitals of Pakistan." Pakistan Armed Forces Medical Journal 73, no. 1 (February 24, 2023): 131–34. http://dx.doi.org/10.51253/pafmj.v73i1.5365.
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Objective: To compare the frequency of Pseudo-Exfoliation Syndrome (PXS) in patients undergoing cataract surgery in different regional hospitals in Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Three Tertiary Care Hospitals of Karachi, Rawalakot and Skardu Pakistan, from Sep 2017 to May 2020.
Methodology: Patients aged 45 years and more undergoing age-related cataract surgery were evaluated for Pseudo-Exfoliation Syndrome. Initially, each patient underwent a complete outpatient ophthalmological workup. Demographic details like age and gender were noted. All the patients were screened for hypertension and diabetes mellitus. In addition, patients were screened for pseudo-exfoliation syndrome. Congenital, developmental, secondary and traumatic cataracts were excluded.
Results: A total of 1882 patients were included in the study. Pseudo-exfoliation was carried out in 249(13.23%) patients. In Hospital-A, 23(3.23%); in Hospital-B, 145(14.92%) and Hospital-C, 81(40.70%) of the patients had pseudo-exfoliation. The frequency of pseudo-exfoliation syndrome was significantly more in Hospital-C and then in Hospital-B and least in HospitalA (p<0.01).
Conclusion: Pseudo-exfoliation syndrome was significantly more common in Skardu and then in Rawalakot and least in Malir, which in the same order have more latitude away from the equator, have less average annual temperature and are situated at higher altitudes.
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Johnson, Alicia J., Lidija B. McGrath, Abigail M. Khan, Craig S. Broberg, Yoshio Otaki, Irving Shen, Ashok Muralidaran, and Castigliano M. Bhamidipati. "Hospital Care for Adult Patients with Congenital Heart Diseases." Heart Surgery Forum 26, no. 6 (December 27, 2023): E842—E854. http://dx.doi.org/10.59958/hsf.6833.
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Objective: The ideal type of hospital to care for adult congenital heart disease (ACHD) patients is not well known. Hospital competitiveness, clinical volume and market structure can influence clinical outcomes. We sought to understand how hospital competitiveness affects clinical outcomes in ACHD patients in the era prior to the Adult Congenital Heart Association accreditation program. Methods: Patient discharges with ACHD diagnosis codes were filtered between 2006–2011 from an all-payer inpatient healthcare database. Hospital-level data was linked to market structure patient flow. A common measure of market concentration used to determine market competitiveness—the Herfindahl-Hirschman Index (HHI)—was stratified into: more competitive (HHI ≤25th percentile), moderately competitive (HHI 25th to <75th percentile), and less competitive (HHI ≥75th percentile) hospital. Any complication, home discharge and mortality were analyzed with clustered mixed effects logistic regression. The combined impact of HHI and any complication on mortality by interaction was assessed. Results: A total of 67,434 patient discharges were isolated. More competitive hospitals discharged the least number of patients (N = 15,270, 22.6%) versus moderately competitive (N = 36,244, 53.7%) and less competitive (N = 15,920, 23.6%) hospitals. The adjusted odds of any complication or home discharge were not associated with hospital competitiveness strata. Compared to more competitive hospitals, mortality at moderately competitive hospitals (Adjusted Odds Ratio (AOR) 0.79, 95% CI: 0.66–0.94) and less competitive hospitals (AOR 0.79, 95% CI: 0.63–0.98) were lower (p = 0.025). Age, race, elective admission, transfer status, and payer mix were all significantly associated with adjusted odds of any complication, home discharge and mortality (p ≤ 0.05). Having any complication independently increased the adjusted odds of mortality more than 6-fold (p < 0.001), and this trend was independent of HHI strata. Failure to rescue an ACHD patient from mortality after having any complication is highest at less competitive hospitals. Sensitivity analysis which excluded the transfer status variable, showed that any complication (p = 0.047) and mortality (p = 0.01) were independently associated with HHI strata. Conclusions: Whether lower competition allow hospitals to focus more on quality of care is unknown. Hospital competitiveness and outcome seem to have an inverse trend relationship among ACHD patients. Since medical care is frequently provided away from the home area, hospital selection is an important issue for ACHD patients. Further research is needed to determine why competitiveness is linked to surgical outcomes in this population.
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Busch-Vishniac, Ilene J. "Hospital acoustics characterization and context." Journal of the Acoustical Society of America 152, no. 4 (October 2022): A95. http://dx.doi.org/10.1121/10.0015661.
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In the last 20 years, attention has been paid to characterize and improve the acoustic environment of hospitals, but much remains to be done. For instance, hospital operations often prevent patients from sleeping well. When the HCAHPS survey of hospital patients included a question about noise preventing sleep, it was routinely the lowest score patients awarded to hospitals. A few preliminary studies also have shown hospitals to be poor to fair spaces for speech intelligibility. The delicate balance between maintaining privacy and establishing good communication is particularly challenging for hospital patients because they often have hearing impairments or are medicated and potentially less able to focus. Noise in hospitals has also prompted the shift to written orders for lab work and pharmaceuticals to avoid errors. A relatively new area of research interest is the stress impact of hospital soundscapes. Hospital patients are a vulnerable population, suffering from anxiety about their medical condition, and the sounds to which they are exposed (such as moans) can exacerbate the problem. Hospital staff as well show the impacts of noise-related stress. This talk summarizes the current state of hospital acoustics.
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Abdul Rahman, Alaa Habib, and Nazem Jawad Al Zaidi. "A Study on the Reluctance of Citizens to Conduct Operations in Governmental Hospitals and Conducting them in the Private Sector." Iraqi Administrative Sciences Journal 2, no. 1 (March 30, 2018): 366–96. http://dx.doi.org/10.33013/iqasj.v2n1y2018.pp366-396.
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This research aims to study the reasons for the reluctance of citizens from having surgical operations in governmental hospitals and their desire to go to hospitals in the private sector. To know the causes and their analysis, a number of private hospitals operating in Baghdad in both Karkh and Rusafa has been selected as follows:
Rusafa: Jarrah Hospital, Hayat Al Rahibat Hospital, Mostanserya Hospital. Bunuk Hospital, Rahibat Hospital, Dijlah Hospital, Firdos Rahibat Hospital, Baghdad Hospital.
Karkh: Meserra Hospital, Dhergham Hospital, Kadhumya Hospital.
Patients who had various surgeries were interviewed, and their views and opinions were taken via a checklist which has been prepared for this purpose. 65 patients were reached, statistical data were processed through calculation frequencies, means, and percentages to know the answers of the sample of patients about the reasons of their reluctance. A set of conclusions were reached, among which: The citizens felt weakness in the performance and responsiveness of staffs in governmental hospitals, the surgeons behavior in private hospitals was more appropriate, respectful, and humane than that in governmental hospitals, the private hospital staff can better handle the patients' emotions.
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Brimhall, Bradley B., Troy Dean, Edgar L. Hunt, Richard B. Siegrist, and William Reiquam. "Age and Laboratory Costs for Hospitalized Medical Patients." Archives of Pathology & Laboratory Medicine 127, no. 2 (February 1, 2003): 169–77. http://dx.doi.org/10.5858/2003-127-169-aalcfh.
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Abstract Objective.—To examine the hypothesis that older hospitalized patients have higher laboratory costs than younger patients in the same severity-adjusted diagnosis-related group (DRG). Design.—We obtained hospital case mix data sets (1995–1997) from the Massachusetts Division of Health Care Finance and Policy. We selected discharge abstracts from 4 medical DRGs, at 5 large academic hospitals (n = 15 265) and 5 midsized community hospitals (n = 10 540), for analysis. We converted laboratory and blood product charges to direct costs using the department-specific ratio of cost to charges. We adjusted diagnostic groups for severity of comorbid conditions and complications using the refined DRG method. Main Outcome Measures.—Hospital length of stay (LOS), laboratory direct cost (LDC) per hospitalization, LDC per hospital day, and ratio of LDC to total direct cost. Results.—Hospital LOS was longer for older patients in all comparisons. Laboratory direct cost per hospitalization was higher for older patients in some DRGs, but lower in other DRGs. Laboratory direct cost per hospital day was almost always less for older patients than for younger patients, both at academic and community hospitals. Data stratification by gender, admission status, and principal diagnosis yielded substantially the same pattern of cost differences observed within the larger data set. Conclusions.—Older medical patients have longer hospital stays and generally higher costs. These patients also have a significantly decreased rate of laboratory resource consumption over the course of hospitalization (LDC per hospital day), as well as lower laboratory costs as a proportion of total costs. Age-specific differences in LOS and cost parameters were essentially unchanged after controlling for several potential sources of bias.
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Samuels, Shenae, Rebekah Kimball, Vivian Hagerty, Tamar Levene, Howard B. Levene, and Heather Spader. "Association of hospital characteristics with outcomes for pediatric neurosurgical accidental trauma patients." Journal of Neurosurgery: Pediatrics 27, no. 6 (June 2021): 637–42. http://dx.doi.org/10.3171/2020.10.peds20538.
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OBJECTIVE In the pediatric population, few studies have examined outcomes for neurosurgical accidental trauma care based on hospital characteristics. The purpose of this study was to explore the relationship between hospital ownership type and children's hospital designation with primary outcomes. METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2006, 2009, and 2012 Kids’ Inpatient Database. Primary outcomes, including inpatient mortality, length of stay (LOS), and favorable discharge disposition, were assessed for all pediatric neurosurgery patients who underwent a neurosurgical procedure and were discharged with a primary diagnosis of accidental traumatic brain injury. RESULTS Private, not-for-profit hospitals (OR 2.08, p = 0.034) and freestanding children's hospitals (OR 2.88, p = 0.004) were predictors of favorable discharge disposition. Private, not-for-profit hospitals were also associated with reduced inpatient mortality (OR 0.34, p = 0.005). A children's unit in a general hospital was associated with a reduction in hospital LOS by almost 2 days (p = 0.004). CONCLUSIONS Management at freestanding children's hospitals correlated with more favorable discharge dispositions for pediatric patients with accidental trauma who underwent neurosurgical procedures. Management within a children's unit in a general hospital was also associated with reduced LOS. By hospital ownership type, private, not-for-profit hospitals were associated with decreased inpatient mortality and more favorable discharge dispositions.
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Everson, Jordan, and Julia Adler-Milstein. "Gaps in health information exchange between hospitals that treat many shared patients." Journal of the American Medical Informatics Association 25, no. 9 (July 11, 2018): 1114–21. http://dx.doi.org/10.1093/jamia/ocy089.
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Abstract Objective Hospitals that routinely share patients are those that most critically need to engage in electronic health information exchange (HIE) with each other to ensure clinical information is available to inform treatment decisions. We surveyed pairs of hospitals in a nationwide sample to describe whether and how hospitals within each hospital referral region (HRR) that have the highest shared patient (HSP) volume engaged in HIE with each other. Methods We used Medicare’s Physician Shared Patient Patterns data to identify hospital pairs with the highest shared patient volume in each hospital referral region. We surveyed a purposeful sample of pairs and then calculated descriptive statistics to compare: (1) HIE with the HSP hospital vs HIE with other hospitals, and (2) HIE with the HSP hospital versus federal measures of HIE engagement that are not partner-specific. Results We received responses from 25.5% of contacted hospitals and 33.5% of contacted pairs, allowing us to examine information sharing among 68 hospitals in 63 pairs. 23% of respondents reported worse information sharing with their HSP hospital than with other hospitals while 17% indicated better sharing with their HSP hospital and 48% indicated no difference. Our HSP-specific measures of HIE differed from federal measures of HIE engagement: while 97% of respondents are classified as routinely sending information electronically in federal measures, in our data only 63% did so with their HSP hospital. Conclusions Despite increased HIE engagement, our descriptive results indicate that HIE is not developing in a way that facilitates information exchange where it might benefit the most patients. New policy efforts, particularly those emerging from the 21st Century Cures Act, need to explicitly pursue strategies that ensure that HSP providers engage in exchange with each other.
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Akré, Ellesse-Roselee L., Deanna Chyn, Heather A. Carlos, Amber E. Barnato, and Jonathan Skinner. "Measuring Local-Area Racial Segregation for Medicare Hospital Admissions." JAMA Network Open 7, no. 4 (April 19, 2024): e247473. http://dx.doi.org/10.1001/jamanetworkopen.2024.7473.
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ImportanceConsiderable racial segregation exists in US hospitals that cannot be explained by where patients live. Approaches to measuring such segregation are limited.ObjectiveTo measure how and where sorting of older Black patients to different hospitals occurs within the same health care market.Design, Setting, and ParticipantsThis retrospective cross-sectional study used 2019 Medicare claims data linked to geographic data. Hospital zip code markets were based on driving time. The local hospital segregation (LHS) index was defined as the difference between the racial composition of a hospital’s admissions and the racial composition of the hospital’s market. Assessed admissions were among US Medicare fee-for-service enrollees aged 65 or older living in the 48 contiguous states with at least 1 hospitalization in 2019 at a hospital with at least 200 hospitalizations. Data were analyzed from November 2022 to January 2024.ExposureDegree of residential segregation, ownership status, region, teaching hospital designation, and disproportionate share hospital status.Main Outcomes and MeasuresThe LHS index by hospital and a regional LHS index by hospital referral region.ResultsIn the sample of 1991 acute care hospitals, 4 870 252 patients (mean [SD] age, 77.7 [8.3] years; 2 822 006 [56.0%] female) were treated, including 11 435 American Indian or Alaska Native patients (0.2%), 129 376 Asian patients (2.6%), 597 564 Black patients (11.9%), 395 397 Hispanic patients (7.8), and 3 818 371 White patients (75.8%). In the sample, half of hospitalizations among Black patients occurred at 235 hospitals (11.8% of all hospitals); 878 hospitals (34.4%) exhibited a negative LHS score (ie, admitted fewer Black patients relative to their market area) while 1113 hospitals (45.0%) exhibited a positive LHS (ie, admitted more Black patients relative to their market area); of all hospitals, 79.4% exhibited racial admission patterns significantly different from their market. Hospital-level LHS was positively associated with government hospital status (coefficient, 0.24; 95% CI, 0.10 to 0.38), while New York, New York; Chicago, Illinois; and Detroit, Michigan, hospital referral regions exhibited the highest regional LHS measures, with hospital referral region LHS scores of 0.12, 0.16, and 0.21, respectively.Conclusions and RelevanceIn this cross-sectional study, a novel measure of LHS was developed to quantify the extent to which hospitals were admitting a representative proportion of Black patients relative to their market areas. A better understanding of hospital choice within neighborhoods would help to reduce racial inequities in health outcomes.
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Jones, Daryl A. "Long term mortality of medical emergency team patients in regional Australia." Critical Care and Resuscitation 24, no. 2 (June 6, 2022): 100–101. http://dx.doi.org/10.51893/2022.2.e.
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Medical emergency teams (METs) have been introduced into hospitals worldwide to improve the recognition of and response to deteriorating hospitalised patients. Australia was an early adopter of this model ofcare, 1 which is now mandatory and linked to hospital accreditation.
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Kim, Soyoung, Sangchun Choi, Hyuk-Hoon Kim, Hee Won Yang, and Sangkyu Yoon. "Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service." Journal of The Korean Society of Clinical Toxicology 17, no. 1 (June 30, 2019): 21–27. http://dx.doi.org/10.22537/jksct.17.1.21.
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Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.
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Toida, Chiaki, Takashi Muguruma, Masayasu Gakumazawa, Mafumi Shinohara, Takeru Abe, Ichiro Takeuchi, and Naoto Morimura. "Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study." Journal of Clinical Medicine 10, no. 7 (April 1, 2021): 1422. http://dx.doi.org/10.3390/jcm10071422.
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Appropriate trauma care systems, suitable for children are needed; thus, this retrospective nationwide study evaluated the correlation between the annual total hospital volume of severely injured patients and in-hospital mortality of severely injured pediatric patients (SIPP) and compared clinical parameters and outcomes per hospital between low- and high-volume hospitals. During the five-year study period, we enrolled 53,088 severely injured patients (Injury Severity Score, ≥16); 2889 (5.4%) were pediatric patients aged <18 years. Significant Spearman correlation analysis was observed between numbers of total patients and SIPP per hospital (p < 0.001), and the number of SIPP per hospital who underwent interhospital transportation and/or urgent treatment was correlated with the total number of severely injured patients per hospital. Actual in-hospital mortality, per hospital, of SIPP patients was significantly correlated with the total number patients per hospital (p < 0.001,). The total number of SIPP, requiring urgent treatment, was higher in the high-volume than in the low-volume hospital group. No significant differences in actual in-hospital morality (p = 0.246, 2.13 (0–8.33) vs. 0 (0–100)) and standardized mortality ratio (SMR) values (p = 0.244, 0.31 (0–0.79) vs. 0 (0–4.87)) were observed between the two groups; however, the 13 high-volume hospitals had an SMR of <1.0. Centralizing severely injured patients, regardless of age, to a higher volume hospital might contribute to survival benefits of SIPP.
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Abdi, Basheer A., and Dlofan A. Salman. "Measuring Inpatients Level of Satisfaction about Health Services Provided by Zakho Governmental Hospitals." Humanities Journal of University of Zakho 5, no. 1 (March 30, 2017): 221. http://dx.doi.org/10.26436/2017.5.1.191.
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Background and aim: Patient’s satisfaction is a central element in the evaluation of health care services and it's an important indicator for measuring the quality of services and regarded as a component of performance improvement. The aim of present research was to measure patients’ satisfaction about health services in Zakho's hospital. Methodology: Descriptive study was conducted in Zakho's hospital. 248 patients were selected from Zakho general hospital, maternity hospital and emergency hospital in Zakho city which are the only hospitals that can receive inpatients in discrete. A validated questionnaire was used to measure patients’ satisfaction about health services by interviewing them on day of discharge.
Results: the results of present study in Zakho’s hospitals (Zakho General Hospital, Emergency Hospital and Maternity Hospital) showed moderate level of satisfaction with health services that provided to them as overall results were (3.56 out of 5). With highest level of satisfaction in Zakho general hospital and lowest level in emergency hospital. Conclusion: the results indicate the need for further efforts should spend to overcome weakness and barriers for provision of better quality of services and enhance better satisfaction. the results also suggest that serious and effective pains are necessary to increase patient's satisfaction in Emergency hospital.
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Roh, Chul-Young, and Keon-Hyung Lee. "Hospital Choice by Rural Medicare Beneficiaries: Does Hospital Ownership Matter? – A Colorado Case." Journal of Health and Human Services Administration 28, no. 3 (September 2005): 346–65. http://dx.doi.org/10.1177/107937390502800304.
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About 45 percent of rural patients in Colorado bypassed their local rural hospitals during the 1990s. The effect of this phenomenon is a reduction in occupancy rates and a decrease in the competitiveness of rural hospitals, thereby ultimately causing rural hospitals to close and adversely affecting the communities that they were designed to serve. This study tests whether hospital ownership affects hospital choice by patients after controlling for institutional and individual dimensions. A conditional logistic regression is used to analyze Colorado Inpatient Discharge Data (CIDD) on 85,529 patients in addition to hospital data. Rural Medicare beneficiaries are influenced to choose a particular hospital by a combination of hospital characteristics (the number of beds, the number of services, accreditation, ownership type, and distance from patient residence) and patient characteristics (medical condition, age, gender, race, and total charge for services). Increasing rural hospitals’ survivability, collaborating with other rural hospitals, expanding the number of available services, making strategic alliance with other providers are possible strategies that may help ward off encroachment by urban competitors.
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Lee, David C., Silas W. Smith, Brendan G. Carr, Lewis R. Goldfrank, and Daniel Polsky. "Redistribution of Emergency Department Patients After Disaster-Related Closures of a Public Versus Private Hospital in New York City." Disaster Medicine and Public Health Preparedness 9, no. 3 (March 17, 2015): 256–64. http://dx.doi.org/10.1017/dmp.2015.11.
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AbstractSudden hospital closures displace patients from usual sources of care and force them to access facilities that lack their prior medical records. For patients with complex needs and for nearby hospitals already strained by high volume, disaster-related hospital closures induce a public health emergency. Our objective was to analyze responses of patients from public versus private emergency departments after closure of their usual hospital after Hurricane Sandy. Using a statewide database of emergency visits, we followed patients with an established pattern of accessing 1 of 2 hospitals that closed after Hurricane Sandy: Bellevue Hospital Center and NYU Langone Medical Center. We determined how these patients redistributed for emergency care after the storm. We found that proximity strongly predicted patient redistribution to nearby open hospitals. However, for patients from the closed public hospital, this redistribution was also influenced by hospital ownership, because patients redistributed to other public hospitals at rates higher than expected by proximity alone. This differential response to hospital closures demonstrates significant differences in how public and private patients respond to changes in health care access during disasters. Public health response must consider these differences to meet the needs of all patients affected by disasters and other public health emergencies. (Disaster Med Public Health Preparedness. 2015;9:256-264).
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Pfaff, Holger, Christoph Kowalski, Lena Ansmann, and Julia Ingendahl. "Hospital characteristics and breast cancer patients’ evaluation of care." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e17550-e17550. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e17550.
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e17550 Background: There is a large body of research on patient evaluations of care and its associations with patient characteristics, such as the sociodemographics or the severity of diseases. A number of studies have recently been published that consider the characteristics of various hospitals in order to explain the differences in patient evaluations between hospitals in non-oncological patient populations. This study investigates the relationship between13 dimensions of satisfaction and breast center hospital characteristics which account for the patient case mix. Methods: The cross-sectional survey data of 3,601 newly-diagnosed breast cancer patients (response rate: 88% of consenting patients) who were treated in 85 out of 91 breast center hospitals in the German state of North Rhine-Westphalia in 2010 were combined with structural data from a key informant survey from the same hospitals. Multilevel linear regression models were calculated in order to investigate patients’ evaluations of the care differences between hospitals and their associations with hospital characteristics (i.e. teaching status, volume, network size, clinical studies, case manager employed) accounting for patient characteristics (self-rated health, mother language, insurance status, age, education, cancer stage, type of surgery). Results: Patients evaluated non-teaching hospitals as being statistically significantly better in 8 out of 13 satisfaction dimensions. None of the other hospital characteristics were significantly associated with any of the satisfaction dimensions. Overall, the differences between hospitals were small to moderate, with null model ICCs ranging from 0.02 to 0.09 for the different dimensions. Conclusions: Teaching breast cancer hospitals face substantial difficulties in achieving patient evaluations that are as good as those from non-teaching hospitals in Germany. The question of extra staffing for the additional teaching tasks needs to be discussed.
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Petrikov, S. S., G. R. Ramazanov, S. B. Binnatova, and M. V. Tikhomirova. "In-Hospital Stroke in a Multidisciplinary Hospital." Russian Sklifosovsky Journal "Emergency Medical Care" 9, no. 4 (January 22, 2021): 504–10. http://dx.doi.org/10.23934/2223-9022-2020-9-4-504-510.
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Introduction. Acute cerebrovascular event (ACVE) is the leading cause of persistent disability and death in the world. Due to the high medical and social significance, much attention is paid to the problem of out-of-hospital stroke, and the issues of diagnostics and treatment of in-hospital stroke are practically not studied.Relevance. In-hospital stroke is defined as stroke that develops in a patient hospitalized for other reasons. It is known that the incidence of in-hospital stroke ranges from 2 to 19% of all acute cerebrovascular accidents recorded in the hospital, 0.04–0.06% of all hospital admissions. It was found that patients with inhospital stroke have significant restrictions on thrombolytic therapy, mortality can reach 60%, and the diagnosis is often made with long delays and deviations in examination protocols. The most common pathogenetic subtype of in-hospital ischemic stroke is the cardioembolic subtype. The explanation for this is that in most cases, in-hospital ischemic strokes develop in patients after open cardiac surgery with prosthetics of one or more valves, bypass surgery in conditions of artificial circulation, carotid endarterectomy. In the overwhelming majority of patients, the first symptoms of in-hospital stroke are observed not by doctors, but by nurses, patients or their relatives. Mortality in in-hospital stroke is significantly higher than in non-hospital stroke, which is due to the high incidence of extracerebral complications in this cohort of patients, as well as initially more severe stroke.Aim of study. To analyze the incidence of in-hospital stroke and the tactics of its treatment in a multidisciplinary hospital.Material and methods. The study included 975 patients with ACVE hospitalized at the N.V. Sklifosovsky Research Institute for Emergency Medicine from January 1, 2018 to January 1, 2019. The inclusion criterion was any case of CVE - out-of-hospital or in-hospital. The study did not include patients with subarachnoid hemorrhage (SAH) where secondary cerebral ischemia developed against the background of vasospasm. Also, we did not include patients with stroke, transferred from other hospitals for neurosurgical treatment.Results. In total, in 2018 at the N.V. Sklifosovsky Institute ACVE were diagnosed in 975 patients, of which in-hospital and out-of-hospital strokes were diagnosed in 109 (11.2%) and 866 patients (88.8%), respectively. The proportion of in-hospital stroke was 0.03% of the total number of patients treated at the institute in 2018. Systemic thrombolytic therapy (sTLT) is the main method of treating patients with IS. However, patients with in-hospital stroke may have a large number of contraindications to this type of therapy. Systemic TLT was performed in 1 patient (1%) with in-hospital stroke, while in out-of-hospital stroke, thrombolysis was performed in 36 patients (4.7%). After analyzing the reasons for refusing to perform sLT in patients with in-hospital and out-of-hospital IS. The leading reason for the impossibility of sTLT in patients with in-hospital stroke was the unspecified time of disease development - 44 (43.2%). In 35 patients (34.3%) with in-hospital stroke, refusal to perform sLTT was associated with late IS diagnosis, despite the fact that the stroke developed in the hospital.Conclusion. Thus, an in-hospital stroke aggravates the course of the underlying disease and, as a consequence, the outcome of the disease, leads to an increase in social and medical and economic costs. In this regard, there is a need to study the prevalence, risk factors, clinical features of in-hospital stroke, as well as the development of diagnostic and therapeutic algorithms in order to improve the efficiency of care for patients with in-hospital stroke.
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Fein, Steven, Dayne Alonso, Jiselle Silva, Monica Menendez, Miriam Hernandez, Megan McCartney, Michelle Gamazo, Gloria Campos, and Meena Mallipeddi. "Identifying and Managing Patients with Life-Threatening Hematology Disorders By Doing Telemedicine Inpatient Hematology Consults in Underserved Hospitals." Blood 142, Supplement 1 (November 28, 2023): 2297. http://dx.doi.org/10.1182/blood-2023-173755.
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Background: Life-threatening hematology disorders require urgent intervention by expert hematologists. In many hospitals, there are no hematologists available to meet this need. This occurs in “underserved” hospitals, including many rural hospitals and many urban hospitals that do not have hospital-affiliated or hospital-employed hematologists on staff. Patients who present to these hospitals with life-threatening hematology conditions may have worse outcomes than those who present to hospitals that have hematologists on staff. The problem is created by the shortage of hematologists and the challenge of providing in-person consults in these hospitals. To address this problem, our telemedicine-based hematology practice joined the staffs of four underserved hospitals. We sought to identify and manage patients who require urgent hematology evaluation and intervention. Methods: We created telemedicine-based heme/onc consult services in four underserved hospitals that had little or no access to hematology experts. These facilities included one rural hospital, one critical access hospital (CAH), and two urban hospitals. In one urban site, we provided “hybrid” telemedicine-based service, in which we evaluated patients in-person alternating with telemedicine. Inpatients were seen on A/V devices with the help of the patient's nurse or with a “telepresenter” who brought the devices to the patients. Hospital EMR's were accessed by our hematology provider team. To identify patients who needed our services, we educated hospitalists about the need for urgent telemedicine heme/onc consults for select patients with clotting, bleeding, abnormal blood counts and emergency heme/onc conditions. Results: 3,202 patients were evaluated during a three-year period, including 180 patients in rural hospitals, 126 patients in a CAH, 349 patients in an urban hospital, and 2,547 patients in an urban “hybrid” hospital (mixed telemedicine and in-person consults). Consultations were mostly requested for non-malignant hematology patients, including those with bleeding, clotting, or abnormal blood count disorders. Heme malignancy and solid tumor patients were also referred. Several patients with life-threatening hematology or heme-malignancy conditions were identified, including 34 with acute life-threatening ITP, 23 with HIT, five with life-threatening high blood counts due to myeloproliferative disorder or newly diagnosed chronic myelogenous leukemia (CML), two with TTP, and two with atypical HUS. Two patients with acute promyelocytic leukemia (APL) were identified, stabilized, transferred to tertiary care hospitals, and ultimately cured of their conditions. Telemedicine enabled our hematology practice to provide same-day consults and weekend coverage for hospitals located far apart and outside our home region. Some patients were transferred to tertiary care hospitals more promptly because of our service, while others were deemed safe to avoid a hospital transfer that would otherwise have been requested. In some cases, we provided stewardship for blood transfusions and guidance for blood transfusion refusal. Finally, in some cases we enabled safe discharge by planning prompt telemedicine follow-up. Some of the challenges we faced included slow internet connections and less sophisticated EMR's in rural and CAH hospitals that required more time to complete a consult than would otherwise be needed. It was sometimes challenging to plan A/V televisits at convenient times. Sometimes we felt hindered by lack of in-person assessment. Some of the tests and interventions we would have requested in larger hospitals were not possible, resulting in delays of care or requiring transfers to tertiary care hospitals. Finally, some patients who may have otherwise received inpatient chemotherapy or radiation were discharged instead of being transferred. Conclusions: Telemedicine inpatient hematology consults for underserved hospitals are feasible, though challenging. It is possible to identify and manage patients who have life-threatening hematology disorders via telemedicine.
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Close, A. A., and E. P. Larkin. "A survey of referrals to a special hospital (Rampton Hospital)." Psychiatric Bulletin 18, no. 4 (April 1994): 221–23. http://dx.doi.org/10.1192/pb.18.4.221.
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The three special hospitals of England and Wales are provided for patients subject to detention on account of their dangerous, violent or criminal properties. Special hospital psychiatrists cannot admit patients directly to hospital – the psychiatrist's recommendations can be overturned by a local admissions panel. A two year retrospective study in Rampton Hospital compared the outcomes of the psychiatrists' recommendations to admit or not to admit, with the decisions of the local admissions panel. There was complete agreement in over 90% of cases. This survey lends support to the view that special hospital psychiatrists could admit patients directly to hospital.
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Semple, Margaret M., Brian R. Ballinger, and Elizabeth Irvine. "Prescribing for patients attending old age psychiatry day hospitals." Psychiatric Bulletin 20, no. 6 (June 1996): 335–37. http://dx.doi.org/10.1192/pb.20.6.335.
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A review of the drug treatment of 163 patients attending two old age psychiatric day hospitals showed that 29 received medication from the day hospital, 44 from general practitioners and 60 from both sources. Many of the patients' knowledge of their drug treatment was incomplete. Of those individuals interviewed, approximately equal numbers expressed a preference for day hospital and general practitioner prescriptions. The origin of the prescription did not bear any obvious relationship to subsequent admission to hospital or continued attendance at the day hospital.
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Parimala, M., and S. Snigtha. "Patients Satisfaction towards Aravind Eye Care Hospital in Madurai City." Shanlax International Journal of Arts, Science and Humanities 9, no. 1 (July 1, 2021): 147–53. http://dx.doi.org/10.34293/sijash.v9i1.4039.
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Customers may decide to select the service or product based on the quality which has been considered as a strategic benefit for any business to gain and sustain in the market for a longer time. Products quality can be measured but the services qualities are not tangible to measure, it is depends upon the perceptions and exceptions of the customers. Perceptions and expectations of patients are considered to be the major indicator to assess the service quality of healthcare organization, because it is also highly competitive. In today’s dynamic business environment from the firm’s point of view it is about to build and sustain a strong relationship with their customers by understanding the ingredients of customer satisfaction and Hospitals sectors also need to do this. Hospitals are also classified on the basis of services provided. The various types of hospitals like Dental Hospitals, Eye Care Hospitals, Fertility Care Hospitals, Cancer Hospitals, Children Hospitals, Maternity Hospitals, Orthopedic Hospitals etc., among the various hospitals, eye care hospitals play a vital role. They provide treatments for various eye related problems. One of the big eye care hospital in Madurai is Aravind Eye Care Hospitals. The present generations are using technology in various forms to complete their task, which may lead to face some eye problems like Low Vision, Eye Irritation, Eye strain and many more. Need of Eye Care Hospital plays important role to overcome such problems. The present study focused on the patients’ satisfaction and perception towards Aravind Eye Care Hospital.
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Janczewski, Lauren M., Joseph Cotler, Ryan P. Merkow, Bryan E. Palis, Heidi Nelson, Timothy Mullett, and Daniel J. Boffa. "Effect of pandemic-related reductions in cancer care delivery on different US health systems." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): e18811-e18811. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e18811.
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e18811 Background: The Covid-19 pandemic caused unprecedented challenges in the diagnosis and evaluation of cancer. At the same time, cancer treatment was potentially impacted by significant constraints on patients and hospitals; however, the extent and differential influence on different hospital types is unknown. Our objective was to assess the patterns of treatment utilization to better characterize the impact of the first year of the Covid-19 pandemic on the US healthcare system. Methods: The National Cancer Database (NCDB) was queried for patients treated for any type of malignancy diagnosed from 2018-2020. Autoregressive models were used to forecast expected findings for 2020 based on observations from the prior two years. Descriptive univariate statistics using chi-squared tests were performed to compare observed-to-expected findings for treatment utilization and losses in provided care in 2020. Results: Overall, 1,229,654 patients underwent treatment for any newly diagnosed cancer in the NCDB in 2020, representing a 16.8% reduction compared to what was expected. Stratified by treatment modality, 146,805 fewer patients than expected underwent surgery, 80,480 fewer received radiation and 68,014 fewer received chemotherapy. Reductions in treatment were examined by hospital type. Academic hospitals experienced the greatest reduction in provided care (-105,093 patients, -19%) compared to community programs (-72,432 patients, -14%) and integrated networks (-40,827 patients, -13%). However, there were fewer hospitals in the academic cohort which exaggerated the impact on each hospital. Thus, academic hospitals lost approximately 484 patients per hospital while community hospitals lost 99 patients and integrated networks lost 110 patients per hospital. The losses in provided care were most dramatic in terms of surgical care, as academic hospitals operated on 314 fewer patients per hospital (-20%) than expected while community hospitals on average operated on 69 fewer patients (-16%) and integrated networks 71 fewer patients (-14%). Conclusions: The impact of the first year of the Covid-19 pandemic on cancer treatment was heterogenous, resulting in nearly twice the number of missed surgical patients, compared to other treatment modalities. While all hospital types were affected by the pandemic, cancer care at academic hospitals experienced disproportionate reductions, with each hospital losing more than 4 times the number of treated patients than other hospital types. Continued efforts to recover from the strain of the pandemic on the US healthcare system will need to consider the complex influence of treatment declines across hospital types and different cancer service lines.
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Uddin, Md Rifat, Abdullah Mahmud Showrav, Rifat Jahan, Md Ruhul Amin Tuhin, Md Imtiaz Khalil Ullah, Md Mirajbillah, and M. Bayzid Amin. "Patients’ Satisfaction Regarding Dietary Service at Tertiary Hospitals." Asian Journal of Medicine and Health 21, no. 9 (July 1, 2023): 128–39. http://dx.doi.org/10.9734/ajmah/2023/v21i9867.
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Aim: Hospital diet is an integral part of the management of in-ward patients. Patient satisfaction is a key criterion by which the quality of dietary services can be evaluated. This study was conducted to assess the patients’ satisfaction regarding dietary service at tertiary hospitals.
Methodology: The present cross-sectional study had been carried out among 247 dietary service receivers to assess the patients’ satisfaction regarding dietary service at tertiary hospitals. The study was conducted in Shaheed Suhrawardi Medical Collage Hospital and Dhaka Dental College Hospital, Bangladesh from January to December, 2022. Convenience sampling technique was adopted and a pre-tested structured questionnaire based on Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) was used for measuring patients’ satisfaction with dietary services.
Results: The mean age of the service receivers was 39.24±13.09 years where more than half of the respondents (59%) were male and 65% of the respondents are from rural area. All of the respondents took hospital diet 3 times daily. Among the respondents 97.6% stated that they never had any option to choose their meal and 47.4% of them sometimes felt hungry between two meals. 87% of the respondents considered that the dietary staff always had good behavior. Among the respondent 41.30% had good satisfaction, 30.40% had moderate satisfaction and 22.70% had very good satisfaction regarding hospital dietary service.
Conclusion: The study concluded that almost half of respondents had good satisfaction with the overall dietary service whereas about one third of the respondents rated dietary services as average. Hospitals should strengthen the ongoing dietary service by providing a menu with variety of food daily and improve the taste of supplied food.
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Cockburn, J. J. "Clinical decisions about patients." Psychiatric Bulletin 13, no. 3 (March 1989): 130–34. http://dx.doi.org/10.1192/pb.13.3.130.
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The structure of mental illness services is changing rapidly. Large hospitals are closing or preparing to close and the service will be provided in other ways, partly by smaller units, partly by increased care in the community outside hospital and partly by amalgamations of two or more large hospitals. Smaller units allow closer working relationships with GPs, social workers and other professionals.
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Silvalila, Meilya, Nurul Huzaifi, Shefina Pyeloni Harnold, and Reza Akbar. "Characteristics of referred patients to the Emergency Department in Aceh before COVID-19 pandemic." Trends in Infection and Global Health 2, no. 1 (July 2, 2022): 27–37. http://dx.doi.org/10.24815/tigh.v2i1.25687.
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As an important entry point for referral patients, the management of the Emergency Department to care and implement the best possible treatment are required. The Emergency Department of provincial hospital plays a vital role as a referral hospital of all district-level hospitals to provide initial treatment for a broad spectrum of illnesses and injuries. In Aceh, many referral issues were encountered at the Emergency Department of Dr. Zainoel Abidin Hospital, which categorized the referral patient's condition that was considered to improve clinical care to patients referred. This quantitative study aims to determine the characteristics of patient referral and the referral issues encountered at the Emergency Department of dr. Zainoel Abidin. In total, 1674 patients were recruited using the purposive sampling method from April to June 2019. The results showed that most referral patients arrived at the Dr. Zainoel Abidin Hospital emergency room during the night and very few arrived in the morning. Most patients arriving at the Emergency Department of Dr. Zainoel Abidin Hospital at night were from Aceh Singkil and Gayo Lues. Meanwhile, patients from Aceh Besar, Aceh Jaya, Banda Aceh, Pidie, and Pidie Jaya mostly arrived at the Emergency Department Dr. Zainoel Abidin Hospital during the afternoon. Most patients from Sabang and Simeulu came in the morning. The most commonly referred patients were adult and elderly patients, aged 46-65 years. Most of the patients had been treated in the daycare unit at the previous hospitals with the longest hospital stay was 36 days before being referred to Dr. Zainoel Abidin Hospital. Head injuries and strokes were the most frequent diagnosis led to Emergency Department Dr. Zainoel Abidin Hospital. Furthermore, our study found that 51% of the referral care system issue was that the patient did not arrive at the Emergency Department of Dr. Zainoel Abidin Hospital after being confirmed to be referred through telephone. Most of this issue happened in June for an unknown reason. At the same time, another 23% was due to the unavailability of intensive care.
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Downey, Lindsey, and Hilary Lloyd. "Bed bathing patients in hospital." Nursing Standard 22, no. 34 (April 30, 2008): 35–40. http://dx.doi.org/10.7748/ns2008.04.22.34.35.c6531.
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O’Regan, Patricia. "Nutrition for patients in hospital." Nursing Standard 23, no. 23 (February 13, 2009): 35–41. http://dx.doi.org/10.7748/ns2009.02.23.23.35.c6799.
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