Dissertations / Theses on the topic 'Inpatients'
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Crichton, John Hugh McDiarmid. "Controlling psychiatric inpatients : the response of staff to inpatient misdemeanour." Thesis, University of Cambridge, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311307.
Full textDavies, Emma Clare. "Adverse drug reactions in hospital inpatients." Thesis, Liverpool John Moores University, 2008. http://researchonline.ljmu.ac.uk/5900/.
Full textCepoiu, Monica Elena. "Recognition of depression in elderly medical inpatients." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97920.
Full textObjectives. To evaluate the validity of four recognition indicators and a global measure of recognition against a diagnosis of depression and the effect of patient characteristics on recognition of depression.
Methods. In a cohort of 264 medical inpatients 65 years and over (115 with major or minor depression, 78 with no depression), using data from two previous studies, sensitivities, specificities, and diagnostic odds ratios (DOR) of four indicators of recognition (Diagnosis, Symptoms, Treatment and Referral) and a global measure of recognition (any of the four indicators) were calculated. Stratified analysis was conducted to assess recognition by age, gender, history of depression, antidepressant use before admission, severity of depression, comorbidity, duration of hospitalization, disability and hospital of admission. The associations of patient characteristics with recognition were described among patients with major or minor depression using multiple logistic regression.
Results. Less than half of the patients were recognized according to the global measure of recognition. The indicator with the highest sensitivity was Treatment (27.8%, 95% CI: 20.0-37.0), while the indicator with the best specificity was Diagnosis (96.6%, 95% CI:91.9-98.7). The unadjusted DOR of global recognition was 2.6 (95% CI: 1.5, 4.4). Comorbidity, severity of depression, history of depression, duration of hospitalization, antidepressant use before admission and hospital of admission were significantly associated with global recognition.
Conclusion. Recognition of depression in elderly medical inpatients is low. Identifying factors that hinder recognition may guide interventions aimed at improving diagnosis and treatment of depression in elderly medical inpatients.
Drummond, Hava. "Demystifying psychiatric inpatients : an interpretative phenomenological analysis." Thesis, Regent's University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.646053.
Full textBenjamin, Amy. "Adolescents' perspectives on their treatment as inpatients." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/13990.
Full textAlcazar, Carla Dorr Darwin A. Morgan C. Don. "Dimensions of depression and psychopathy in psychiatric inpatients." Diss., Click here for available full-text of this thesis, 2005. http://library.wichita.edu/digitallibrary/etd/2005/d003.pdf.
Full text"July 2005." Title from PDF title page (viewed on February 13, 2007). Thesis advisers: Darwin Dorr, C. Don Morgan. Includes bibliographic references leaves 61-65).
Dursun, Pinar. "Recognition Of Facial Expressions In Alcohol Dependent Inpatients." Master's thesis, METU, 2007. http://etd.lib.metu.edu.tr/upload/12608450/index.pdf.
Full textö
z June 2007, 130 pages The ability to recognize emotional facial expressions (EFE) is very critical for social interaction and daily functioning. Recent studies have shown that alcohol dependent individuals have deficits in the recognition of these expressions. Thereby, the objective of this study was to explore the presence of impairment in the decoding of universally recognized facial expressions -happiness, sadness, anger, disgust, fear, surprise, and neutral expressions- and to measure their manual reaction times (RT) toward these expressions in alcohol dependent inpatients. Demographic Information Form, CAGE Alcoholism Inventory, State- Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), The Symptom Checklist, and lastly a constructed computer program (Emotion Recognition Test) were administered to 50 detoxified alcohol dependent inpatients and 50 matched-control group participants. It was hypothesized that alcohol dependents would show more deficits in the accuracy of reading EFE and would react more rapidly toward negative EFE -fear, anger, disgust, sadness than control group. Series of ANOVA, ANCOVA, MANOVA and MANCOVA analyses revealed that alcohol dependent individuals were more likely to have depression and anxiety disorders than non-dependents. They recognized less but responded faster toward disgusted expressions than non-dependent individuals. On the other hand, two groups did not differ significantly in the total accuracy responses. In addition, the levels of depression and anxiety did not affect the recognition accuracy or reaction times. Stepwise multiple regression analysis indicated that obsessive-compulsive subscale of SCL, BDI, STAI-S Form, and the recognition of fearful as well as disgusted expressions were associated with alcoholism. Results were discussed in relation to the previous findings in the literature. The inaccurate identification of disgusted faces might be associated with organic deficits resulted from alcohol consumption or cultural factors that play very important role in displaying expressions.
Dixon, Susan. "Understanding sleep problems in rehabilitation inpatients after stroke." Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/3646/.
Full textZanger, Jonathan. "Predicting surgical inpatients' discharges at Massachusetts General Hospital." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/117956.
Full textThesis: S.M., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, in conjunction with the Leaders for Global Operations Program at MIT, 2018.
Cataloged from PDF version of thesis.
Includes bibliographical references (pages 121-124).
In the last few years, MGH has grappled with severe bed capacity management problems. As a result, delays occur in delivering the patient to the right bed at the right time, hindering patient care. One of the root causes for those delays is the mismatch between the timing of admissions and discharges. Particularly, while bed managers know about most admissions well in advance, there is a prevalent lack of central transparency regarding which patients might be ready to leave the hospital and what are the barriers that may delay their discharge. This project aims to improve MGHs bed management processes by introducing a predictive model (based on neural network) that identifies, in real time, surgical inpatients discharges that will occur in the next 24 hours. As part of this research, we present a new modeling methodology, formalizing concepts of 'Milestones to Post-Operative Recovery' and 'Barriers to Discharge', which systematically track patients progress towards discharge. For every admitted surgical patient, our solution outputs a score that is correlated with the likelihood for discharge within 24 hours, and derives a list of barriers to discharge ranked by their significance. In addition, the solution predicts with high accuracy (R-Square 0.86) the total number of daily surgical inpatient discharges, a key piece of information for bed managers. Given training population of 15,553 surgical inpatients admitted to MGH between May 2016 and August 2017, and test population (out-of-sample) of 1,151 surgical inpatients hospitalized during September 2017, the model achieved remarkable performance with ROC of 0.857. During non-holiday weekdays, among the top 10 ranked surgical inpatients identified by the algorithm to have the highest probability of being discharged, 90% were discharged within 24 hours and 97% were discharged within 48 hours, capturing 23% of the hospital's daily surgical discharges. Among the top 30 patients ranked by the algorithm, 69% were discharged within 24 hours and 89% were discharged within 48 hours, capturing 53% of the hospital's daily surgical discharges. The model was implemented as a web-based tool and is currently being piloted at MGH. Preliminary results show potential to promote proactive discharge processes to eliminate unnecessary delays. The implemented solution is using standard EMR data streams, and can be generalized across hospitals.
by Jonathan Zanger.
M.B.A.
S.M.
Andover, Margaret S. "Self-mutilation and suicide attempts in psychiatric inpatients." Diss., Online access via UMI:, 2006.
Find full textCrisanti, Annette Susan. "A descriptive longitudinal cohort study of involuntary psychiatric inpatients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0023/NQ31017.pdf.
Full textPtashinsky, Natalya. "Acute care nutritional intake for inpatients with diabetes mellitus." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527742.
Full textPhysiologic insulin protocols are replacing conventional sliding-scale practices in hospitals because of their flexibility in adapting doses to the patient's nutritional intake and insulin sensitivity. Although many noncritical wards have updated their prandial therapy to insulin-to-carbohydrate ratios, most hospitals continue fixed preprandial dosing. If patients are receiving fixed dose insulin based on prescribed nutrition and they are not consuming what is provided, the obvious outcome is an increased risk for hypoglycemia. Despite this, there are no studies aimed at profiling nutritional intake for patients with diabetes in the noncritical setting. This study was conducted for that purpose. The results validated the positivistic knowledge that these patients do not generally eat all of their rations. Further, this study included an ancillary investigation for the quality of compliance to new diabetic protocols as recorded in paper-based patient records compared to computerized medical records.
Qi, Ling S. M. Massachusetts Institute of Technology. "Predicting department of medicine inpatients' discharges at US hospitals." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/117962.
Full textThesis: S.M., Massachusetts Institute of Technology, Department of Mechanical Engineering, in conjunction with the Leaders for Global Operations Program at MIT, 2018.
Cataloged from PDF version of thesis.
Includes bibliographical references (page 67).
In the last few years, US hospitals have faced severe challenges with bed capacity management that leads to capacity congestion. Delivering patients to the right bed at the right time is very important to patient care quality. However, the current process employs a self-reporting system to receive bed availability from each unit. This method does not provide consistent estimates nor does it provide a standardized, proactive bed capacity management perspective. In addition, the Department of Medicine (DOM) has a very complex patient population, both clinically and non-clinically. Various team structure and uneven distributed bed resources introduce additional challenge on patient discharges. The project aims to develop a predictive analytics tool that consistently and reliably identifies potential patient discharges in the next 24 hours. The prediction tool allows hospitals to incorporate a more proactive bed capacity management process. Every day, a ranked list with each patient's likelihood to be discharged will be the output. This list guides a more focused conversation within the care team to make patient discharge decisions. In addition, the prediction tool provides a comprehensive summary of barriers to discharge. In this work, we extended the model developed by Zanger [9] for predicting surgical patients' discharges to medicine inpatients' discharge prediction. By partitioning the training and validation set by the date on 12/31/2017, the current performance for the full model on January 2018 medicine inpatients has a prediction power of - 0.74 (Area Under Curve of a Receiver Operating Characteristic curve - AUC ROC there onwards). We further evaluated the model performance for specific patient populations. With patients' Length-Of-Stay (LOS) up to 3 days, the model's performance in terms of AUC ROC can reach ~ 0.8; 0.78 for model with patients' LOS up to 5 days, 0.77 for model with patients' LOS up to 7 days, and 0.72 for model with patients' performance up to 12 days. In addition, the model can capture 57.8% discharges in the next 48 hours, and 33.1% discharges in the next 24 hours.
by Ling Qi.
M.B.A.
S.M.
Eisenbrandt, Lydia L., and Jill D. Stinson. "Differentiating Forensic Inpatients With and Without Psychotic Spectrum Diagnoses." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7938.
Full textBrdaroska, Bilyana. "The Hypothalamic-Pituitary-Gonadal Axis In Male Psychiatric Inpatients." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1604.
Full textGong, Zhiping, and gongzhiping@gmail com. "Developing Casemix classification for acute hospital inpatients in Chengdu, China." La Trobe University. School of Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050314.195349.
Full textGong, Zhiping. "Developing casemix classification for acute hospital inpatients in Chengdu, China /." Access full text, 2004. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050314.195349/index.html.
Full textIncludes bibliographical references (leaves 320-329). Also available via the World Wide Web.
Goodwin, A. J. ""Us vs Them" : inpatients or fellow inmates? : an autoethnographic exploration." Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/20386/.
Full textMoodley, Aneshree. "Methamphetamine use and HIV risk among severely mentally ill inpatients." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/10989.
Full textSub-Saharan Africa accounts for 69% of the global HIV burden. Due to a variety of social, economic and behavioural factors, mentally ill patients are more likely to engage in high risk sexual behaviours. In turn, co-morbid substance use which is present in up to 75% of mentally ill patients is a leading risk factor for sexual risk behaviours. Worldwide methamphetamines are the most commonly used illicit stimulant. Both injectable and noninjectable methamphetamines have evidenced associations with high risk sexual behaviours. Smoking and inhalation of crystal methamphetamine is the predominant mode of use in South Africa. The use of crystal methamphetamine amongst mentally ill persons in Cape Town has escalated over the last decade. We aimed to determine the occurrence of methamphetamine use and risky sexual practices amongst mentally ill patients. In addition we aimed to explore the associations between methamphetamine use and HIV sexual risk behaviours in a sample of mentally ill inpatients in Cape Town, South Africa.
Thomas, Peter F. "Functions of self-injurious thoughts and behaviors within adolescent inpatients." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9731/.
Full textThomas, Peter F. Kaminski Patricia L. "Functions of self-injurious thoughts and behaviors within adolescent inpatients." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9731.
Full textGaudiano, Brandon A. Herbert James D. "Acceptance and commitment therapy for psychiatric inpatients with psychotic symptoms /." Philadelphia, Pa. : Drexel University, 2004. http://dspace.library.drexel.edu/handle/1860/295.
Full textLyon, R. "Increasing physical activity through motivational interviewing with adult forensic psychiatric inpatients." Thesis, University of the West of England, Bristol, 2014. http://eprints.uwe.ac.uk/22276/.
Full textMorreale, Mark J. "Evaluation of a care map for community-acquired pneumonia hospital inpatients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22365.pdf.
Full textCarr, Catherine. "Modelling of intensive group music therapy for acute adult psychiatric inpatients." Thesis, Queen Mary, University of London, 2014. http://qmro.qmul.ac.uk/xmlui/handle/123456789/26966.
Full textMoghazy, Ezzat. "Development and validation of an outcome measure for orthopaedic trauma inpatients." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/2662.
Full textIntroduction In clinical physiotherapy, there is a growing importance for the accuracy and reliability of assessment and outcome measures. The purpose of this study is to develop a valid outcome measure for orthopaedic trauma inpatients. Item generation was done by conducting a systematic review of published functional outcome measures and patients' interview. Item reduction was conducted by using a panel of physiotherapists and patients. Objectives The overall study objectives were: 1) To determine if a functional outcome measurement scale for trauma inpatients exists and has been published; 2) To generate functional items for the construction of a new outcome measurement tool for trauma inpatients; 3) To construct a new outcome measurement tool for trauma inpatients and assess elements of validity and reliability (face and content validity, response to change, internal consistency and floor and ceiling effects) of the new developed outcome measure. Methodology Convenience sampling was applied to collect data from 35 trauma inpatients in trauma wards at Rashid Hospital in Dubai, UAE. 88% of the trauma inpatients were male (total sample n= 100), mean age =34.75, and the standard deviation = 14.46. 21 functional activity items were generated from the collated results of the patient interviews. Internal consistency reliability, responsiveness and floor and ceiling effect were assessed. Data analysis was conducted using Statistica Version 7. Results The final number of functional activity items included in the newly developed Functional Scale outcome measure was 29 activity items relevant for trauma inpatients. A Cronbach's alpha ranged between 0.76 and 0.97. The lowest alpha result was for the 'ADL' activities at follow-up (0.76). The highest alpha result was for 'out of bed' activity at admission and discharge (0.97). The response to change of the Functional Scale for trauma inpatients over time results illustrates that there was a significant difference in the mean scores over three administrations of 'Bed', 'Out of bed' and 'ADL' activity items of Functional Scale for trauma inpatients (p=O.OOOO). In general, there was no significant floor and ceiling effects at admission or discharge for 'bed', 'out of bed' and 'ADL' activities, except there was a floor effect noted at discharge for 'bed' activities and 'ADL' activities, and a ceiling effect noted at admission for 'out of bed activities' only. Discussion and Conclusion The newly developed Functional Scale outcome measurement for trauma inpatients has been shown to be internally consistent and appears to be valid with respect to response to change in this sample of trauma inpatients. The results of this study thus suggest that the Functional Scale for trauma inpatients may be an appropriate tool when the goal is the assessment of change in disability functions in trauma inpatients, although further psychometric testing may be required.
Philpott, Rosanna Lewissa. "Trauma-related psychological processes & psychotic-like experiences in adolescent inpatients." Thesis, King's College London (University of London), 2014. http://kclpure.kcl.ac.uk/portal/en/theses/traumarelated-psychological-processes--psychoticlike-experiences-in-adolescent-inpatients(3f7e4946-3f1b-48d7-98fe-7cb9a420f3d3).html.
Full textChau, Cecilia, Córdova Hugo Morales, and Espinoza Micaela Wetzell. "Coping style and performance status in a group of oncological inpatients." Pontificia Universidad Católica del Perú, 2002. http://repositorio.pucp.edu.pe/index/handle/123456789/102502.
Full textSe estudian las asociaciones entre estilos de afrontamiento medidos a través del Test de Estimación del Afrontamiento COPE-versión disposicional (Carver, Scheier y Weintraub. 1989) y Estado de Salud inferido a través del Estatus Performance, medido a través del Índice de EjecuciónConductual de Karnofsky, en un grupo de 28 pacientes oncológicos hospitalizados de ambos sexos. La investigación alcanza el nivel descriptivo-correlacional, y se encontraron asociaciones entre ambas variables expresadas en correlaciones Pearson positivas y moderadas interpretadas en el siguiente sentido: a mayor empleo del estilo, menor estatus de salud entre las escalas supresión de actividades competentes, postergación del afrontamiento, apoyo social instrumental, enfocar y liberar emociones y desentendimiento conductual. La escala afrontamiento activo, presentó una correlación negativa respecto al Estatus Performance como medida de salud.
Booth, A., and Jill D. Stinson. "Effects of Adverse Childhood Experiences on High-Risk Inpatients’ Criminal Behavior." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7908.
Full textBooth, Alexis, Jill D. Stinson, and Carrie C. LeMay. "Effects of Adverse Childhood Experiences on High-Risk Inpatients’ Criminal Behavior." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7960.
Full textNguyen, Ngoc Tu. "Atrial fibrillation and frailty in older inpatients in Australia and Vietnam." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15480.
Full textBooth, Alexis L., and Jill D. PhD Stinson. "Effects of Adverse Childhood Experiences on High Risk Inpatients Criminal Behavior." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/honors/289.
Full textWhittle, Peter. "Causal beliefs and psychiatric disorder." Thesis, University of Exeter, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337740.
Full textAlsunni, Ahmed. "Ischaemic and diabetic cardiomyopathy : pathological and immunohistochemical studies inpatients and animal models." Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.506843.
Full textGhaleb, Maisoon Abdullah Adel. "The incidence and nature of prescribing and administration errors in paediatric inpatients." Thesis, University College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435831.
Full textLeMay, Carrie C., Jill D. Stinson, Lydia L. Eisenbrandt, Courtney Smith, and Megan Quinn. "Polypharmacy Among Psychiatric Inpatients With Serious Mental Illness in Secure Forensic Care." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7951.
Full textTalatala, Mvuyiso. "Cannabis use in psychiatry inpatients." Thesis, 2008. http://hdl.handle.net/10413/661.
Full textThesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.
Lin, Ling-Hua, and 林玲華. "Screening for Depression in Cancer Inpatients." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/94616541303048891268.
Full text長庚大學
護理學研究所
88
Depression is the common problem for cancer patients. However, to have psychiatrists performing diagnostic assessment for every cancer patient is not feasible. A simple and valid method to screen depression is in need. The purpose of this research is to compare the screening ability of two simple instruments of depression for cancer inpatient. A secondary aim is to examine the risk factors of depression. 121 cancer inpatients aged over 18 were invited to participate in this research, and who completed two depression scales (HADS and GDS) and psychiatric interview within 72 hours. According to the structured interview (M.I.N.I.), we got psychiatric diagnosis which based on DSM-Ⅳ. Using the DSM-Ⅳ diagnosis as a golden standard, we proceeded analysis of ROC curves. The result indicates the prevalence of depression in this population is 34.7%. A cut-off point of 7 for HADS-D gives 81.0% sensitivity and 63.3% specificity. And a cut-off point of 11 for HADS contributes 81.0% sensitivity and 54.4% specificity. GDS and SF-GDS can not get an optimal cut-off point from analysis of ROC curve. With the criterion of 70% sensitivity, the better cut-off points of GDS and SF-GDS are 10 and 6 respectively. The AUC of HADS-D (.7575) is the greatest of all scales. This study also affirms poor functional status, perceived ineffective of treatment, lower educational level and lower income of family associated with higher depression prevalence rate. HADS-D appears on this study, to be a more feasible screening scale, but original cut-off point is inadequate. Optimal cut-off point of HADS-D is 7 for clinical implication. Besides, nurses should offer more physical and psychosocial support for high-risk patients of depression.
Kapoor, Shitij McAlister Alfred Sexton Ken. "Burden of diabetes in cancer inpatients." 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1467406.
Full textChiu, Chin-Kai, and 邱勁凱. "Using RFID for the inpatients' nursing care." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/29284888163648524850.
Full text國立暨南國際大學
資訊管理學系
97
The financial crisis has severe impacts on many businesses. Many companies bankrupt during this impact. Medical facilities also suffer the pressure due to the rise of operation cost and man power shortage. It is well known that medical manpower shortage will bring great threaten to inpatients’ health. How to utilize the modern technology to save the tedious and routine medical checkup is very important. This study focuses on developing a system which utilizes the Radio-frequency identification (RFID) device to inpatient in hospital. This study also shows the automatic operations by RFID can save many tiresome works and can be used to enhance patients’ safety.
Chu, Kuan-Yu, and 朱觀宇. "An oral epidemiological study of schizophrenic inpatients." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/63767931781396538729.
Full text國立陽明大學
公共衛生研究所
99
Background: Schizophrenia is considered as one complex psychiatric disorder. A consequential poor oral health has been reported in schizophrenic inpatients. Schizophrenic inpatients are, probably, a disadvantaged minority who receive inadequate dental care. However, there is little comparative research evidence to support the claim that there is disparity in dental care between schizophrenic inpatients and the disabled people, or the general population. Meanwhile, little research has been done on the relationship between dental caries and the personal characteristics of schizophrenic inpatients. An oral health survey of schizophrenic inpatients in the largest public psychiatric hospital was conducted in Taiwan in 2006. Based on this data, this study aims (1) to provided descriptive epidemiological information on the oral health of hospitalized schizophrenic inpatients; (2) to investigate whether the subjects received poorer dental care compared with disabled people, and compared their oral health with the general population; and (3) to evaluated the association between some potential factors and oral health indexes. Methods: All subjects were selected according to a psychiatric diagnosis of schizophrenic disorder (ICD-9 code: 295) and underwent a standardized oral health examination. A total of 1,103 subjects participated in this survey. The type of research used in the survey was the clinical method, consisting of an oral examination using dental instruments and a light source. Indexes for oral health included caries experience; decayed, missing, and filled teeth index (DMFT); care index (CI); number of remaining teeth (NT); percentage edentulous; and community periodontal index (CPI). The survey index was consistent with those recommended by the WHO. The above results were compared with the findings of oral health investigations on disabled people or the general population in Taiwan using the proportion test and the t-test. Multiple regression models were used to measure the independent effects of the subjects’ characteristics on the oral health indexes. Results: A total of 1,103 with schizophrenic inpatients participated in this survey. Among the subjects, (1) caries experience is 98.5%; average number of DMFT, 13.9; mean of the care index (CI), 14.3%; average number of teeth (NT), 17.7; 5% edentulous and 39.4% having periodontal pockets above 4mm (CPI≧3). (2) compared with the disabled people, subjects’ care index (CI) is lower but caries experience (CExp) is higher in the group aged 19 to 44 years; the mean number of decayed, missing, and filled teeth index (DMFT) is lower in the group aged 45 or more. Compared with the general population, their CExp, mean number of DMFT, percentage edentulous, and community periodontal index are higher but CI and number of tooth are lower among various gender or age groups. (3) The multiple regression results indicated that age was the only variable independently associated with DMFT>8 (OR=7.74, 95% CI=3.86–15.55, p<0.001 in comparison to residents aged 65+ years vs. 20–44 years; OR=3.06, 95% CI=2.02-4.61, p<0.001 in comparison to residents aged 55–64 years vs. 20–44 years) after making adjustments for other potential explanatory variables. In addition, those with an education of only elementary school (OR=1.67, 95% CI=1.08–2.56, p=0.021), low income (OR=1.58, 95% CI=1.02–2.44, p=0.039), and length of stay (LOS) of >10 years (OR=2.09, 95% CI=1.30–3.37, p=0.002) were associated with a care index <54.7%. Older age, lower educational level, and longer hospital stays were associated with number of remaining teeth being <24. Conclusion: The findings of this study may be summarized by pointing out that (1) the unmet dental treatment needs and supported the conclusion that there was lack of dental care among the schizophrenic inpatients; (2) the CI of schizophrenic inpatients is likewise worse compared to the disabled people; overall oral health status is considerably worse compared to the general population; (3) aging was the most important factor related to a high level of dental caries. Low educational level, low income, and LOS were also associated with the indicators of dental caries among institutionalized subjects with schizophrenia. It is necessary to address the treatment factors such as prolonged stay in institutions when decision-makers are planning for preventive strategies of oral health for schizophrenic inpatients.
Yang, Yu-Kuang, and 楊玉冠. "Determinants of the Hospital Growth in Inpatients Services." Thesis, 1998. http://ndltd.ncl.edu.tw/handle/46550349778814331934.
Full textChen, Shih Ming, and 陳世明. "A study of inpatients’ transfer task assignment problem." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/07239593099650554491.
Full text長庚大學
資訊管理學系
99
In recent years, the advancement in medical technology and changes in public’s perceptions of healthcare service has leaded people to expect better quality of cares and treatment. This study focus on solving the tasks of transfer inpatients for the scheduled examinations in a hospital, where we instigated a scheme that can assign the transfer task efficiently and, in the process, reduce the inpatients’ waiting time. The scheme for the assignment problem of inpatients’ transfer task has two phases: The first phase deals with the schedule of inpatients’ transfer tasks. According to inpatients’ number of examinations required, we scheduled and classified inpatients’ transfer and examination time. The second phase deals with the task of assign manpower for the transfer center, where we implement a greedy algorithm for finding solutions for the assignment problem. We used a set of raw data collected from the hospital on inpatients’ transfer and sets of randomly simulated data to test and verify the algorithm. The result seems to indicate that the algorithm is able to find satisfying solutions for the assignment problem and are much more effective than the current existed solutions (solution derived manually). The greedy algorithm produces results that have dramatically improved on the inpatients’ waiting time and able to complete all assignments under the stipulated time.
Yang, Fei-Ching, and 楊斐卿. "To simplify the fall risk screening tool for inpatients." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/km9x6n.
Full text高雄醫學大學
護理學系碩士班
104
Falling, a major health care issue in countries across the world is also the first one accident occurring most frequently in our hospital, accounting for more one quarter of all cases reports on patient safety incidents. Almost half of the patients fall that exhibited minor, moderate or severe injuries. An original 16 items fall risk screening tool was complicated and wasted time that the outcomes of sensitivity and specificity benefit was ineffective. The purpose of this study was to simplify a risk screening tool that applicable to predict the patient fall in a medical center in southern Taiwan. We used a 16 items screening tool and conducted a retrospective case-control study based on data collected between January 2016 and February 2016 regarding 169 cases of inpatient falls reported in a medical center in 2015. A control group was selected from stratified random sampling of patients treated at various departments. By controlling age and conducting a 1:1 matched sampling, we recruited inpatients that did not fall during hospitalization, totally obtaining 338 cases of data. SPSS Version 20.0 was employed to analyze the descriptive statistics of the two groups and conduct chi-square tests and diagnostic test. The 338 inpatients including male 211, female 127, and ages mostly from 52.0 to 80.3 were gathered for analysis. The results of a chi-square analysis indicated the following seven risk factors of falling: unsteady gait, past history of falls, dizziness/vertigo, patient overestimates ability/forgets limitation, needing assistance in ambulation, sedative hypnotics medication and laxative medication. The simple version of fall risk screening tool including 7 items is appropriate, the data were analyzed by receiver operating characteristic curve (ROC), the result of the analysis showed an AUC = .725. The sensitivity, specificity, positive predictive value and negative predictive value were 83.4%, 43.8%, 59.7% , 72.5% and Youden index .40, respectively, for detecting high risk of patients falling, based on the fall risk screening score using 2 points as a cutoff value. The falls risk screening tool could be used by clinical nurses as a procedure in daily physical assessments or patient admissions to identify patients with a high risk of falling. On the basis of the results of the screening, nurses can immediately formulate nursing plans and interventions that prevent patient falling.
Chung, Cheng-Ling, and 鍾政玲. "A study on satisfaction to hospital meals among inpatients." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/09639043504934432424.
Full text臺北醫學大學
保健營養學研究所
96
The reception of hospital meals by patients have until now been a matter of speculation. The purposes of this study were (1) to investigate the overall satisfaction of hospital inpatients eating. (2) to investigate different individual characteristics and contextual factors of the inpatients satisfaction and (3) to find out the factors that affected inpatients eating satisfaction. A structural questionnaire was used to collect and survey the inpatients eating satisfaction and a Likert 5-point scale was used to quantify satisfaction. The study sampling for this research was collected from the hospitalized patients of Mackay Memorial Hospital (Medical Center) - Taipei District. The newborn center, pediatric ward, intensive care unit, psychiatric ward inpatients and those inpatients who were unable to eat by mouth or whose meals were part of an examination diet such as TPN nutrition support patients and NG tube feeding patients were excluded. The investigational period took place in: August/2005, August/2006 and August/2007, three times altogether. Each questionnaire needed to be collected on three consecutive working days (excluding Saturdays and public holidays). In total 548 valid questionnaires were collected. The statistical analysis was performed with the software SPSS version 10.0. The results showed that age, type of diet, appetite before hospitalization, and whether dietary consult took place were parameters that significantly affected satisfaction (p<0.05). Educational level and type of diet, were also significantly different (p<0.05). The patients employment status was found to be statistically different as well (p<0.05). The scores with regard to the hospital’s meals indicated that the satisfaction scores were higher than the dissatisfaction ones. Gender and main dish (cereal, rice, etc.,), the temperature of the side dishes were all significantly different (p<0.05). Educational level and the amount of side dishes and the temperature of the main dishes have significant differences (p<0.05). The overall satisfaction and satisfaction project (n=8) were significantly different (p<0.05). In conclusion, the main factors impacting the satisfaction with hospital catering are the contents of meal, flavor of meal, freshness of meal and hospitalized appetite.
Ho, Hsin-Lei, and 何心磊. "A Pilot Study of Healthcare Quality in Asthma Inpatients." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/55771599574064912470.
Full text國立臺灣大學
衛生政策與管理研究所
93
Abstract Background: Although the convenience and access to healthcare have been greatly improved since the implementation of National Health Insurance in Taiwan, the quality of healthcare is still a crucial issue. Take asthma care as an example; the national clinical guideline on the management of asthma was published by DOH (department of health) Taiwan in 2001. The rate of guideline adherence is still poor and the quality among hospitals varys significantly from patients’ perspective. In this study we try to explore the structure, process and outcome perspectives of care quality for asthma inpatients in Taiwan and analyze the relationships among these 3 dimensions of quality measure. Method: We conducted 2 surveys of asthma inpatients service to investigate patients’ satisfaction and process of care in 2002 and 2004. To measure the process of care, we established 7 indicators in accordance with asthma clinical guidelines. Furthermore, we intergrated the self-reported hospital accreditation data for descriptive and inference analyses. Results: There are significantly differences of patient satisfaction scores on hospitals with distinctive accreditation level and ownership. Among the 7 indicators of guideline adherence, the highest rate of adherece is “systemic steroid given” (83.13%), while the rate of “PEF measurement” is the lowest. The average items (score) of guideline suggested treatment received by patients are 3.42 out of 7. In addition, the rate of readmission for the same disease was associated with the degree of adherence to the guideline suggested treatment. In correlation and regression analyses, there are significant correlations between (1) guideline aherence score and patient satisfaction score (2) guideline adherence score and proportion of nurses with undergraduate or higher degree. The average of ICU lenth of stay, the proportion of nurses with undergraduate or higher degree and the ownership of hospital are significant independent variables to the guideline adherence score in the multiple regression model, while the hospital accreditation level, the guideline adherence score, and the average LOS and deathrate of ICU are significant independent variables to patient satisfaction score. Conclusion: Patient satisfaction scores of asthma inpatients vary among hospitals with different accreditation level and ownership. Moreover, the condition of asthma guideline adherence is not satisfactory. Further studies should be done to investigate the comprehensive measure of quality of asthma care. Keywords: asthma, quality of care, clinical guideline, patient satisfaction
Chen, Ying-Yi, and 陳穎儀. "Trends in the use of Cephamycin in Taiwanese inpatients." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/82078280563862593769.
Full text高雄醫學大學
藥學研究所碩士班
93
Objectives The major purpose of this study was to analyze cefotetan、cefoxitin and cefmetazole utilization and trends for Taiwanese inpatients, from 1997 to 2001. We analyzed the utilization and long-term trends within patient’s social demography(age, sex)and medical care institution’s characteristics(branch local, hospital level), and the usage situation of every month. Methods Data source was derived from“inpatients expenses claims data, inpatients order claim data, and medical care institutional files in National Health Insurance Research Database from 1997 to 2001. According these data files, we selected cefotetan、cefoxitin and cefmetazole for analysis. The total number of patients were 4345, and among these patients,cefoxitin was 1938, cefmetazole was 2407. SAS for Windows 8.2 was used for data management and statistic analysis, and undered the usage trends of cefotetan、cefoxitin and cefmetazole variety by analyzing the result. Results Results of the study indicated that increasing used cefoxitin and cefmetazole from 1997 to 2001. Cefoxitin used 307 patients in 1997 to 484 patients in 2001, and Cefmetazole used 468 patients in 1997 to 551 patients in 2001. In part of age and sex, cefoxitin used the most in above 65-year-old male, but cefmetazole used the most in above 65-year-old female. In part of month, cefoxitin used the most in July, and cefmetazole used the most in February. In the aspect of medical level, cefoxitin and cefmetazole both used most in medical centers, cefoxitin and cefmetazole were decreasing trends use to decreasing level of the institutions. In the aspect of branch local, cefoxitin and cefmetazole both used in Taipei Branch more than other branchs. So for this reason cefoxitin and cefmetazole usage were some differences. Conclusions Although the usage quantity of cefotetan、cefoxitin and cefmetazole at Taiwan did not be regarded as at most, but we could find that the usage still had some difference from the results. So clinicians who should use cefoxitin and cefmetazole wit caution, and could tell patients correct the medicinal methods, thus could reduce resistance and abuse.
Tai, Chien-Shu, and 戴千淑. "A Study on Medical Resource Utilization of Burn Inpatients." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/26769351574176798365.
Full text國立陽明大學
醫務管理研究所
93
Abstract Background: In recent several years, the government emphasized burn prevention and first aid initial management, and got a lot of improvement in both fields. With the process of health care technology, the survival rate of burn injury improved but the cost of care and rehabilitation also increased. The cost of each burn inpatient is the highest among all trauma patients, however it varies with severity. Paying an average fee with geographic and other adjustments would promote efficiency by letting the hospitals keep any profit if their costs were less than the payment and encouraging them to drop services if their costs consistently exceeded the payment. If the gap between reimbursement and actual expense is great, it may cause case shifting and patient dumping. It not only delays the treatment but also increases the cost accordingly. Therefore, the cost of burn care and reimbursement can’t be emphasized more. Objective: 1. Understanding the burn inpatient medical resource utilization. 2. Analyzing the influence factors of burn inpatient resource. Methodology: Data were collected from the NHI research database in 2001. To analyze the extent to which burn care cost is determined by the characteristics of patient(sex, age and comorbidity), severity of burn(the type, area, depth of burn, inhalation injury and ABSI score), and the characteristics of the institution in which the patient is treated(accreditation level, ownership and locality). Then compare the different burn severity model to cost of burn . Result: Costs of care are higher in elderly, with comorbidity, multiple burns, large burn area, the third burn depth, with inhalation injury, public facilities and medical center. Compare to the model of ABSI, the common severity index model own a higher explanation. Conclusion: The characteristics of patient, severity of burn and the characteristics of the institution where the patient is treated account for portions of the variance in medical resource utilization. We suggest NHI reconsider the reimbursement for burn care.
Chang, Yen-Chan, and 張晏甄. "Quality of Care of Inpatients with Acute Myocardial Infarction." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/94408725874015712421.
Full text國立陽明大學
衛生福利研究所
93
Lots of clinical trials have found that some therapies, like aspirin, could prevent acute myocardial infarction’s patients from death. However, studies have also showed these therapies generally were underused. In order to improve the quality of care of acute myocardial infarction, American Heart Association (AHA)、American College of Cardiology (ACC) and Centers for Medicare & Medicaid Service(CMS) developed a clinical guideline and quality indicators to assess the quality of care of AMI. The quality indicators in our study were adopted from CMS and ACC/AHA. The process quality indicators included :using aspirin、beta-blockers、angiotensin-Converting Enzyme inhibitors(ACEI)、cholesterol-lowing therapy、withhold calcium- channel blocker、received reperfusion therapy and angiography during the hospitalization. The outcome quality indicators included death in hospital、AMI and AMI related disease readmission in 14、30 and 180 days . The study populations were divided into eligible patients and ideal patients. The source of data was National Health Insurance (NHI) inpatients’ database from 2000 to 2003 provided by Bureau of NHI. Target populations were primary acute myocardial infarction hospitalization (with ICD-9-CM codes 410) aged over 18 years. The exclusion criteria included whose without discharge date, have been transferred from other hospitals, suicide during hospitalization, escaped from hospitals, hospitalized less then two days, and has been hospitalization in previous month. . A total of 29645 patients meet the criteria. The control variables included years, patients’ age, sex, comorbidity index, and disease severity. The independent variables included hospital ownership、levels、branches and volumes. The dependent variables included the process and outcome quality indicators. To assess the process and outcome quality of care,, we use logistic regression, multiple regression, and Generalized Estimating Equation (GEE) to evaluate the influence of the independent variables. The major results were as below: (1)62.95% AMI inpatients received aspirin during the hospitalization; 53.18% patients received beta-blockers; 66.74% patients received ACE inhibitors; 63.96% patients received cholesterol-lowing therapy;79.13% patients withheld calcium-channel blocker; 45.01% patients received reperfusion therapy and 59.48% patients received angiography. (2)Average length of stay of AMI inpatients were 10.08 days and 3.23 days for general and ICU respectively. In general 1/2 to 2/3 AMI patients received the ideal therapies in Taiwan, similar to other countries. However, reperfusion therapy rate was lower than other countries. (3)Death rate of AMI inpatients was about 5.07%, death rate including those auto discharged during the hospitalization is about 14.78%; Readmission rate of AMI was 1.34-2.82%. Readmission rate AMI related disease was1.35-2.97%. In general Inpatient outcome quality of care in Taiwan was better than other studies, but the readmission rate might be underestimated in our study. (4)After controlling other variables, low-volume hospitals tended to have worse process and outcome quality of care. We have the following recommendations: (1)To the health government:(a)The government should help doctors to make better treatment decision. (b) Quality indicators of our study could be used to evaluate the quality of care of AMI. (c) The results of our study could be used to enhance hospitals’ quality of care continuously. (2) To medical providers:(a) Should follow the well established clinical guideline to improve the quality of care of their patients. (3) To other researchers:(a) Can combine NHI claim data with clinical database to conduct further analysis. Physicians’ specialists and patient volumes could be included in the analysis to conduct international comparison. (b) Can further assess the appropriateness of care during hospitalization.
Wang, Yi-Fen, and 王憶芬. "Influencing Factors and Radiological Medical Utilizations among Elderly Inpatients." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/91935017083595648172.
Full text中臺科技大學
醫療暨健康產業管理系碩士班
103
Background and objective: Elderly acute and chronic disease incidence and severity are higher than that of young people, and therefore more dependent on modern medical imaging diagnostic tool. Population ageing increased demand for diagnostic imaging. This study was to explore the elderly aged over 65 of radiological medical utilizations and influence factors. Methods: We used data from 2010 National Health Insurance Research Database and cross-sectional study. All inpatients over the age of 65 with a total of 531,850 people were enrolled. In addition to descriptive analyses of radiological medical utilizations, we used negative binominal regression to analysis the influence factors of 65 years and over aged inpatients radiological medical utilizations. Results: In 2010, the radiological examination of elderly inpatients aged 65+, chest X-ray (66.9%) used the largest number, followed by CT (23.8%), abdominal X-ray (23.7%), other X-ray (14.6%), and MRI (8.5%). The age group in the most used chest X-ray and CT is 75-79 years, abdominal X-ray is 80-84 years, other X-ray and MRI is 70-74 years. Once hospitalized is 62.4%, and greater than or equal to twice hospitalized is 37.6%. In using medical imaging tool, the proportion of inpatients for once hospitalized and greater than or equal to twice hospitalized are 61.8% and 90.8%. In using medical imaging tool, the ratio of inpatients for once hospitalized and greater than or equal to twice hospitalized are 61.8% and 90.8%. Negative binomial regression analysis of radiological examination in hospitalized patients over 65 years, found that utilization of chest X-ray and abdominal X-rays increased with age (reference group 65-69 years); before age 95 years, CT utilization increased with age; after age 80 years, the utilization of other X-ray and MRI decreased with age. Males received significant more chest X-ray, abdominal X-ray and CT than females; males received less other X-ray and MRI than females. Ischemic stroke inpatients have a higher radiological medical utilization in chest X-ray, abdominal X-ray, other X-ray, CT and MRI than non-ischemic stroke inpatients. Hemorrhagic stroke inpatients have a higher radiological medical utilization in chest X-ray, abdominal X-ray, CT and MRI than non-hemorrhagic stroke inpatients except other X-ray. Conclusion: Inpatients older age and male over 65 years old have higher possibility of radiological examination in chest X-ray, abdominal X-ray and CT. Ischemic and hemorrhagic stroke inpatients have higher radiological medical utilization than non-stroke inpatients. Increasing age, elderly patients' radiological medical utilization increased, and the workload of radiological department increased. We hope the results provide references to policy decision-making. Stroke increased not only disability, but also the long-term costs of health care and radiological medical utilization. In response to Taiwan's population ageing, appropriate emphasis on stroke prevention and health care advocate, in order to reduce the future burden on society.