The number of frail patients for whom the care of a single acute episode necessarily requires both a global approach and a close interaction with the local health services and social services is progressively growing. The issue of managing frail and complex patients at hospitals still needs to be resolved. Currently, care is fragmented in multiple specialized interventions and patients often find themselves moved from one ward to another, resulting in a perilous loss of information and continuity. The purpose of this paper is to analyze hospitalization modalities, the impact of internal medicine (IM) on the hospital activities, the relationship with emergency room (ER) and general patient characteristics, in order to explore putting the current discussion on the new role of IM in the future hospital into practice.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
Levels of Utilization and Socio - Economic Factors Influencing Adherence to U...inventionjournals
This document analyzes levels of utilization and socio-economic factors influencing adherence to antiretroviral therapy (ART) among people living with HIV/AIDS in Dodoma Municipality and Kongwa District, Tanzania. The study found that ART usage rates ranged from 100% at some facilities to 40% at others. Common reasons for dropping out of ART programs included side effects like vomiting (25.1%) and frequent sickness (19.9%), as well as lack of employment support (66.7%) and lack of confidentiality (50%). The document concludes that improving adherence requires addressing side effects, providing income assistance, and ensuring confidentiality in HIV services.
2 tool to estimate patient costs literature review_finalAira Bhabe
This document provides a literature review and conceptual framework for developing a tool to estimate patient costs of tuberculosis. It discusses approaches used to measure the cost of illness, including direct costs like medical expenses and indirect costs from lost income. The review found studies on patient costs in various stages: before diagnosis, during diagnosis/pre-treatment, and during treatment. Developing the cost estimation tool will help programs understand economic barriers patients face and design interventions to reduce costs and alleviate poverty. The tool aims to assess the impoverishing impact of tuberculosis and establish evidence for poverty reduction strategies.
This document discusses approaches to improving emergency department (ED) throughput and addressing overcrowding. It provides background on the problem of ED overcrowding, including factors contributing to increased patient volumes and decreased bed capacity. Common models for improving throughput focus on separating patients by acuity, expediting diagnostics, and using technology. The document also discusses a conceptual model of ED crowding involving input, throughput, and output phases. Key approaches to improving throughput discussed are patient-specific flow models, rapid triage, providers in triage, flow expeditors, and technology. The significance of addressing overcrowding relates to accreditation standards, hospital finances, and patient satisfaction.
Healthcarecosts conv vs CAM GP's BMJOpenSept2014BaarsMarco Ephraïm
This study compared the healthcare costs and mortality rates of over 1.5 million Dutch patients receiving care from conventional general practitioners (GPs) to over 18,000 patients receiving care from GPs additionally trained in complementary and alternative medicine (CAM). The study found that patients of CAM GPs had on average €225 lower annual compulsory healthcare costs, mainly from lower hospital and pharmaceutical costs. Costs in the last year of life were €1161 lower for CAM GP patients. However, supplementary insurance costs were €33 higher annually for CAM GP patients. Mortality rates did not differ between the two patient groups. This 6-year comparative economic evaluation indicates that CAM provided by GPs in the Netherlands may help lower some healthcare costs without
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
This study assessed the impact of austerity measures in Greece on survival rates of out-of-hospital cardiac arrest victims. Data was collected from a Greek hospital on immediate and 24-hour survival pre-crisis (2007-2010) and during the crisis (2011-2014). Results showed no significant difference in return of spontaneous circulation or 24-hour survival between the two periods, suggesting healthcare workers were working hard to maintain standards despite budget cuts. However, overall survival rates remained low compared to international studies, highlighting the need for more Greek data on cardiac arrests.
Lack of a family medicine system in Kurdistan Region: Challenges and solutionsAI Publications
This document discusses the lack of a family medicine system in the Kurdistan Region of Iraq, including challenges and potential solutions. It begins by providing background on family medicine and its role in public health. The study aims to understand the challenges of developing family medicine in Erbil through interviews with 16 professionals. Three main themes emerged: 1) the past lacked family medicine and primary care centers provided limited services, 2) the present is in the early stages with one family medicine center, and 3) the future requires addressing challenges like shortages to develop objectives and strategies. The conclusion is that cooperation is needed between the Ministry of Health, universities, and parliament to further develop family medicine in the region.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
Levels of Utilization and Socio - Economic Factors Influencing Adherence to U...inventionjournals
This document analyzes levels of utilization and socio-economic factors influencing adherence to antiretroviral therapy (ART) among people living with HIV/AIDS in Dodoma Municipality and Kongwa District, Tanzania. The study found that ART usage rates ranged from 100% at some facilities to 40% at others. Common reasons for dropping out of ART programs included side effects like vomiting (25.1%) and frequent sickness (19.9%), as well as lack of employment support (66.7%) and lack of confidentiality (50%). The document concludes that improving adherence requires addressing side effects, providing income assistance, and ensuring confidentiality in HIV services.
2 tool to estimate patient costs literature review_finalAira Bhabe
This document provides a literature review and conceptual framework for developing a tool to estimate patient costs of tuberculosis. It discusses approaches used to measure the cost of illness, including direct costs like medical expenses and indirect costs from lost income. The review found studies on patient costs in various stages: before diagnosis, during diagnosis/pre-treatment, and during treatment. Developing the cost estimation tool will help programs understand economic barriers patients face and design interventions to reduce costs and alleviate poverty. The tool aims to assess the impoverishing impact of tuberculosis and establish evidence for poverty reduction strategies.
This document discusses approaches to improving emergency department (ED) throughput and addressing overcrowding. It provides background on the problem of ED overcrowding, including factors contributing to increased patient volumes and decreased bed capacity. Common models for improving throughput focus on separating patients by acuity, expediting diagnostics, and using technology. The document also discusses a conceptual model of ED crowding involving input, throughput, and output phases. Key approaches to improving throughput discussed are patient-specific flow models, rapid triage, providers in triage, flow expeditors, and technology. The significance of addressing overcrowding relates to accreditation standards, hospital finances, and patient satisfaction.
Healthcarecosts conv vs CAM GP's BMJOpenSept2014BaarsMarco Ephraïm
This study compared the healthcare costs and mortality rates of over 1.5 million Dutch patients receiving care from conventional general practitioners (GPs) to over 18,000 patients receiving care from GPs additionally trained in complementary and alternative medicine (CAM). The study found that patients of CAM GPs had on average €225 lower annual compulsory healthcare costs, mainly from lower hospital and pharmaceutical costs. Costs in the last year of life were €1161 lower for CAM GP patients. However, supplementary insurance costs were €33 higher annually for CAM GP patients. Mortality rates did not differ between the two patient groups. This 6-year comparative economic evaluation indicates that CAM provided by GPs in the Netherlands may help lower some healthcare costs without
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
This study assessed the impact of austerity measures in Greece on survival rates of out-of-hospital cardiac arrest victims. Data was collected from a Greek hospital on immediate and 24-hour survival pre-crisis (2007-2010) and during the crisis (2011-2014). Results showed no significant difference in return of spontaneous circulation or 24-hour survival between the two periods, suggesting healthcare workers were working hard to maintain standards despite budget cuts. However, overall survival rates remained low compared to international studies, highlighting the need for more Greek data on cardiac arrests.
Lack of a family medicine system in Kurdistan Region: Challenges and solutionsAI Publications
This document discusses the lack of a family medicine system in the Kurdistan Region of Iraq, including challenges and potential solutions. It begins by providing background on family medicine and its role in public health. The study aims to understand the challenges of developing family medicine in Erbil through interviews with 16 professionals. Three main themes emerged: 1) the past lacked family medicine and primary care centers provided limited services, 2) the present is in the early stages with one family medicine center, and 3) the future requires addressing challenges like shortages to develop objectives and strategies. The conclusion is that cooperation is needed between the Ministry of Health, universities, and parliament to further develop family medicine in the region.
Healthcare Utilization and Self-assessed Health in Turkey: Evidence from the ...Economic Research Forum
Firat Bilgel - Okan University
Burhan Can Karahasan - Piri Reis University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
By providing a short pocket guide describing
the best possible practices in the treatment and management
of Transfusion Dependent Thalassaemia (TDT), TIF seeks to support physicians worldwide in making
good clinical decisions that can benefit individual patients and
enable them to advocate for more and better resources for
thalassaemia care at the level of national health authorities.
This effort is also supported in TIF’s educational programme,
aiming to ensure that physicians and other healthcare
professionals have all the necessary knowledge to support
their patients.
This document discusses medication errors, including their scope and causes. It notes that medication errors are a major problem, causing many preventable deaths each year and billions in costs. Common causes of errors include look-alike drug names and packaging, multiple drug concentrations, labeling issues, and time constraints on nurses. High-risk drugs and IV medications are particularly prone to errors. Errors can involve wrong drugs, doses, preparations or contamination. The document outlines various technologies and practices that can help reduce errors, such as electronic prescribing, bar coding, and computerized physician order entry.
WHO PAYS MORE: Public, Private, Both or None? The Effects of Health Insuranc...Economic Research Forum
Oznur Ozdamar, Bologna University
Eleftherios Giovanis, University of Verona
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
This document summarizes the findings of the 7th wave of the Europ Assistance/CSA Health & Society Barometer conducted in 2013 across 8 European countries and the US. Key findings include:
- Opinions on healthcare systems varied by country, with Austrians most satisfied (6.3/10) and Poles least (2.8/10). Germany saw the largest improvement.
- Views on doctors' competence were relatively stable, with the US most positive (6.8/10) and Poles least (4.7/10).
- Confidence in authorities to limit medication/device risks stabilized, though it increased in some countries like the UK and decreased in others like Spain and Italy.
This document summarizes a study on data sharing practices and ethics in Vietnam. The study explored stakeholders' attitudes, experiences and expectations regarding sharing individual-level clinical research data through interviews and focus groups. Key findings included the importance placed on trust, respect and reciprocity in the local research culture. Existing Vietnamese laws and guidelines do not prohibit data sharing but do not specifically address it either. There is a need to develop culturally appropriate policies and best practices for data sharing in Vietnam to maximize benefits while respecting local needs and expectations.
Exploring the role of racial associations within life and psychiatry the diss...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
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HOẶC
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https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Cost profiles of colorectal cancer patients in Italy based on individual patt...Enrique Moreno Gonzalez
Due to changes in cancer-related risk factors, improvements in diagnostic procedures and treatments, and the aging of the population, in most developed countries cancer accounts for an increasing proportion of health care expenditures. The analysis of cancer-related costs is a topic of several economic and epidemiological studies and represents a research area of great interest to public health planners and policy makers. In Italy studies are limited either to some specific types of expenditures or to specific groups of cancer patients. Aim of the paper is to estimate the distribution of cancer survivors and associated health care expenditures according to a disease pathway which identifies three clinically relevant phases: initial (one year following diagnosis), continuing (between initial and final) and final (one year before death).
Operartions research in US Healthcare IndustryPrasant Patro
1. This document describes how operations research (OR) models can help reduce delays in healthcare. It identifies three major sources of delays: emergency department delays, delays for medical appointments, and delays for nursing care.
2. Within emergency department delays, it notes long wait times to see physicians and delays in getting inpatient beds once admitted. For medical appointments, it describes waits of several weeks on average to see primary care physicians. Delays for nursing care can compromise patient safety due to insufficient staffing levels.
3. It argues that healthcare delays remain prevalent because they have not been well measured or reported, hospitals face cost pressures to maximize occupancy, and national shortages of healthcare professionals exacerbate delays. OR models have
This document outlines the doctoral thesis of Dr. Svin Deneckere on improving teamwork and preventing burnout through the use of care pathways. It discusses the growing need for teamwork in healthcare due to factors like increasing specialization and fragmented structures. Care pathways are presented as a tool to improve teamwork by facilitating communication, coordinating roles, and documenting care processes. The thesis involved 4 studies: 1) developing a set of indicators for measuring teamwork; 2) a literature review finding care pathways can improve teamwork; 3) a cluster randomized controlled trial finding care pathways positively impact teamwork; and 4) process evaluations of implementation. The thesis examines how care pathways can enhance teamwork in healthcare organizations.
Global Medical Cures™ | Medicare Payments- How Much Do Chronic Conditions Mat...Global Medical Cures™
Erdem, E., Prada, S. I., Haffer, S. C.
E6
MMRR
2013: Volume 3 (2)
1) The document analyzes differences in Medicare payments by beneficiary characteristics such as gender, age, and chronic conditions using 2008 and 2010 Chronic Conditions Public Use Files.
2) It finds that beneficiaries with multiple chronic conditions account for a disproportionate share of Medicare payments, with payments increasing significantly with the number of chronic conditions. "Stroke/Transient Ischemic Attack" and "Chronic Kidney Disease" were the most costly conditions for Part A, while "Cancer" and "Chronic Kidney Disease" were most
International Journal of Mathematics and Statistics Invention (IJMSI) is an international journal intended for professionals and researchers in all fields of computer science and electronics. IJMSI publishes research articles and reviews within the whole field Mathematics and Statistics, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Factors influencing the receipt of diabetic retinopathy screening in a high r...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
of study know the prevalence of burn in Hebron government hospitals to provide guidance for burn prevention, and to reduce
burns in Hebron and West Bank. Background Burns are a large cause of injury world. We discusses the epidemiology and result of burn patients in a big hospital and burn unite in south of west bank between 2016 and 2017 to provide directing for burn prevention
The Link between Health Condition Costs and Standard of Living Through Out-of...Economic Research Forum
Eleftherios Giovanis - University of Verona
Oznur Ozdamar - Bologna University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
This document summarizes a study on patient satisfaction at DHQ Zanana Hospital in Dera Ismail Khan, Pakistan. The study collected data through interviews with hospital staff (doctors, nurses, administrators) and questionnaires with 50 patients. Key findings include:
- Patients had various complaints about hospital facilities, services, medicines, and the general environment. Doctors and nurses attributed problems to lack of resources and patient attitudes.
- Lack of funds is a major hurdle in improving facilities and services to meet patient satisfaction levels.
- Most patients were visiting the hospital for the first time or occasionally for general or seasonal health issues, though some visited regularly for serious conditions.
Decline of empathy during medical educationAhmad Ozair
This document contains 3 letters responding to an article on empathy decline among medical students.
The first letter proposes a multi-institutional longitudinal study to identify causal factors for empathy decline internationally. Empathy is important but current studies are cross-sectional.
The second letter questions the significance of small empathy declines found in medical school given that burnout is very high after graduation, negatively impacting patient care.
The third letter supports a longitudinal study and notes a large study found empathy declines in Indian medical students as well, suggesting it's a universal issue important for good patient outcomes worldwide.
Scaling up ems under universal health insurance scheme in thailandThira Woratanarat
This document summarizes the scaling up of emergency medical services (EMS) in Thailand under the universal health insurance scheme. It describes how Thailand addressed obstacles to developing effective EMS through incremental initiatives focused on trauma care since the 1990s. Universal health insurance and health system reforms created opportunities to develop sustainable EMS. Key initiatives included establishing standardized EMS training programs, an emergency call number, and integrated trauma care systems in provinces like Khon Kaen that served as models for EMS development in Thailand.
The COVID-19 pandemic led to a 55% decrease in urological consultations in emergency departments in Italy between March 2019 and March 2020. Hospitals in northern Italy, which was hit hardest by the pandemic, saw a 64% decrease, while southern Italy saw an 82% decrease. Patients in 2020 tended to be older and had conditions like gross hematuria and acute urinary retention that required urgent treatment. There was more aggressive early treatment for some conditions to reduce hospital visits and risk of infection. The study suggests emergency departments need to prepare for around half the usual urological caseload during the pandemic.
Intentional Rounding vs standard of care for patients hospitalised in interna...Daiana Campani
This study evaluated the effects of intentional rounding (IR), a nursing care intervention, compared to standard of care on rates of falls and pressure ulcers in internal medicine hospital units. The cluster randomized controlled trial assigned 26 units to either IR (n=14) or standard care (n=12). A total of 1822 patients were enrolled with 779 included in the primary analysis. The IR intervention was associated with a lower risk of falls compared to standard care. There were no significant differences in rates of new pressure ulcers or the combined outcome of falls and pressure ulcers. Patient satisfaction was high in both groups. The study provides support for the use of IR to reduce falls in complex internal medicine patients.
Healthcare Utilization and Self-assessed Health in Turkey: Evidence from the ...Economic Research Forum
Firat Bilgel - Okan University
Burhan Can Karahasan - Piri Reis University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
By providing a short pocket guide describing
the best possible practices in the treatment and management
of Transfusion Dependent Thalassaemia (TDT), TIF seeks to support physicians worldwide in making
good clinical decisions that can benefit individual patients and
enable them to advocate for more and better resources for
thalassaemia care at the level of national health authorities.
This effort is also supported in TIF’s educational programme,
aiming to ensure that physicians and other healthcare
professionals have all the necessary knowledge to support
their patients.
This document discusses medication errors, including their scope and causes. It notes that medication errors are a major problem, causing many preventable deaths each year and billions in costs. Common causes of errors include look-alike drug names and packaging, multiple drug concentrations, labeling issues, and time constraints on nurses. High-risk drugs and IV medications are particularly prone to errors. Errors can involve wrong drugs, doses, preparations or contamination. The document outlines various technologies and practices that can help reduce errors, such as electronic prescribing, bar coding, and computerized physician order entry.
WHO PAYS MORE: Public, Private, Both or None? The Effects of Health Insuranc...Economic Research Forum
Oznur Ozdamar, Bologna University
Eleftherios Giovanis, University of Verona
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
This document summarizes the findings of the 7th wave of the Europ Assistance/CSA Health & Society Barometer conducted in 2013 across 8 European countries and the US. Key findings include:
- Opinions on healthcare systems varied by country, with Austrians most satisfied (6.3/10) and Poles least (2.8/10). Germany saw the largest improvement.
- Views on doctors' competence were relatively stable, with the US most positive (6.8/10) and Poles least (4.7/10).
- Confidence in authorities to limit medication/device risks stabilized, though it increased in some countries like the UK and decreased in others like Spain and Italy.
This document summarizes a study on data sharing practices and ethics in Vietnam. The study explored stakeholders' attitudes, experiences and expectations regarding sharing individual-level clinical research data through interviews and focus groups. Key findings included the importance placed on trust, respect and reciprocity in the local research culture. Existing Vietnamese laws and guidelines do not prohibit data sharing but do not specifically address it either. There is a need to develop culturally appropriate policies and best practices for data sharing in Vietnam to maximize benefits while respecting local needs and expectations.
Exploring the role of racial associations within life and psychiatry the diss...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Cost profiles of colorectal cancer patients in Italy based on individual patt...Enrique Moreno Gonzalez
Due to changes in cancer-related risk factors, improvements in diagnostic procedures and treatments, and the aging of the population, in most developed countries cancer accounts for an increasing proportion of health care expenditures. The analysis of cancer-related costs is a topic of several economic and epidemiological studies and represents a research area of great interest to public health planners and policy makers. In Italy studies are limited either to some specific types of expenditures or to specific groups of cancer patients. Aim of the paper is to estimate the distribution of cancer survivors and associated health care expenditures according to a disease pathway which identifies three clinically relevant phases: initial (one year following diagnosis), continuing (between initial and final) and final (one year before death).
Operartions research in US Healthcare IndustryPrasant Patro
1. This document describes how operations research (OR) models can help reduce delays in healthcare. It identifies three major sources of delays: emergency department delays, delays for medical appointments, and delays for nursing care.
2. Within emergency department delays, it notes long wait times to see physicians and delays in getting inpatient beds once admitted. For medical appointments, it describes waits of several weeks on average to see primary care physicians. Delays for nursing care can compromise patient safety due to insufficient staffing levels.
3. It argues that healthcare delays remain prevalent because they have not been well measured or reported, hospitals face cost pressures to maximize occupancy, and national shortages of healthcare professionals exacerbate delays. OR models have
This document outlines the doctoral thesis of Dr. Svin Deneckere on improving teamwork and preventing burnout through the use of care pathways. It discusses the growing need for teamwork in healthcare due to factors like increasing specialization and fragmented structures. Care pathways are presented as a tool to improve teamwork by facilitating communication, coordinating roles, and documenting care processes. The thesis involved 4 studies: 1) developing a set of indicators for measuring teamwork; 2) a literature review finding care pathways can improve teamwork; 3) a cluster randomized controlled trial finding care pathways positively impact teamwork; and 4) process evaluations of implementation. The thesis examines how care pathways can enhance teamwork in healthcare organizations.
Global Medical Cures™ | Medicare Payments- How Much Do Chronic Conditions Mat...Global Medical Cures™
Erdem, E., Prada, S. I., Haffer, S. C.
E6
MMRR
2013: Volume 3 (2)
1) The document analyzes differences in Medicare payments by beneficiary characteristics such as gender, age, and chronic conditions using 2008 and 2010 Chronic Conditions Public Use Files.
2) It finds that beneficiaries with multiple chronic conditions account for a disproportionate share of Medicare payments, with payments increasing significantly with the number of chronic conditions. "Stroke/Transient Ischemic Attack" and "Chronic Kidney Disease" were the most costly conditions for Part A, while "Cancer" and "Chronic Kidney Disease" were most
International Journal of Mathematics and Statistics Invention (IJMSI) is an international journal intended for professionals and researchers in all fields of computer science and electronics. IJMSI publishes research articles and reviews within the whole field Mathematics and Statistics, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Factors influencing the receipt of diabetic retinopathy screening in a high r...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
of study know the prevalence of burn in Hebron government hospitals to provide guidance for burn prevention, and to reduce
burns in Hebron and West Bank. Background Burns are a large cause of injury world. We discusses the epidemiology and result of burn patients in a big hospital and burn unite in south of west bank between 2016 and 2017 to provide directing for burn prevention
The Link between Health Condition Costs and Standard of Living Through Out-of...Economic Research Forum
Eleftherios Giovanis - University of Verona
Oznur Ozdamar - Bologna University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
This document summarizes a study on patient satisfaction at DHQ Zanana Hospital in Dera Ismail Khan, Pakistan. The study collected data through interviews with hospital staff (doctors, nurses, administrators) and questionnaires with 50 patients. Key findings include:
- Patients had various complaints about hospital facilities, services, medicines, and the general environment. Doctors and nurses attributed problems to lack of resources and patient attitudes.
- Lack of funds is a major hurdle in improving facilities and services to meet patient satisfaction levels.
- Most patients were visiting the hospital for the first time or occasionally for general or seasonal health issues, though some visited regularly for serious conditions.
Decline of empathy during medical educationAhmad Ozair
This document contains 3 letters responding to an article on empathy decline among medical students.
The first letter proposes a multi-institutional longitudinal study to identify causal factors for empathy decline internationally. Empathy is important but current studies are cross-sectional.
The second letter questions the significance of small empathy declines found in medical school given that burnout is very high after graduation, negatively impacting patient care.
The third letter supports a longitudinal study and notes a large study found empathy declines in Indian medical students as well, suggesting it's a universal issue important for good patient outcomes worldwide.
Scaling up ems under universal health insurance scheme in thailandThira Woratanarat
This document summarizes the scaling up of emergency medical services (EMS) in Thailand under the universal health insurance scheme. It describes how Thailand addressed obstacles to developing effective EMS through incremental initiatives focused on trauma care since the 1990s. Universal health insurance and health system reforms created opportunities to develop sustainable EMS. Key initiatives included establishing standardized EMS training programs, an emergency call number, and integrated trauma care systems in provinces like Khon Kaen that served as models for EMS development in Thailand.
The COVID-19 pandemic led to a 55% decrease in urological consultations in emergency departments in Italy between March 2019 and March 2020. Hospitals in northern Italy, which was hit hardest by the pandemic, saw a 64% decrease, while southern Italy saw an 82% decrease. Patients in 2020 tended to be older and had conditions like gross hematuria and acute urinary retention that required urgent treatment. There was more aggressive early treatment for some conditions to reduce hospital visits and risk of infection. The study suggests emergency departments need to prepare for around half the usual urological caseload during the pandemic.
Intentional Rounding vs standard of care for patients hospitalised in interna...Daiana Campani
This study evaluated the effects of intentional rounding (IR), a nursing care intervention, compared to standard of care on rates of falls and pressure ulcers in internal medicine hospital units. The cluster randomized controlled trial assigned 26 units to either IR (n=14) or standard care (n=12). A total of 1822 patients were enrolled with 779 included in the primary analysis. The IR intervention was associated with a lower risk of falls compared to standard care. There were no significant differences in rates of new pressure ulcers or the combined outcome of falls and pressure ulcers. Patient satisfaction was high in both groups. The study provides support for the use of IR to reduce falls in complex internal medicine patients.
International Hospital Federation's journal 50-2Battur Lk
National infection prevention and control (IPC) programmes are important for reducing health care-associated infections (HAIs) and improving quality of care. Since 2005, the Pan American Health Organization has assessed IPC programmes in over 130 hospitals across 18 countries, finding many to be poor. National IPC programmes can help contain antimicrobial resistance and build capacity to respond to disease outbreaks. Key components of effective national programmes include guidelines, training, surveillance, coordination with other health stakeholders, and ensuring IPC is integrated into health systems. Strong commitment from national health authorities is needed to fully implement IPC programmes and continually reduce HAIs.
This document summarizes a workshop on patient summaries in pediatric emergencies. The workshop aims to identify challenges and recommendations for digital health policies related to standards. Several speakers will present on topics including disparities in national policies on emergency clinical information availability for school children based on a MOCHA project survey. The Trillium-II project extending patient summaries beyond cross-border settings will also be discussed. Case studies on complex pediatric patients and mobile apps to assist families during emergencies will likewise be presented. The expected outcome is a workshop report to guide follow-up child health activities.
The future of patient data the danish perspective 2018Future Agenda
The Danish perspective on implications from the future of patient data - insights from discussions in Copenhagen
Denmark is recognised as one of the leading nations for healthcare and is at the forefront of digital transformation in the sector. As new challenges and opportunities emerge over the next decade this article considers what the core drivers of change may be and explores how developments in the availability and use of more and better patient data may impact the Danish health system. Linking together previous research, a recent related Future Agenda initiative and insights from a number of expert discussions in Copenhagen, it then examines the pivotal issues that will affect healthcare providers in the future and considers how the wider sharing of exemplary data can change delivery models.
Given the overall dynamics, many conclude that Denmark is one of the most connected, well-funded and healthy nations in the world. The advent of more and better health data should therefore have additional impact. So, what about the future? How will the global changes underway impact and enhance the Danish system? Moreover, what will be the national vs regional response?
A recent global project exploring the future of patient data was undertaken by Future Agenda in partnership with leading organisations around the world. (www.futureofpatientdata.org) Twelve events across many different healthcare systems brought together over 300 experts to debate the primary shifts for the next decade as well as explore their implications. Within this, several shared ambitions in a number of different countries were identified – many of which can already be seen as existing assets of the Danish system: Good quality patient data, common access to it, and means of interacting with both the information and the different communities who form the full care system.
As the first phase of a subsequent series of more regional, national dialogues, in June 2018 additional discussions were undertaken with healthcare experts in Copenhagen to uncover more detail. Hosted by DTU Business, the aim was to both respond to the global context from the Future of Patient Data project and debate what the implications may be for Denmark. In particular, a core objective was to identify what are the primary issues for the Danish healthcare system for the next decade.
Descriptive analytics | Data analysis in qualitative research | Dementia diag...Pubrica
Writing a research paper or thesis is challenging and time-consuming, requiring considerable focus and mental effort. Readers are typically most interested in the paper's fresh findings. Writing the results part, which incorporates new information from research, is more challenging than writing the methods section, which is previously completed during the proposal writing stage and requires just language changes.
Read more @ https://pubrica.com/insights/study-guide/how-should-a-data-analysis-write-up-for-a-manuscript-be-formatted/
Descriptive analytics | Data analysis in qualitative research | Research data...Pubrica
Our comprehensive data analytics and ML services includes text mining and natural language processing, medical imaging analyses, semantic annotation, deep learning application, predictive modeling for personalized treatment, algorithm flow chart or rule making medical recommender systems, visual analytics for healthcare.
Read more @ https://pubrica.com/insights/sample-work/diagnostic-analysis-empowering-change-initiatives/
Factors associated adherence to TB treatment in Georgia report (eng)Ina Charkviani
This document summarizes a study on barriers and facilitators to adherence to treatment among drug resistant tuberculosis (DR-TB) patients in Georgia. The study identified several key factors that influence patient adherence through in-depth interviews and focus groups with patients, providers, and experts. These factors were grouped into structural, social, personal, and health system categories. The study aims to understand reasons for loss to follow-up and inform recommendations to improve treatment outcomes.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Indicators and Information Standards for Frailty ManagementAnnaSeebergHansen
Frailty is a multidimensional condition affecting older adults that can lead to frequent and complex transitions between different health care settings. These transitions often involve multiple providers but lack coordination, resulting in failures to meet patient needs and preferences. Developing standardized patient summaries that consolidate key health information may help coordinate care during transitions and improve outcomes for frail older adults.
Time to Think Differently: The case for changeThe King's Fund
Our Time to Think Differently programme has made the case for change and highlighted the trends that will influence the way health and social care is delivered in future.
To help you explore and share this work, we are creating a series of downloadable slidepacks. We hope that they will inform your thinking and discussions about the future of care.
The first pack in this series explores the pressures on the health and social care delivery system and why it needs to change to meet the challenges of the future.
The document discusses the healthcare industry and provides context for analyzing delays in patient discharge processes at a hospital from May to July 2015. It describes the objectives of studying delays, the sample size, tools used, and limitations. It then provides an overview of the global healthcare industry, key segments including hospitals, providers and professionals, models for healthcare delivery, and the market size of the industry in different regions. Porter's five forces model is applied to analyze competition in the healthcare industry.
Effect of nursing intervention on clinical outcomes and patient satisfaction ...Alexander Decker
1) The study aimed to determine the effect of nursing intervention on clinical outcomes and patient satisfaction among patients with upper gastrointestinal bleeding.
2) A quasi-experimental study was conducted on 50 patients divided into a study group that received nursing intervention and a control group.
3) Statistically significant differences were found between the groups in clinical outcomes like bleeding, vital signs, and lab tests as well as higher patient satisfaction scores in the study group compared to the control group, showing that nursing intervention improved patients' outcomes and satisfaction.
This document discusses prevention and health promotion in healthcare across Europe. It defines what good prevention and health promotion looks like, including health education programs, adult and child immunization policies, disease screening programs, infection prevention policies, and improving secondary prevention through risk factor reduction. The document emphasizes that while policymakers acknowledge the need to shift focus to prevention, progress has been variable. It argues that prevention is a cost-effective investment that can improve health and reduce disease burden and health inequalities.
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems_...CrimsonpublishersTTEH
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems by Karla Muñoz Esquivel in Trends in Telemedicine & E-health
The population across Northern Europe is aging. Coupled with socio-economic challenges, health care systems are at risk of overloading and incurring unsustainable high costs. Rehabilitation services are used disproportionately by older people. One solution pertinent to rural areas is to change the model of rehabilitation to incorporate new technologies. This has the potential to free resources and reduce costs. However, implementation is challenging. In the Northern Periphery and Artic Programme (NPA), the Smart sensor Devices for rehabilitation and Connected health (SENDoc) project.
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For more articles in Open access journal of Innovation in urgical Open Access Journal
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Patient harm during healthcare is a leading cause of death and disability worldwide. Each year over 134 million adverse events occur in hospitals in low- and middle-income countries resulting in 2.6 million deaths. Medication errors, healthcare-associated infections, unsafe surgical practices, and diagnostic errors are some of the biggest causes of patient harm. Ensuring safe healthcare is a prerequisite for achieving universal health coverage and strengthening health systems. The World Health Organization works to advance patient safety globally by setting priorities, developing guidelines, and building capacity in member states.
The COVID-19 pandemic has significantly impacted urology services in northern Italy. In the province of Bergamo in Lombardy, over 50% of urologists are now infected with COVID-19. Urology departments have had to dedicate resources to treating COVID-19 patients, reducing operating capacity and outpatient services. Prioritizing and scheduling cancer surgeries is now difficult given limited resources. The long-term effects of delays in urology treatments are unknown, but could negatively impact patient outcomes.
The document discusses the evolving roles of hospital and community pharmacists in managing the COVID-19 pandemic. It outlines how pharmacists have historically transitioned from compounding medications to providing more clinical services and collaborating across healthcare sectors. The COVID-19 crisis has highlighted pharmacists' key roles and propelled changes, with preliminary evidence suggesting a new era where community pharmacists provide more services and are frontline healthcare workers. The pandemic challenged health systems but also presented opportunities for pharmacists to demonstrate their value through interprofessional collaboration addressing this public health crisis.
1) An ICU provides around-the-clock specialized care for critically ill patients, including mechanical ventilation and cardiac monitoring. Mortality rates in ICUs average 10-20% in most hospitals.
2) Whether intensivists, who are specialists in critical care, are providing care in the ICU and how the staff is organized can strongly influence outcomes. Intensivists are better equipped to minimize errors and complications.
3) Hospital-associated infections are a major issue in ICU care and a leading cause of mortality and morbidity. Surveillance of ICU-acquired infections and monitoring of antimicrobial resistance patterns are important for improving practices and outcomes.
Similar to Identikit of the Person Seeking Care at Public Hospital in Italy in the European Health Context: A Collaborative Study (20)
Convalescent Plasma and COVID-19: Ancient Therapy Re-emergedasclepiuspdfs
Convalescent plasma has been used as a treatment for infectious diseases for over a century. It involves transfusing plasma from patients who have recovered from an infection into patients who are currently ill with that same infection. Clinical trials are now investigating its use for COVID-19. While some early studies showed promising results, larger randomized controlled trials found no significant benefit of convalescent plasma for severe COVID-19. Further research is still needed to determine whether certain patient populations or plasma dosages may be more effective.
The Negative Clinical Consequences Due to the Lack of the Elaboration of a Sc...asclepiuspdfs
Until a few years ago, the immune system was considered as responsible for the only defense against microbial infections and other external agents. On the contrary, the immune cells have been proven to be linked not only through cell-cell contact but also by releasing proteins capable of influencing the immune-inflammatory response, the so-called cytokines or interleukins. Moreover, the cytokines have appeared to play not only immune activities but also metabolic and systemic effects influencing the overall biological systems, including the nervous, the endocrine, and the cardiovascular systems, by representing the main endogenous molecules responsible for the maintenance of the unity of the biological life. Therefore, only the systematic clinical consideration of cytokine effects may allow the generation of real future holistic medicine.
The great benefit of blood/blood constitutes therapy is the ability to provide transfusion support for patients with many unique hematologic conditions. For some patients, such as patients with sickle cell disease, thalassemia major, immune hemolytic anemia, anemia of kidney disease, and aplastic anemia may need for this consolidation extends throughout their life. By knowing the alteration mechanisms of these conditions, we can appreciate the stationary, urgency, and the value of the transfused red blood cell (RBC).
Decreasing or Increasing Role of Autologous Stem Cell Transplantation in Mult...asclepiuspdfs
During the past four decades, autologous stem cell transplantation (ASCT) has been the first choice and the standard option for the treatment of newly diagnosed patients with multiple myeloma. The introduction of new agents such as thalidomide, lenalidomide, and bortezomib has led to a clear improvement in basic approach and those agents became the standard of care in the induction phase; however, they were not able to play the role of ASCT in term of progression-free survival and overall survival. Debate continues about the best induction, consolidation, and maintenance taking into account the toxicities of these new agents. The new monoclonal antibody (anti CD38) starts to take its place in the induction setting and it seems to be a promising agent in the high-risk group. Until recently, ASCT is the standard treatment for newly diagnosed patients.
Comparison of the Hypocalcemic Effects of Erythropoietin and U-74389Gasclepiuspdfs
Aim: This study calculated the effects on serum calcium (Ca) levels, after treatment with either of two drugs: The erythropoietin (Epo) and the antioxidant lazaroid (L) drug U-74389G. The calculation was based on the results of two preliminary studies, each one of which estimated the certain influence, after the respective drug usage in an induced ischemia-reperfusion animal experiment. Materials and Methods: The two main experimental endpoints at which the serum Ca levels were evaluated were the 60th reperfusion min (for the Groups A, C, and E) and the 120th reperfusion min (for the Groups B, D, and F). Especially, the Groups A and B were processed without drugs, Groups C and D after Epo administration, whereas Groups E and F after the L administration. Results: The first preliminary study of Epo presented a non-significant hypocalcemic effect by 0.34% ± 0.68% (P = 0.6095). However, the second preliminary study of U-74389G presented a non-significant hypercalcemic effect by 0.14% ± 0.66% (P = 0.8245). These two studies were coevaluated since they came from the same experimental setting. The outcome of the coevaluation was that L is 2.3623042-fold (2.3482723–2.3764196) more hypercalcemic than Epo (P = 0.0000). Conclusions: The antioxidant capacities of U-74389G ascribe 2.3623042-fold more hypercalcemic effects than Epo (P = 0.0000).
The term refractory anemia (RA) may be confusing to those who are not hematologists. RA should be well defined because it means more than what it says. RA is defined as anemia that is not responsive to therapy except transfusion.[1] The term RA is used to rule out those types of anemia with a known cause such as anemia of systemic diseases (liver and kidney) and anemia of inflammation even though they are considered refractory to therapy.[2] RA with cellular or hypercellular bone marrow was formerly used to exclude aplastic anemia.
Management of Immunogenic Heparin-induced Thrombocytopeniaasclepiuspdfs
Immunogenic heparin-induced thrombocytopenia (HIT) is an immune response to heparin associated with significant morbidity and mortality in hospitalized patients if unidentified as soon as possible, due to thromboembolic complications involving both arterial and venous systems. Early diagnoses based on a comprehensive interpretation of clinical and laboratory information improve clinical outcomes. Management principles of strongly suspected HIT should not be delayed for laboratory result confirmation. Treatment strategies have been introduced including new, safe, and effective agents. This review summarizes the clinical therapeutic options for HIT addressing the use of parenteral direct thrombin inhibitors and indirect factor Xa inhibitors as well as the potential non-Vitamin K antagonist oral anticoagulants.
A 73-year-old woman presented with fever and linearly arranged erythema on her chest, back, and abdomen. She was initially diagnosed with drug-related scratch dermatitis due to antibiotic use. However, her fever persisted and lab work showed abnormal liver enzymes and very high ferritin levels. Biopsies ruled out infection and malignancy. She was ultimately diagnosed with adult Still's disease (ASD) based on her symptoms and lab results. Treatment with prednisolone resolved her symptoms within a week. This case demonstrates that ASD can present with various skin lesions, and a high index of suspicion is needed for diagnosis.
Bone Marrow Histology is a Pathognomonic Clue to Each of the JAK2V617F, MPL,5...asclepiuspdfs
According to the World Health Organization and Clinical Laboratory Molecular and Pathological criteria bone marrow pathology in JAK2V617F mutated trilinear myeloproliferative neoplasm (MPN) patients essential thrombocythemia (ET) and polycythemia vera are indistinguishably featured by clustered medium to large pleomorphic megakaryocytes and increased cellularity (60–90%) due to increased erythropoiesis and megakaryopoiesis. MPL515 mutated ET is the second distinct clonal MPN characterized by thrombocythemia in a normocellular bone marrow showing clustered increased large to giant mature megakaryocytes with staghorn-like hyperlobulated nuclei. Calreticulin (CALR) mutated hypercellular thrombocythemia associated with prefibrotic megakaryocytic, granulocytic myeloproliferation (MGM) recently became the third distinct MPN featured by dense clusters of immature megakaryocytes with cloud-like nuclei. Bone marrow pathology in newly diagnosed MPN patients appears to be a pathognomonic clue for diagnostic differentiation between JAK2V617F mutated trilinear MPN, MPL515 normocellular thrombocythemia, and CALR thrombocythemia with MGM characteristics followed by secondary reticulin fibrosis. Their natural histories clearly differ featured by an increase of erythro/granulopoiesis and cellularity in JAK2V617F, decrease of erythropoiesis and cellularity in MPL515 and increase of dual megakaryo/granulopoiesis and cellularity in CALR mutated MPN.
Helicobacter pylori Frequency in Polycythemia Vera Patients without Dyspeptic...asclepiuspdfs
Introduction: In polycythemia vera (PV) patients, peptic ulcer and gastroduodenal erosions are more common than the general population, but there are insufficient data on the frequency of Helicobacter pylori (HP) and its role in etiopathogenesis. In this study, we aimed to compare the prevalence of HP infection in PV patients without dyspeptic complaints with a healthy control group without dyspeptic complaints. Materials and Methods: Fifty patients with PV without dyspeptic complaints and 50 controls without dyspeptic complaints were enrolled in this study after informed consent obtained. Stool samples of selected patients were analyzed using HP stool antigen test (True Line®). Results: There was surprisingly striking difference between HP prevalence in PV patients without dyspeptic complaints and asymptomatic healthy controls (64% vs. 2%) (P < 0.05). There was no significant relationship found between HP presence and age, gender, treatment modalities, complete blood count, positivity of JAK2 V617F, serum erythropoietin level, and splenomegaly in PV patients (P > 0.05). Conclusion: As the susceptibility of HP infections in PV patients are higher, it is recommended to have close surveillance of these patients by screening HP presence. In addition, when HP positivity is determined, the eradication of HP is essential to prevent possible future gastrointestinal lesions in patients with PV.
Lymphoma of the Tonsil in a Developing Communityasclepiuspdfs
The lymphoma of the tonsil is a rarity. Single case reports have appeared in countries as disparate as China, Greece, India, Japan, and Turkey. Therefore, this paper presents cases found in Nigeria among the Ibo ethnic group. The epidemiological comparisons are deemed to be worthy of documentation such as age ranges and sides of involvement.
Should Metformin Be Continued after Hospital Admission in Patients with Coron...asclepiuspdfs
Background: In most patients with diabetes, guidelines recommend discontinuation of oral anti-diabetic agents. Preliminary data suggest that pre-admission metformin use may have a mortality benefit in patients with coronavirus disease (COVID)-19 admitted to the hospital. Objective: The objective of the study was to review the impact of metformin on morbidity and mortality among hospitalized patients with COVID-19. Methods: Review of English literature by PUBMED search until November 10, 2020. Search terms included diabetes, COVID-19, metformin, retrospective studies, meta-analyses, pertinent reviews, pre-print articles, and consensus guidelines are reviewed.
Clinical Significance of Hypocalcemia in COVID-19asclepiuspdfs
- Several retrospective studies found that hypocalcemia is common in hospitalized patients with COVID-19, occurring in 62-78% of patients.
- Hypocalcemia is associated with more severe disease and worse outcomes, including increased risk of hospitalization, longer hospital stays, multi-organ failure, acute respiratory distress syndrome, and death.
- The cause of hypocalcemia in COVID-19 patients is unclear but may involve consumption of calcium for viral entry into cells or reflect severity of illness. Further study is needed.
Excess of Maternal Transmission of Type 2 Diabetes: Is there a Role of Bioche...asclepiuspdfs
Objective: An excess of maternal transmission of Type 2 diabetes (T2D) has been reported in some populations but not confirmed in other studies. Mitochondrial inheritance has been proposed to explain such excess. In the present paper, we have considered the presence of T2D in the mother and/or in the father in relation to the risk of T2D and to age at onset of the disease in the offspring. The distribution of two genetic polymorphisms involved in glucose metabolism in relation to the presence of T2D in the mother has been also considered. Materials and Methods: Two hundred and seventy-nine participants with T2D were studied in the population of Penne, a small rural town in the eastern side of central Italy. Adenosine deaminase locus 1 (ADA1) and phosphoglucomutase locus 1 (PGM1) phenotypes were determined by starch gel electrophoresis. Statistical analyses were carried out using commercial software (SPSS). Results: The proportion of patients from T2D mothers is much greater as compared to the proportion of the patients from T2D fathers (P < 0.0001). Age at onset of the disease in patients in whom one or both parents are T2D is lower as compared to other patients. The distribution of ADA1 and PGM1 phenotypes in participants with T2D depends on the presence of diabetes in the mother. Conclusions: About the transmission of T2D, our data confirm the high proportion of maternal T2D and show the role of two common biochemical polymorphisms involved in glucose metabolism.
The Effect of Demographic Data and Hemoglobin A 1c on Treatment Outcomes in P...asclepiuspdfs
Objective: Diabetes mellitus, the most common cause of non-traumatic foot amputations, is a life-threatening condition due to its high mortality and morbidity. In our study, we retrospectively evaluated our patients with diabetic foot syndrome in our clinic. Materials and Methods: The demographic data, duration of diabetes, Wagner classification, haemoglobin A 1c (HbA1c) levels, white blood cell, C-reactive protein sedimentation levels, hospital stay, and treatment results were evaluated retrospectively in 14 patients with diabetic foot between January 2017 and December 2018. Results: The mean age of the patients was 62.43 ± 7.7 years. Of the 14 patients, 3 were females and 11 were males. All 14 patients were type 2 diabetes mellitus. When diabetic foot Wagner classification was performed, 6 patients were evaluated as Wagner 2, five patients were Wagner 3, and three patients were evaluated as Wagner 4. Nine patients had complete amputation and 3 had vascular surgery. Conclusion: Although the level of HbA1c is below the target level, the risk of diabetic foot is increased when there is no adequate diabetes mellitus foot training. Inadequate diabetic patient education and hospitalization of patients after infection progress the amputation rate.
Self-efficacy Impact Adherence in Diabetes Mellitusasclepiuspdfs
The aim of the paper is to explore how self-efficacy (SE) is associated with adherence among adults with diabetes mellitus (DM). Methods: The search of electronic databases identified 564 records from 2007 to 2017 on SE and adherence from different perspectives and its effect on adults with DM. Discussions: SE increases the confidence in adults in their self-care behaviors. Non-adherence continues to be a significant barrier to SE. SE and adherence should be informed by an understanding of theoretical frameworks and the individual characteristics. Conclusion: Adherence is likely among adults with better SE to empower them to make valid decisions about their health. Interventions to improve SE should be tailored based on different types of non-adherence such as intentional and unintentional non-adherence. Implications: An intercollaborative professional practice approach is crucial to improve SE and adherence for sound judgment and valid decision-making.
Uncoiling the Tightening Obesity Spiralasclepiuspdfs
While an underweight prevalence was once more than twice that of obesity, now more people are obese than underweight. Obesity is one of the leading causes of preventable death in the world. There are an estimated 2,100,000,000 obese people worldwide and that number is forecast to grow to 51% of the world’s population by 2030. Escalating obesity-related disease costs threaten to bankrupt the world’s health-care systems.
Prevalence of Chronic Kidney disease in Patients with Metabolic Syndrome in S...asclepiuspdfs
Background and Objective: Chronic kidney disease (CKD) which is an increasingly important clinical and public health issue is associated with cardiovascular disease. Epidemiologic studies have also linked metabolic syndrome (MetS) with an increased risk of incident CKD. Therefore, the present study was designed retrospectively to find the prevalence and potential risk factors of CKD in patients with MetS in Saudi Arabia.
Management Of Hypoglycemia In Patients With Type 2 Diabetesasclepiuspdfs
Hypoglycemia is the rate-limiting step of intensive management in patients with diabetes. Lowering one’s A1C to a prescribed target is expected to mitigate one’s risk of developing long- and short-term diabetes-related complications. Several of the less expensive and commonly prescribed glucose lowering agents favored by practitioners result in weight gain, hypoglycemia, and even an increased risk of cardiovascular (CV) mortality. Although achieving a targeted A1C of <7 % is the standard of care, clinicians often fail to evaluate patients for glycemic variability which can increase oxidative stress driving long-term diabetes-related complications including CV death. The use of concentrated insulins and glucagon-like peptide-1 receptor agonists separately or in combination with each other reduces glycemic variability and one’s risk of hypoglycemia. Pharmaceutical agents which allow patients to safely achieve their targeted A1C without weight gain and hypoglycemia should be preferred in patients with type 2 diabetes.
Predictive and Preventive Care: Metabolic Diseasesasclepiuspdfs
South Asians have a very high incidence of ischemic heart disease and stroke. In addition, they also have a very high incidence of metabolic diseases such as prehypertension, hypertension, visceral obesity, metabolic syndrome, prediabetes, type-2 diabetes, and its clinical complications. Currently, there are over 75 million diabetic subjects in India and an equal number of prediabetics. Republic of China has taken over India as the diabetes capital of the world, with over 115 million diabetics. Modern medicine is disease focused and has failed to address the prevention of these chronic diseases. According to the reports from the United Nations (Millennium Development Goals [MDGs], the World Health Organization, Global Health Initiatives, and the non-communicable disease risk task force), obesity has increased by 2-fold and type-2 diabetes by 4-fold worldwide. Experts in this field predict that chances of meeting the MDGs set by the UN members of reducing the incidence of these diseases at 2025 to the level of 2020 are very little. Western medicine has failed to reduce or reverse the trend in the incidence of these diseases. We feel that an integrated approach to health care may be a better option, to reduce the disease burden in developing and resource-poor countries. Having said that, one cannot prevent something that one is not aware of, as such it is the need of the hour for us, to develop a robust predictive and preventive health-care platform. In an earlier article, we presented our views on reducing or reversing cardiometabolic diseases. There is great enthusiasm among the health-care providers and professional bodies that integration of emerging technologies will help develop personalized, precision medicine, as well as reduce the cost of health-care worldwide.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
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Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptxAyeshaZaid1
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2. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019
intensity care. The management of acute, clinically unstable,
complex diseases working through diagnostic challenges are
the bread and butter of the internist’s job which often goes
beyond the scope of other specialists’ clinical activity. In
contrast, the management of complexity, comorbidity, frailty,
disability, and social problems is also shared with other
specialists (geriatricians, physiatrists...) and settings.[4,5]
In Italy, the number of Internists has grown by 10% since
1990 reaching 11,435 units. They manage 39,000 beds
handling 1 million admissions in 1060 hospital internal
medicine (IM) wards.[6]
The internist is expected to ensure
cost-effective management of complex patient, reducing
the fragmented management of several specialists that can
results in significant growth in health-care costs through
the increased use of technology and subsequent referrals to
super-specialists.[7]
With the changed Italian epidemiological
scenario and the increased life expectancy, the internist
role appears particularly crucial in response to the growing
pressure on the emergency department due to overcrowding.
The purpose of this paper is to analyze the modalities of
hospitalization, the impact of IM on the hospital activities,
the relationship with emergency room and general patient
characteristics in order to implement the current discussion
on the new role of IM in the future hospital.[8]
Impact of IM in hospital activities
In November 2014, a collaborative study assessed the role of
internal medicine departments in relation to overall clinical
activity in Italian hospitals nationwide by processing data
derived from discharge records (SDO) provided by the
MinistryofHealth.AlltheSDOfrom2013wereanalyzed.The
analysis is intended solely for the hospitals’ acute admissions
in the ordinary regime, excluding both admissions for vaginal
delivery and cesarean. To date, preliminary data analysis is
available describing the role of IM in the management of
chronic diseases both at hospital and at community level and
the relationship with primary care facilities. Preliminary data
has revealed that 55% of Italian hospital admissions come
from the Emergency Room. Figure 1 shows the regional
differences between urgent and planned admission rates.
Total general acute hospital admission (not considering
access through Day Hospital) in 2013 were 6,635,112, a
falling by 4% compared to 2012 and following a general
trend evident since 2001.[9]
The DRGs emanated from medical wards are 3,846,601 of
which the discharged from the IM are 1,073,525. The male/
female ratio is 49/51%. Of the total number of discharged
patients, 16.18% came from Internal Medicine Units. The
IM is responsible for 28% of all patients discharged from
medical wards.
The top 10 DRG were reimbursed at rates of between 1600€
and 5492€, and an average weight between 0.7 and 1.62.
The most and second-most DRGs are heart failure and
pulmonary edema. The top 10 DRGs represented 5% of the
total value of admissions, of which Internal Medicine DRGs
contributed 13.92%, which supports the hypothesis that IM
patients are more complex and carry more weight in terms
of reimbursement. Of the top 10 DRGs: 6% were transferred
to step-down care, 75% were discharged home and registered
deaths amounted to 14%. The national average length of stay
in IM in 2013 was 9.28 (7–13 days). Table 1 is a synoptic table
of the main characteristics of the top 10 DRGs in Italian IM.
IM has a central role in the management of urgent
hospital admissions
The top eight wards receiving most of the patients from
urgent admission are the following in descending order:
Figure 1: Differences of urgent admission rates compared to planned ones in Italian regions
Font: 2013 SDO data processing by CREA Sanità
-20%
0%
20%
40%
60%
80%
100%
120%
110% 108%
90%
89% 89% 86%
49%
47% 44%
34% 26%
25%22%19%16%12%
7%
3% 2% 0% -9%
3. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019 19
Table
1:Top
10
DRGs
present
in
internal
medicine
departments
in
Italy
(Font
Ministry
of
Health,
2013)
Casuistry
of
internal
medicine
admissions
(Code
26)
Font:
Ministry
of
Health
2013
SDO
National
total
admissions
663.5112
16.18%
DRG
Description
Cases
Days
Mean
length
of
stay
Cost
Value
(€)
DRG
weight
1.073.526
9.960.799
9,28
3.336,20
3.426.285.053,85
FIRST10
416.986
4.050.969
9,71
1.
127
Cardiac
failure
and
shock
107.280
1.010.181
9,42
3.052,24
327.444.527,78
1,0270
2.
87
Pulmonary
edema
and
respiratory
failure
69.699
672.287
9,65
3.801,92
264.990.091,83
1,2243
3.
89
Simple
pneumonia
and
pleurisy
age
17
years
with
complications
46.463
514.533
11,07
3.557,54
165.294.056,80
1,1394
4.
576
Sepsis
without
mechanical
ventilation
96
h
age
17
years
32.774
415.184
12,67
5.492,83
180.021.998,81
1,6432
5.
14
Cerebral
hemorragia
or
cerebral
infarction
30.619
307.224
10,03
3.890,66
119.128.166,91
1,2605
6.
88
Chronic
obstructive
pulmonary
disease
30.331
260.751
8,60
1.600,34
48.539.957,12
0,8209
7.
395
Red
cells
diseases,
age
17
years
27.520
238.394
8,66
1.675,70
46.115.233,36
0,8552
8.
316
Renal
failure
26.807
256.848
9,58
3.734,46
100.109.791,50
1,1501
9.
524
Transient
cerebral
ischemia
25.722
180.647
7,02
2.543,05
65.412.329,52
0,7692
10.
202
Hepatocirrhosis
and
alcoholic
hepatitis
19.771
194.920
9,86
4.013,21
79.345.200,28
1,2862
4. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019
IM (general medicine), general surgery, orthopedics,
cardiology, pediatrics, obstetrics and gynecology, neurology
and geriatrics. IM seems to play the most important role in
the management of emergency hospitalizations, covering
27% of admissions from ER. Other departments also have
important roles: general surgery manages 10% of emergency
hospitalizations, orthopedics and cardiology both manage
8%. About 7% of emergency patients are treated by pediatrics
and 6% by the obstetrics and gynecology wards. Although
increasing, neurology and geriatrics receive less patients
coming from ER (4% and 3%, respectively). About 27% of
admissions are in minor specialties [Figure 2]. The impact of
the IM on the management of urgent admissions can be partly
explained by the fact that the IM is present in all hospitals with
a high number of beds, while the specialized wards (geriatrics,
neurology, pediatrics, etc.) are less well represented and have a
lower number of beds.According to the literature,[10,11]
Internal
Medicine wards mainly admit complex cardiac, neurological
and geriatric DRGs. Older age, together with polypharmacy,
absence of formal and/or informal home help services, history
of falls, temporal disorientation, place of living, and use of
psychoactive drugs contribute significantly to determine the
hospital admission through ER.
Table 2 is a synopsis of the different national and regional
performance indicators analyzed in the article and Figure
3 shows examples of the IM performances of regions
representing different Italian healthcare scenarios.
Relationship between available primary health
care/community facilities and emergency
admission demand
Examining the percentage of admissions in IM coming from
the ER allows us to deduce the role of the “non hospital”
facilities in determining the demand for emergency
admissions. The data analyzed clearly demonstrates that the
duration of length of hospital stay decreases in regions with
efficient/well organized primary care facilities [Figure 3].
Notably,thepercentageofemergencyhospitalizationsadmitted
to internal medicine departments is unexpectedly high in Italian
regions in which the community-based healthcare system is
better able to efficiently respond to the needs of the population,
and in which primary care is organized to provide appropriate
management of chronic disease during phases of stability.
Indeed in Emilia Romagna 86% of admissions to Internal
Medicine came from the ER and had an average stay of 8.74
days less than the average Italian length of stay (LOS). The
average LOS increases with increasing age of patients, with
inpatient admissions reaching 10.18 days for those over 85
years. These findings suggest that step-down facilities enable
hospital patients to be discharged more quickly and effectively,
but do not impact significantly on the percentage of patients
urgently admitted to Internal Medicine wards.
Similarly in Tuscany, also considered a “virtuous” region,
90% of Internal Medicine admissions originate from the
ER with a mean length of stay of 8.26 days, again below
the national average. There seems to be little correlation
between efficiency of primary care facilities and admissions
to Medicine: perhaps the patients are hospitalized more
appropriately, exclusively selecting for “real” emergencies,
however still representing an irreducible percentage of
admissions. Lazio, a region adherent to the the national
reimbursement plan, presents poorly organized “non
hospital” facilities that are unable to meet citizens health
needs. In addition, due to the budget deficit, choices in
health-care management are limited. The average LOS in
Internal Medicine of 9.74 days, above the national average,
is testimony to the manifest under-performance of this
regional health system. Unexpectedly, despite the reduced
performance, the urgent admissions are only 78% of the total
admissions. This is difficult to explain when comparing these
figures with those of other Italian regions with better health
performance. The Lazio region scenario confirms that the
average LOS mirrors the increasing age of patients, with an
average of 7.43 days for patients between 15 and 39 years of
age and an increase to 11 days for those between 75 and 84.
However, the percentage of urgent admissions seems to be
unaffected by these services due to the number of patients
requiring admissions for acute or complex conditions. This
is driven primarily by complex elderly patients during
exacerbation of diseases that cannot be treated in primary
care structures, but require hospitalization with advanced
technological capability and intensive care.
0% 5% 10% 15% 20% 25% 30%
INTERNAL MEDICINE
GENERAL SURGERY
ORTHOPEDICS
CARDIOLOGY
PAEDIATRICS
OBSTETRICS GINECOLOGY
NEUROLOGY
GERIATRICS
27%
10%
8%
8%
7%
6%
4%
3%
% of ER admissions
Figure 2: Distribution of emergency admissions according to discharge specialties
Font: 2013 SDO data processing by CREA Sanità mod. 2019
5. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019 21
Table
2:
Comparison
between
national
and
regional
performance
indicators:
synoptic
table
Area
Regions
Emergency
admissions
(age
standardized
rates)
Planned
admissions
(age
standardized
rates)
Emergency
admissions
length
of
stay
Emergency
admissions
value
Average
age
of
emergency
admissions
Demand
[12-15]
Demographic
(mortality
rate
and
%
of
≥60
years)
Health
needs
(drug
consumption,
%
disabled
people
6
years,
%
mortality
for
NCDs
Italy
56/1000
inhabitants
46/1000
inhabitants
8,43
days
3.682,19
€
Emergency
59,8
years
Mortality
rate:
10.01/1000
inhabitants
Population
60
years:
27%
Average
annual
cost
of
drugs
pro
capita:
438€
%
disabled
people
6
years:
4.85%
Mortality
for
NCDs:
92%
North
Aosta
Valley
74
40
9,23
3.603,56
60
+
–
Piedmont
47
44
9,89
4.198,44
62
++
–
Lombardy
52
58
9,16
3.744,30
58
=
–
Provincia
Autonoma
Bolzano
86
41
7,40
3.172,81
60
+
–
Provincia
Autonoma
Trento
59
31
9,14
3.735,31
61
+
–
Veneto
51
34
9,83
3.699,71
63
+
–
Friuli
Venezia
Giulia
57
46
9,33
3.764,86
65
++
=
Liguria
62
30
9,03
3.888,23
64
+++
++
Emilia
Romagna
58
50
8,03
3.660,95
64
+
=
Center
Tuscany
50
49
8.02
4.081,34
65
+
+
Umbria
69
46
7,64
3.477,82
62
+
++
Marche
48
48
9,29
3.871,98
63
+
=
Lazio
56
50
8,80
3.727,46
58
–
++
Abruzzo
56
47
8,37
3.560,31
59
+
=
Molise
64
55
8,04
3.341,64
58
+
=
South
Campania
57
46
6.91
3.363,23
53
–
–
Puglia
65
49
7,52
3.366,24
55
–
=
Basilicata
50
40
8,22
3.689,61
61
–
+
Calabria
51
27
7,48
3.368,97
56
–
=
Sicily
56
39
7,71
3.768,92
54
–
++
Sardinia
69
37
7,50
3.262,18
58
–
=
+
and
–
indicates
the
grading
of
deviation
from
the
national
average;
=
means
the
same
value
of
the
national
average.
NCD:
Noncommunicable
diseases
6. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
22 Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019
Identikit of the person seeking care at public
hospital in Italy
The identikit of the person seeking care at public hospital is
as follow: (1) Older age (over 65 are 79%, 60% in IM, (2)
low level of education (primary school 51%, 60% in IM), (3)
active comorbidities (from 3 to 4), (4) emergency admission
55% of hospital admissions, 27% admitted in IM due to
exacerbation of one or more of the diseases which the patient
is suffering, (5) mainly admitted in IM department (medical
area 42% of the emergency admissions), and (6) needing
continuous monitoring and advanced technology (Table 3).
DISCUSSION
The educational level factor can explain the preferential use
of the emergency department for inadequate management of
the diseases the patient is suffering from. In fact, both the
level of education and age are constituent elements of the
human development index (ISU), a synthetic measure that
assess long-term progress in three fundamental dimensions
of human development: Life expectancy, the years of school
attendance and per capita income in dollars, at the constant
rate of 2005, converted using purchasing power parity.
According to the 2013 UN Human Development Report,
Italy is below the Organisation for Economic Cooperation
and Development (OECD) average, in 25th
place, preceded
by 20th
place in France, but ahead of Great Britain (28th
).[16]
Italy’s ISU score is 0.881, placed in the category of very high
human development, however low levels of education are
specific to many hospital inpatients, in particular those found
inInternalMedicinewards.Thelevelofeducationisoneofthe
most important determinants of health (it is in fact associated
with almost all the health indicators of a population) and is
particularly important also for the full and conscious exercise
of citizenship rights. According to ISTAT (National Statistics
Institute),[17]
expenditureoneducationandtraining–measured
in relation to gross domestic product (GDP) – is one of the
key indicators for assessing the policies implemented on the
subject of growth and development of human capital. The
Passi Report[18]
also defines the direct relationship between
the level of health and education. The population groups
that claim to be more satisfied with their health are young
people (87%), men (72%), and people with a higher level of
education (79%), those who do not have financial difficulties
(76%), who do not report severe pathological conditions.
According to Eurostat,[19]
levels of tertiary education vary
widely between different Italian regions. All the central
regions have values higher than the national average: in
particular, in Lazio the indicator reaches the highest value
(26.2%). Conversely, in the Southern regions, the lowest
levels are recorded, the worst performances being found in
Campania (12.9%) and Sicily (14.6%). The exceptions are
Abruzzo (20.9) and Molise (24.4%), which boast levels above
the Italian average. Among the Northern regions, the highest
share of young graduates is found in Liguria (24.8%). The
gender differential in education is favorable for women in all
Italian regions. According to the OECD report,[20]
Italy ranks
at the top for life expectancy, at almost 83 years and people
with a higher level of education can expect to live on average
6 years longer. The increase in life expectancy is linked to the
improvement in care, related to reductions in mortality due
to heart attack and stroke and to improvements in diabetes
and cancer treatments. This has led to an increase in health
spending (around 9% of GDP in the OECD countries). In
Table 3: Identikit of the person seeking care at public hospital in Italy (Font 2013 SDO, Italian Ministry of Health)
Items All departments (%) Internal medicine unit
1. Older age (over 65 years) 79 60%
2.
Low level of education (percentage with certificate of primary
education)
51 60%
3. Active comorbidities N.A. From 3 to 4
4. Emergency admissions 55 27% of the 55%
5. Admitted to a medical area 42 N.A.
6. Needing continuous monitoring and advanced technology N.A. 20–25%
Figure 3: Internal medicine admissions: examples of regional
health system performances. IM: Internal medicine, ER:
Emergency Room, LOS: Length of stay
7. Pietrantonio and Tyndall: Identikit of the person seeking care at public hospital
Journal of Community and Preventive Medicine • Vol 2 • Issue 2 • 2019 23
2013, Italy spent $3,077 per capita compared to an OECD
average of 3,453. Pharmaceutical spending has also increased
up to $ 800 billion (20% of health expenditure) in 2013 in
OECD countries, mainly attributable to hospital expenditure.
However, the OECD data shows that the health status of the
elderly in Italy is unsatisfactory. Indeed, health indicators
at the age of 65 are worse than the other OECD countries,
the reason being that healthcare assistance for the aging
population remains inferior as compared to other OECD
countries, particularly in terms of quality of long-term care
and patient monitoring. This is further exacerbated by risk
factors such as increased obesity and difficulty in accessing
certain specialized care services.
CONCLUSIONS
The Internal Medicine department is positioned to play a
central role in overall patient management in the hospitals
of the future. Regional health planning cannot disregard
the increasing burden of acutely ill patients with complex
diseases on hospital networks, and the key function of
Internal Medicine specialists in ensuring efficient and
adequate patient management.
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How to cite this article: Pietrantonio F, Tyndall E.
Identikit of the Person Seeking Care at Public Hospital
in Italy in the European Health Context: A Collaborative
Study. J Community Prev Med 2019;2(2):17-23.