The aim of this study was to evaluate the anaesthesia care of an enhanced recovery after surgery (ERAS) program for patients having abdominal surgical in Victorian hospitals. The main outcome measure was the number of ERAS items implemented following introduction of the ERAS program. Secondary endpoints included process of care ...

Background: South Asians presenting with chest pain in the UK experience disproportionately greater delays with respect to diagnosis and treatment for acute myocardial infarction (AMI). The duration of time between symptom onset and hospital intervention is a critical delay for AMI but there are limited data amongst South Asians. The ...

Community support in the post-discharge period is of importance, as difficulties managing at home can lead to readmission to hospital (Strunin et al, 2007; Arbaje et al, 2009). There is evidence that support from family in the community is perceived to be the best option by older people (McCann and ...

To evaluate whether the inclusion of advice in the hospital discharge letter regarding published guidelines for the review of PPI therapy can increase the number of patients that have documented PPI therapy review, consistent with the published guidelines, following hospital discharge. Patients on PPIs at discharge from hospital were randomised ...

Context: Post-intensive care unit (ICU) mortality predictors are unknown. Objective: To assess post-ICU in-hospital mortality predictors. Materials and methods: Analysis of 296 patients discharged alive from a medical-surgical ICU during an 18-month period. Results: Post-ICU in-hospital mortality was 22.6%. Nonsurvivors had significantly higher Charlson comorbidity score and more often had ...

Hospitalizations for decompensated heart failure (HF) are thought to increase long-term mortality. However, previous reports focus on newly hospitalized HF patients or clinical trial populations and do not always adjust for baseline mortality risk. We hypothesized that the number of HF hospitalizations within the prior 12 months would improve overall ...

BACKGROUND: Failure to follow up microbiology results pending at the time of hospital discharge can delay diagnosis and treatment of important infections, harm patients, and increase the risk of litigation. Current systems to track pending tests are often inadequate. OBJECTIVE: To design, implement, and evaluate an automated system to improve ...

BACKGROUND: -Population-based research on heart failure (HF) is hindered by lack of consensus on diagnostic criteria. Framingham (FRM), National Health and Nutrition Examination Survey (NHANES), Modified Boston (MBS), Gothenburg (GTH), and International Classification of Disease, 9(th) Revision, Clinical Modification (ICD-9-CM) code criteria do not differentiate acute decompensated heart failure (ADHF) ...

BACKGROUND: -Beta blockers (BB) are a mainstay of heart failure (HF) treatment, yet there is inconclusive data regarding their efficacy in African American individuals. METHODS AND RESULTS: -We performed a retrospective study of insured patients who received care from a large health system who were hospitalized for HF between January, ...

BACKGROUND: <0.005 for all). Smoking cessation counseling rates were similar (94.1% versus 94.0%; P=0.51). There was no significant difference in compliance with noncardiac process of care. After heart failure discharge, all-cause readmission at 30 days was 24.5% and mortality at 30 days after admission was 11.1%. After adjustment for hospital ...

In-hospital mortality measures, which are widely used to assess hospital quality, are not based on a standardized follow-up period and may systematically favor hospitals with shorter lengths of stay (LOSs). To assess the agreement between performance measures of U.S. hospitals by using risk-standardized in-hospital and 30-day mortality rates. Observational study. ...

Substantial hospital-level variation in the risk of readmission after hospitalization for heart failure (HF) or acute myocardial infarction (AMI) has been reported. Prior studies have documented considerable state-level variation in rates of discharge to skilled nursing facilities (SNFs), but evaluation of hospital-level variation in SNF rates and its relationship to ...

: Trauma systems are threatened from declining reimbursement. To increase trauma system participation in Mississippi, a novel "Play or Pay" (PoP) state trauma funding law went into effect on September 1, 2008. Hospitals were required to participate in the trauma system or pay a fee of up to $1.5 million ...

Accreditation is an internationally recognized evaluation process used to assess, promote, and guarantee efficient and effective patient care and safety. Saudi Arabia is one of the first countries in the eastern Mediterranean region to implement health care accreditation standards. This study provides valuable information pertaining to the impact of accreditation ...

Delirium is one of the most serious and common complications that up to one third of older patients admitted to hospital develop. It is characterized by a disturbance of consciousness, decreased attention, and disorganized thinking that develops over a short period of time, and fluctuates during the course of the ...

Background and Objective. The purpose of this retrospective observational study was to examine the influence of severe obesity on length of stay (LOS), rehabilitation efficiency, and hospital costs post-acute rehabilitation in a population-based, tertiary care, publicly-funded regional rehabilitation center. Participants. 42 severely obese subjects (mean age 53 y; mean BMI 50.9 kg/m(2)) ...

Witnessing the change in AIDS patients; from death sentence to miraculous recovery in a single year as antiretroviral drug supply lines began flowing was the biggest motivator to continue doctoring in the deep rural former Transkei for Liz Gatley. The Eastern Cape's Rural Doctor of the Year admits that 'overwhelm' ...

AIMS: Several models for predicting the prognosis of heart failure (HF) patients have been developed, but all of them focus on a single outcome variable, such as all-cause mortality. The purpose of this study was to develop a multistate model for simultaneously predicting survival and HF-related hospitalization in patients discharged ...

Objectives: To investigate whether market competition is a potential driver of hospital performance on the key evidence-based Joint Commission heart-failure (HF) quality indicators of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescribed, left ventricular function assessment, smoking-cessation counseling, and discharge instructions. Study Design: Retrospective multivariate analysis. Methods: Hospital performance data for HF ...

Abstract Background: The Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial showed that tolvaptan use improved heart failure (HF) signs and symptoms without serious adverse events. Objective: To evaluate the potential cost savings associated with tolvaptan usage among hospitalized hyponatremic HF patients. Methods: The Healthcare ...

BACKGROUND: Heart failure (HF) is the leading cause of hospitalization for Medicare beneficiaries. Nearly half of all HF patients have diastolic HF or HF with preserved ejection fraction (HF-PEF). Because these patients were excluded from major randomized clinical trials of neurohormonal blockade in HF there is little evidence about their ...

OBJECTIVE: To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction (AMI) or heart failure (HF) that best predicts current year hospital mortality rates. SETTING: A total of 1,868 U.S. hospitals reporting process and outcome measures for AMI and HF to the Centers for Medicare ...

It is not known whether recent declines in ischemic heart disease and its risk factors have been accompanied by declines in heart failure (HF) hospitalization and mortality. To examine changes in HF hospitalization rate and 1-year mortality rate in the United States, nationally and by state or territory. From acute ...

OBJECTIVES: To determine the association between cardiology consultation and evidence-based care for nursing home (NH) residents with heart failure (HF). PARTICIPANTS: Hospitalized NH residents (n = 646) discharged from 106 Alabama hospitals with a primary discharge diagnosis of HF during 1998-2001. DESIGN: Observational. MEASUREMENTS OF EVIDENCE-BASED CARE: Preadmission estimation of left ...

Heart failure (HF) is a leading cause of hospitalization. Although a number of multicenter international HF hospital registries have been published, there are limited data for the Asia Pacific region. ADHERE (ie, Acute Decompensated Heart Failure Registry) International-Asia Pacific is an electronic web-based observational database of 10,171 patients hospitalized with ...

Conventional composite outcomes in heart failure (HF) trials, for example, time to cardiovascular death or first HF hospitalization, have recognized limitations. We propose an alternative outcome, days alive and out of hospital (DAOH), which incorporates mortality and all hospitalizations into a single measure. A refinement, the patient journey, also uses ...

BACKGROUND: Advances in the treatment of heart failure (HF) have resulted in reduced mortality and hospitalization rates. On the other hand, when hospitalized, patients are at high risk of death. OBJECTIVE: As there are few studies in this group of patients in Brazil, we analyzed the numbers of hospitalization and ...

AIMS: Red cell distribution width (RDW) has been associated with cardiovascular disease, but the relation to heart failure (HF) is unclear. We investigated the association between RDW and incidence of first hospitalization due to HF in a population-based cohort. METHODS AND RESULTS: Red cell distribution width was measured in 26 ...

OBJECTIVE: Heart failure (HF) is a leading cause of hospitalization. Clinical and socio-demographic factors have been associated with cardiac admissions, but little is known about the role of anxiety. We examined whether symptoms of anxiety were associated with cardiac hospitalizations at 12 months in HF patients. METHODS: HF outpatients (N = 237) completed ...

BACKGROUND: Heart failure (HF) is a leading morbid cause of hospitalization and death. HF is often accompanied by comorbid conditions, increasing the health care burden. This study describes hospital mortality and identifies comorbid conditions associated with HF. METHODS: Acute care hospital separations in 2005-2006, with a diagnosis of HF I50, ...

This study examined the degree to which hospital performance for acute myocardial infarction (AMI) and heart failure (HF) care processes are correlated. Although AMI and HF care processes may be amenable to similar quality improvement interventions, whether these are indeed correlated and whether hospitals with consistently superior performance for both ...

INTRODUCTION:: Although differences in heart failure (HF) hospitalization rates by race and sex are well documented, little is known about geographic variations in hospitalizations for HF, the most common discharge diagnosis for Medicare beneficiaries. METHODS:: Using exploratory spatial data analysis techniques, the authors examined hospitalization rates for HF as the ...

Hispanics are the fastest growing segment of the US population and have a higher prevalence of cardiovascular risk factors than non-Hispanic whites. However, little is known about whether elderly Hispanics have higher readmission rates for heart failure (HF) and acute myocardial infarction (AMI) than whites and whether this is due ...

To estimate the cost-consequence of interventions to prevent hospitalizations for heart failure (HF) in people with type 2 diabetes. In HF events (63) from type 2 diabetes-related hospitalizations (N = 462) recorded in an Argentine hospital (March 2004-April 2005), we verified 1) the presence of one metabolic HF predictor (glycosylated ...

AIMS: To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF). METHODS AND RESULTS: Using data on 61 182 admissions in 307 US hospitals from March 2004 to March 2006 from the Acute Decompensated Heart Failure National Registry (ADHERE)-United States ...

Health care quality in the US territories is poorly characterized. We used process measures to compare the performance of hospitals in the US territories and in the US states. Our sample included nonfederal hospitals located in the United States and its territories discharging Medicare fee-for-service (FFS) patients with a principal ...

BACKGROUND: Most studies of heart failure (HF) in Medicare beneficiaries have excluded patients age <65years. We examined baseline characteristics, quality of care, and outcomes among younger and older Medicare beneficiaries hospitalized with HF in the Alabama Heart Failure Project. METHODS: Of the 8049 Medicare beneficiaries discharged alive with a primary ...

BackgroundValidity of Heart Failure (HF) diagnoses from administrative records has not been extensively evaluated, especially with respect to small / unselected hospitals. ObjectivesTo determine the positive predictive value of a primary / most responsible diagnosis of HF among a general population of subjects discharged from Saskatchewan hospitals. MethodsUsing administrative health records from ...

Despite the magnitude and impact of heart failure (HF) in the United States, relatively little data are available that describe the prognosis associated with acute HF, especially from the perspective of a population-based investigation. The purpose of this nonconcurrent prospective study was to describe the overall, and changing trends therein, ...

To respond to the increasing requests of non-infectious disease physicians for access to infectious diseases expertise, a hotline was created in the infectious diseases consultation (IDC) unit of the Grenoble university-affiliated hospital (GUH). This study describes the patterns of solicited consultations provided by the hotline during a 1-year period. We ...

The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine the ...

OBJECTIVES: To assess the prevalence of protocols or guidelines for selected domains of inpatient care for older adults; to explore associations between hospital characteristics and adoption of these guidelines or protocols. DESIGN: Telephone- and Web-based questionnaire. SETTING: General acute care hospitals in Pennsylvania. PARTICIPANTS: Chief nursing officers, directors of nursing, ...

BACKGROUND: Using a health outcome research framework, the hospitalization risk for a type 2 diabetes (T2DM) cohort is evaluated. Diabetes is "ambulatory care sensitive"--a condition largely manageable with appropriate care in the community. Thus, hospitalization may represent a negative care outcome. DATA AND METHODS: Analyses were conducted by linking data ...

Background.  Within hospitals, there is a need for dermatological expertise, as hospitalized patients have a wider spectrum of severe and serious dermatological conditions, associated with significant morbidity. Aim.  To characterize the patient profile and referral pattern of inpatient dermatology consultations, and to evaluate the diagnostic accuracy of non-dermatologists. Methods.  This ...

OBJECTIVE: To determine if there was any uniform experience across the United States relative to retinopathy of prematurity (ROP) services provided, reimbursement, and malpractice insurance coverage. METHODS: An online pediatric ophthalmology listserv poll queried pediatric ophthalmologists regarding ROP screening, reimbursement, malpractice insurance, and call and consult coverage. RESULTS: Compensation for ...

This study explored the views and experiences of a sample of hospital consultants using the RCGP e-portfolio, within the wider context of WPBA. Whilst the use of e-portfolios and WPBA in a hospital setting was broadly valued and accepted, issues of e-portfolio functionality often hindered the professional judgement of competencies. ...

The pervasive menace of a potential audit by an insurer or Medicare's Recovery Audit Contractor program has physicians more concerned than ever about their coding and documentation. Physicians and experts agree that one of a practice's best lines of defense lies in regular coding and documentation audits. TMA Practice Consulting ...

Secure and reliable power is critical for any hospital or healthcare building. However, according to global energy management specialist Schneider lectric, with the closure of electrical generation and nuclear plants becoming a real threat, there will be a reduction in the spare capacity of energy. Considering how hospitals might react ...

In Belgium and the Netherlands, consultation of a second independent physician by the attending physician is mandatory in euthanasia cases. In both countries, specialized consultation services have been established to provide physicians trained for that purpose. This retrospective study describes and compares the quality of consultation of both services based ...

BACKGROUND: Many studies have addressed changes in psychiatric consultation variables, but data from newly-opened hospitals is scarce. Thus, the aim of this study was to investigate changes in consultation-liaison services in the first five years of operation of a newly-opened hospital and compare this with similar data from established hospitals. ...