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1. |||....... 25%  Devine EB, Alfonso-Cristancho R, Devlin A, Edwards TC, Farrokhi ET, Kessler L, Lavallee DC, Patrick DL, Sullivan SD, Tarczy-Hornoch P, Yanez ND, Flum DR, CERTAIN Collaborative: A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network. J Clin Epidemiol; 2013 Aug;66(8 Suppl):S122-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network.
  • OBJECTIVE: To describe the inaugural comparative effectiveness research (CER) cohort study of Washington State's Comparative Effectiveness Research Translation Network (CERTAIN), which compares invasive with noninvasive treatments for peripheral artery disease, and to focus on the patient centeredness of this cohort study by describing it within the context of a newly published conceptual framework for patient-centered outcomes research (PCOR).
  • STUDY DESIGN AND SETTING: The peripheral artery disease study was selected because of clinician-identified uncertainty in treatment selection and differences in desired outcomes between patients and clinicians.
  • Patient centeredness is achieved through the "Patient Voices Project," a CERTAIN initiative through which patient-reported outcome (PRO) instruments are administered for research and clinical purposes, and a study-specific patient advisory group where patients are meaningfully engaged throughout the life cycle of the study.
  • RESULTS: Primary outcomes are PRO instruments that measure function, health-related quality of life, and symptoms, the latter developed with input from the patients.
  • Input from the patient advisory group led to revised retention procedures, which now focus on short-term (3-6 months) follow-up.
  • The research advisory panel is piloting a point-of-care, patient assessment checklist, thereby returning study results to practice.
  • CONCLUSION: The CERTAIN's inaugural cohort study may serve as a useful model for conducting PCOR and creating a learning health care network.
  • [MeSH-major] Advisory Committees. Comparative Effectiveness Research / methods. Outcome Assessment (Health Care) / methods. Patient Participation / methods. Peripheral Arterial Disease / therapy. Translational Medical Research / methods
  • [MeSH-minor] Cohort Studies. Data Collection. Humans. Intermittent Claudication / therapy. Models, Theoretical. Patient Satisfaction. Patient-Centered Care / organization & administration. Washington

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  • [Copyright] Copyright © 2013 Elsevier Inc. All rights reserved.
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  • (PMID = 23849146.001).
  • [ISSN] 1878-5921
  • [Journal-full-title] Journal of clinical epidemiology
  • [ISO-abbreviation] J Clin Epidemiol
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / 1 R01 HS 20025-01; United States / NCRR NIH HHS / RR / UL1 RR025014; United States / NCATS NIH HHS / TR / UL1 TR000423; United States / NCATS NIH HHS / TR / UL1TR000423
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS540290; NLM/ PMC4097950
  • [Keywords] NOTNLM ; Comparative effectiveness research / Patient-centered outcomes research / Patient-reported outcomes / Peripheral artery disease / Research infrastructure / Stakeholders
  • [Investigator] Clowes A; Alexander F; Meissner M; Van Eaton E; Yetisgen-Yildiz YY; Armstrong C; Berman M; Boland R; Capurro D; Grant R; Hativa M; Johansen M; Johnson S; Klamp W; Lawrence S; Lloyd A; Machinchick E; Mallahan S; Nickel K; Osman R; Pagoaga C; Patel K; Salazar R; Gaston Symons R; Tepper M; Tran T; Yantsides C; Zadworny M; Farrokhi E
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2. ||........ 23%  Gehring K, Schwappach DL, Battaglia M, Buff R, Huber F, Sauter P, Wieser M: Frequency of and harm associated with primary care safety incidents. Am J Manag Care; 2012 Sep;18(9):e323-37
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Frequency of and harm associated with primary care safety incidents.
  • OBJECTIVE: To assess frequency and severity of patient safety incidents in primary care.
  • STUDY DESIGN: Cross-sectional survey of health-care professionals in Swiss primary care offices.
  • METHODS: Physicians and nurses in primary care offices were surveyed about the frequency and severity of 23 safety incidents.
  • The frequency-harm matrix suggests that triage by nurse at initial contact, diagnostic errors, medication errors, failure to monitor patients after medical procedures, and test or intervention errors should be prioritized for action.
  • CONCLUSIONS: This study presents a supplemental approach to identification of safety threats in primary care.
  • Many incidents occur regularly and are highly relevant for healthcare professionals' daily work.The results offer guidance on setting priorities for patient safety in primary care.
  • [MeSH-major] Iatrogenic Disease / epidemiology. Patient Care / statistics & numerical data. Primary Health Care / statistics & numerical data. Risk Management / statistics & numerical data. Safety / statistics & numerical data
  • [MeSH-minor] Confidence Intervals. Cross-Sectional Studies. Diagnostic Errors. Health Care Surveys. Humans. Outpatients. Retrospective Studies. Risk Assessment / methods. Switzerland / epidemiology. Triage

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  • (PMID = 23009331.001).
  • [ISSN] 1936-2692
  • [Journal-full-title] The American journal of managed care
  • [ISO-abbreviation] Am J Manag Care
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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3. ||........ 21%  Warren C, Njuki R, Abuya T, Ndwiga C, Maingi G, Serwanga J, Mbehero F, Muteti L, Njeru A, Karanja J, Olenja J, Gitonga L, Rakuom C, Bellows B: Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth; 2013;13:21
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  • [Title] Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya.
  • Preliminary clinical and anthropological evidence suggests that one major factor inhibiting pregnant women from delivering at facility is disrespectful and abusive treatment by health care providers in maternity units.
  • DISCUSSION: This study seeks to conduct implementation research aimed at designing, testing, and evaluating an approach to significantly reduce disrespectful and abusive (D&A) care of women during labor and delivery in facilities.
  • [MeSH-major] Attitude of Health Personnel. Delivery, Obstetric / psychology. Health Facilities / utilization. Labor, Obstetric / psychology. Patient Care / adverse effects. Prejudice / prevention & control. Professional-Patient Relations
  • [MeSH-minor] Adult. Clinical Protocols. Confidentiality. Female. Humans. Informed Consent. Kenya. Pregnancy. Prevalence. Quality of Health Care. Questionnaires. Reproducibility of Results. Women's Rights / standards

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  • (PMID = 23347548.001).
  • [ISSN] 1471-2393
  • [Journal-full-title] BMC pregnancy and childbirth
  • [ISO-abbreviation] BMC Pregnancy Childbirth
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Validation Studies
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3559298
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4. |||||||||. 192%  Opekun AR, Gotschall AB, Abdalla N, Agent C, Torres E, Sutton FM, Graham DY, Tsuchiya K: Improved infrared spectrophotometer for point-of-care patient 13C-urea breath testing in the primary care setting. Clin Biochem; 2005 Aug;38(8):731-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Improved infrared spectrophotometer for point-of-care patient 13C-urea breath testing in the primary care setting.
  • The 13C-urea breath test provides non-invasive testing for Helicobacter pylori infection with the possibility of analysis at the point of care.
  • Point of care tests require accurate and efficient desktop instrumentation.
  • [MeSH-major] Breath Tests / instrumentation. Point-of-Care Systems. Spectrophotometry, Infrared / instrumentation. Urea / diagnostic use
  • [MeSH-minor] Adolescent. Adult. Aged. Carbon Isotopes. Female. Helicobacter Infections / diagnosis. Helicobacter pylori. Humans. Male. Middle Aged. Primary Health Care. Prospective Studies

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  • (PMID = 15963485.001).
  • [ISSN] 0009-9120
  • [Journal-full-title] Clinical biochemistry
  • [ISO-abbreviation] Clin. Biochem.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK56338
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Carbon Isotopes; 8W8T17847W / Urea
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5. |||||||||. 183%  Higginson IJ, Simon ST, Benalia H, Downing J, Daveson BA, Harding R, Bausewein C, PRISMA: Which questions of two commonly used multidimensional palliative care patient reported outcome measures are most useful? Results from the European and African PRISMA survey. BMJ Support Palliat Care; 2012 Mar;2(1):36-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Which questions of two commonly used multidimensional palliative care patient reported outcome measures are most useful? Results from the European and African PRISMA survey.
  • AIM: To evaluate the views of clinicians and researchers on their use of outcome measures and which questions are most important in palliative and end-of-life care.
  • METHODS: Online survey of professionals working in clinical care, clinical audit and research in palliative care across Europe and Africa identified through national and international associations and databases.
  • Questions focused on measures used, reasons and which questions were important in two commonly used multidimensional measures, the Palliative care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS).
  • The main uses were similar: assessing patients' symptoms/needs (88% and 85% of POS and STAS users, respectively), monitoring changes (62%, 58%), evaluating care (61%, 48%) and assessing family needs (59%, 60%).
  • CONCLUSIONS: In palliative care, outcome measures often used in clinical practice are also often used in research.
  • Questions relating to pain, symptoms, emotional needs and family concerns are consistently considered the most useful and important in palliative patient reported outcome measures (PROMs).

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  • (PMID = 24653497.001).
  • [ISSN] 2045-4368
  • [Journal-full-title] BMJ supportive & palliative care
  • [ISO-abbreviation] BMJ Support Palliat Care
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Investigator] Albers G; Antunes B; Bennett E; Barros Pinto A; Bausewein C; Bechinger-English D; Benalia H; Bradley L; Ceulemans L; Daveson BA; Deliens L; Derycke N; de Vlieger M; Dillen L; Downing J; Echteld M; Evans N; Faksvåg Haugen D; Gikaara N; Gomes B; Gysels M; Hall S; Harding R; Higginson IJ; Kaasa S; Koffman J; Ferreira PL; Menten J; Monteiro Calanzani N; Murtagh F; Onwuteaka-Philipsen B; Pasman R; Pettenati F; Pool R; Powell T; Ribbe M; Sigurdardottir K; Simon S; Toscani F; van den Eynden B; van der Steen J; Vanden Berghe P; van Iersel T
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6. |......... 6%  Cooper IF, Siadaty MS: 'Patient or Disabled Groups' associated with 'Animation': Top Publications. BioMedLib Review; PatientOrDisabled;Animation:706404623. ISSN: 2331-5717. 2014/8/26
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  • [Title] 'Patient or Disabled Groups' associated with 'Animation': Top Publications.
  • [Transliterated title]
  • Background: There are articles published each month which present 'Patient or Disabled Group' for 'animation'.
  • Finding such articles is important for researchers, clinicians, and patients.
  • However these articles are spread across thousands of journals, and there are many types of 'Patient or Disabled Group'.
  • This makes searching and locating the relevant publications a challenge.
  • We have used BioMedLib's semantic search technology to address the issue, and gathered all the pertinent publications in this review article.
  • Methods: We categorized the publications we found into two groups.
  • We used the strength of textual-association to separate the groups.
  • In group one there are publications with the strongest evidence of association. We focused finding the most relevant publications pertinent to our goal, rather than combining them into a conclusion section. Such textual synthesis will be the focus of our next project.
  • Results: Group one includes 17 publications, and group two 624 publications.
  • Here are the top 10.
  • Liu F et al: Effects of an animated diagram and video-based online breathing program for dyspnea in patients with stable COPD.
  • Pandharipande P et al: Liberation and animation for ventilated ICU patients: the ABCDE bundle for the back-end of critical care.
  • Zimprich H: [The use of play therapy (Animazione) in the hospitalized child].
  • Bianchi B et al: Facial animation in patients with Moebius and Moebius-like syndromes.
  • King MS et al: Liberation and animation: strategies to minimize brain dysfunction in critically ill patients.
  • Terwee CB et al: Development and validation of the computer-administered animated activity questionnaire to measure physical functioning of patients with hip or knee osteoarthritis.
  • Tou S et al: Effect of preoperative two-dimensional animation information on perioperative anxiety and knowledge retention in patients undergoing bowel surgery: a randomized pilot study.
  • Blakemore SJ et al: The detection of intentional contingencies in simple animations in patients with delusions of persecution.
  • Hermann M: [3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].
  • Salter G et al: Can autistic children read the mind of an animated triangle?.

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  • [Copyright] Copyright 2014 Siadaty and Cooper; licensee BioMedLib LLC.
  • (UID = 706404623.001).
  • [ISSN] 2331-5717
  • [Journal-full-title] BioMedLib Review
  • [Language] eng
  • [Publication-type] Review
  • [Publication-country] UNITED STATES
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7. ||........ 20%  Davidson KW, Bigger JT, Burg MM, Carney RM, Chaplin WF, Czajkowski S, Dornelas E, Duer-Hefele J, Frasure-Smith N, Freedland KE, Haas DC, Jaffe AS, Ladapo JA, Lespérance F, Medina V, Newman JD, Osorio GA, Parsons F, Schwartz JE, Shaffer JA, Shapiro PA, Sheps DS, Vaccarino V, Whang W, Ye S: Centralized, stepped, patient preference-based treatment for patients with post-acute coronary syndrome depression: CODIACS vanguard randomized controlled trial. JAMA Intern Med; 2013 Jun 10;173(11):997-1004
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Centralized, stepped, patient preference-based treatment for patients with post-acute coronary syndrome depression: CODIACS vanguard randomized controlled trial.
  • OBJECTIVE: To determine the effects of providing post-ACS depression care on depressive symptoms and health care costs.
  • SETTING: Patients were recruited from 2 private and 5 academic ambulatory centers across the United States.
  • PARTICIPANTS: A total of 150 patients with elevated depressive symptoms (Beck Depression Inventory [BDI] score ≥10) 2 to 6 months after an ACS, recruited between March 18, 2010, and January 9, 2012.
  • INTERVENTIONS: Patients were randomized to 6 months of centralized depression care (patient preference for problem-solving treatment given via telephone or the Internet, pharmacotherapy, both, or neither), stepped every 6 to 8 weeks (active treatment group; n = 73), or to locally determined depression care after physician notification about the patient's depressive symptoms (usual care group; n = 77).
  • MAIN OUTCOME MEASURES: Change in depressive symptoms during 6 months and total health care costs.
  • RESULTS: Depressive symptoms decreased significantly more in the active treatment group than in the usual care group (differential change between groups, -3.5 BDI points; 95% CI, -6.1 to -0.7; P = .01).
  • Although mental health care estimated costs were higher for active treatment than for usual care, overall health care estimated costs were not significantly different (difference adjusting for confounding, -$325; 95% CI, -$2639 to $1989; P = .78).
  • CONCLUSIONS: For patients with post-ACS depression, active treatment had a substantial beneficial effect on depressive symptoms.
  • This kind of depression care is feasible, effective, and may be cost-neutral within 6 months; therefore, it should be tested in a large phase 3 pragmatic trial.
  • [MeSH-major] Depression / economics. Depression / therapy. Patient Preference

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  • (PMID = 23471421.001).
  • [ISSN] 2168-6114
  • [Journal-full-title] JAMA internal medicine
  • [ISO-abbreviation] JAMA Intern Med
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT01032018
  • [Grant] United States / NHLBI NIH HHS / HL / 5RC2HL101663; United States / NHLBI NIH HHS / HL / HL-088117; United States / NHLBI NIH HHS / HL / HL-84034; United States / NHLBI NIH HHS / HL / K24 HL084034; United States / NHLBI NIH HHS / HL / P01 HL088117; United States / NHLBI NIH HHS / HL / RC2 HL101663; United States / NCATS NIH HHS / TR / UL1 TR000040; United States / NCATS NIH HHS / TR / UL1TR000040
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS463638; NLM/ PMC3681929
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8. ||........ 19%  Kim MM, Barnato AE, Angus DC, Fleisher LA, Kahn JM: The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med; 2010 Feb 22;170(4):369-76
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  • [Title] The effect of multidisciplinary care teams on intensive care unit mortality.
  • BACKGROUND: Critically ill patients are medically complex and may benefit from a multidisciplinary approach to care.
  • METHODS: We conducted a population-based retrospective cohort study of medical patients admitted to Pennsylvania acute care hospitals (N = 169) from July 1, 2004, to June 30, 2006, linking a statewide hospital organizational survey to hospital discharge data.
  • RESULTS: A total of 112 hospitals and 107 324 patients were included in the final analysis.
  • After adjusting for patient and hospital characteristics, multidisciplinary care was associated with significant reductions in the odds of death (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.76-0.93 [P = .001]).
  • When stratifying by intensivist physician staffing, the lowest odds of death were in intensive care units (ICUs) with high-intensity physician staffing and multidisciplinary care teams (OR, 0.78; 95% CI, 0.68-0.89 [P < .001]), followed by ICUs with low-intensity physician staffing and multidisciplinary care teams (OR, 0.88; 95% CI, 0.79-0.97 [P = .01]), compared with hospitals with low-intensity physician staffing but without multidisciplinary care teams.
  • The effects of multidisciplinary care were consistent across key subgroups including patients with sepsis, patients requiring invasive mechanical ventilation, and patients in the highest quartile of severity of illness.
  • CONCLUSIONS: Daily rounds by a multidisciplinary team are associated with lower mortality among medical ICU patients.
  • [MeSH-major] Intensive Care / organization & administration. Patient Care Team / organization & administration
  • [MeSH-minor] Cohort Studies. Hospital Mortality. Hospitalization / statistics & numerical data. Humans. Models, Organizational. Outcome and Process Assessment (Health Care). Pennsylvania. Personnel Staffing and Scheduling / organization & administration. Retrospective Studies. Risk Factors

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  • [CommentIn] Evid Based Nurs. 2010 Jul;13(3):91-2 [20584839.001]
  • [CommentIn] Arch Intern Med. 2010 Jul 12;170(13):1174-5 [20625032.001]
  • [CommentIn] Arch Intern Med. 2010 Feb 22;170(4):319-20 [20177033.001]
  • [ErratumIn] Arch Intern Med. 2010 May 24;170(10):867. Fleisher, Lee F [corrected to Fleisher, Lee A]
  • (PMID = 20177041.001).
  • [ISSN] 1538-3679
  • [Journal-full-title] Archives of internal medicine
  • [ISO-abbreviation] Arch. Intern. Med.
  • [Language] eng
  • [Grant] United States / NIA NIH HHS / AG / K08 AG 21921; United States / NIA NIH HHS / AG / K08 AG021921; United States / NHLBI NIH HHS / HL / K23 HL 082650; United States / NHLBI NIH HHS / HL / K23 HL082650
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS619266; NLM/ PMC4151479
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9. |||||||||. 160%  Koroloff N, Boots R, Lipman J, Thomas P, Rickard C, Coyer F: A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient. Intensive Care Med; 2004 Jun;30(6):1122-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient.
  • OBJECTIVE: To compare the efficacy of two forms of eye care (hypromellose and Lacri-Lube combination vs polyethylene/Cling wrap covers) for intensive care patients.
  • PATIENTS AND PARTICIPANTS: One hundred ten patients with a reduced or absent blink reflex were followed through until they regained consciousness, were discharged from the facility during study enrolment, died or developed a positive corneal ulcer or eye infection.
  • INTERVENTIONS: All patients received standard eye cleansing every 2 h.
  • No patients had corneal ulceration in the polyethylene cover group, but 4 patients had corneal ulceration in the HL group.
  • CONCLUSIONS: Polyethylene covers are as effective as HL in reducing the incidence of corneal damage in intensive care patients.
  • [MeSH-minor] Australia / epidemiology. Chlorobutanol / therapeutic use. Drug Combinations. Female. Humans. Intensive Care Units. Lanolin / therapeutic use. Male. Methylcellulose / analogs & derivatives. Methylcellulose / therapeutic use. Middle Aged. Mineral Oil / therapeutic use. Petrolatum / therapeutic use. Polyethylene. Statistics, Nonparametric

  • HSDB. structure - CHLORETONE.
  • HSDB. structure - LANOLIN.
  • HSDB. structure - PETROLATUM.
  • HSDB. structure - POLYETHYLENE.
  • HSDB. structure - METHYL CELLULOSE.
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  • [CommentIn] Intensive Care Med. 2005 Feb;31(2):313 [15565358.001]
  • (PMID = 15014864.001).
  • [ISSN] 0342-4642
  • [Journal-full-title] Intensive care medicine
  • [ISO-abbreviation] Intensive Care Med
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Ophthalmic Solutions; 78200-24-5 / lacri-lube; 8006-54-0 / Lanolin; 8009-03-8 / Petrolatum; 8020-83-5 / Mineral Oil; 8063-82-9 / hypromellose; 9002-88-4 / Polyethylene; 9004-67-5 / Methylcellulose; HM4YQM8WRC / Chlorobutanol
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10. ||||...... 38%  Shepperd S, Doll H, Broad J, Gladman J, Iliffe S, Langhorne P, Richards S, Martin F, Harris R: Early discharge hospital at home. Cochrane Database Syst Rev; 2009;(1):CD000356
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  • BACKGROUND: 'Early discharge hospital at home' is a service that provides active treatment by health care professionals in the patient's home for a condition that otherwise would require acute hospital in-patient care.
  • If hospital at home were not available then the patient would remain in an acute hospital ward.
  • OBJECTIVES: To determine, in the context of a systematic review and meta-analysis, the effectiveness and cost of managing patients with early discharge hospital at home compared with in-patient hospital care.
  • SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register , MEDLINE (1950 to 2008), EMBASE (1980 to 2008), CINAHL (1982 to 2008) and EconLit through to January 2008.
  • SELECTION CRITERIA: Randomised controlled trials recruiting patients aged 18 years and over.
  • Studies comparing early discharge hospital at home with acute hospital in-patient care.
  • We requested individual patient data (IPD) from trialists, and relied on published data when we did not receive trial data sets or the IPD did not include the relevant outcomes.
  • For patients recovering from a stroke and elderly patients with a mix of conditions there was insufficient evidence of a difference in mortality between groups (adjusted HR 0.79, 95% CI 0.32 to 1.91; N = 494; and adjusted HR 1.06, 95% CI 0.69 to 1.61; N = 978).
  • Readmission rates were significantly increased for elderly patients with a mix of conditions allocated to hospital at home (adjusted HR 1.57; 95% CI 1.10 to 2.24; N = 705).
  • For patients recovering from a stroke and elderly patients with a mix of conditions respectively, significantly fewer people allocated to hospital at home were in residential care at follow up (RR 0.63; 95% CI 0.40 to 0.98; N = 4 trials; RR 0.69, 95% CI 0.48 to 0.99; N =3 trials).
  • Patients reported increased satisfaction with early discharge hospital at home.
  • There was insufficient evidence of a difference for readmission between groups in trials recruiting patients recovering from surgery.
  • AUTHORS' CONCLUSIONS: Despite increasing interest in the potential of early discharge hospital at home services as a cheaper alternative to in-patient care, this review provides insufficient objective evidence of economic benefit or improved health outcomes.
  • [MeSH-major] Home Care Services, Hospital-Based / standards. Hospitalization
  • [MeSH-minor] Adult. Humans. Patient Care / economics. Patient Care / standards. Patient Discharge. Randomized Controlled Trials as Topic

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  • [UpdateOf] Cochrane Database Syst Rev. 2005;(3):CD000356 [16034853.001]
  • (PMID = 19160179.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Meta-Analysis; Review
  • [Publication-country] England
  • [Number-of-references] 77
  • [Other-IDs] NLM/ EMS57066; NLM/ PMC4175532
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11. |||....... 32%  Piers RD, Azoulay E, Ricou B, Dekeyser Ganz F, Decruyenaere J, Max A, Michalsen A, Maia PA, Owczuk R, Rubulotta F, Depuydt P, Meert AP, Reyners AK, Aquilina A, Bekaert M, Van den Noortgate NJ, Schrauwen WJ, Benoit DD, APPROPRICUS Study Group of the Ethics Section of the ESICM: Perceptions of appropriateness of care among European and Israeli intensive care unit nurses and physicians. JAMA; 2011 Dec 28;306(24):2694-703
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  • [Title] Perceptions of appropriateness of care among European and Israeli intensive care unit nurses and physicians.
  • CONTEXT: Clinicians in intensive care units (ICUs) who perceive the care they provide as inappropriate experience moral distress and are at risk for burnout.
  • This situation may jeopardize patient quality of care and increase staff turnover.
  • OBJECTIVE: To determine the prevalence of perceived inappropriateness of care among ICU clinicians and to identify patient-related situations, personal characteristics, and work-related characteristics associated with perceived inappropriateness of care.
  • Participants were 1953 ICU nurses and physicians providing bedside care.
  • MAIN OUTCOME MEASURE: Perceived inappropriateness of care, defined as a specific patient-care situation in which the clinician acts in a manner contrary to his or her personal and professional beliefs, as assessed using a questionnaire designed for the study.
  • RESULTS: Of 1651 respondents (median response rate, 93% overall; interquartile range, 82%-100% [medians 93% among nurses and 100% among physicians]), perceived inappropriateness of care in at least 1 patient was reported by 439 clinicians overall (27%; 95% CI, 24%-29%), 300 of 1218 were nurses (25%), 132 of 407 were physicians (32%), and 26 had missing answers describing job title.
  • Of these 439 individuals, 397 reported 445 situations associated with perceived inappropriateness of care.
  • The most common reports were perceived disproportionate care (290 situations [65%; 95% CI, 58%-73%], of which "too much care" was reported in 89% of situations, followed by "other patients would benefit more" (168 situations [38%; 95% CI, 32%-43%]).
  • Independently associated with perceived inappropriateness of care rates both among nurses and physicians were symptom control decisions directed by physicians only (odds ratio [OR], 1.73; 95% CI, 1.17-2.56; P = .006); involvement of nurses in end-of-life decision making (OR, 0.76; 95% CI, 0.60-0.96; P = .02); good collaboration between nurses and physicians (OR, 0.72; 95% CI, 0.56-0.92; P = .009); and freedom to decide how to perform work-related tasks (OR, 0.72; 95% CI, 0.59-0.89; P = .002); while a high perceived workload was significantly associated among nurses only (OR, 1.49; 95% CI, 1.07-2.06; P = .02).
  • Perceived inappropriateness of care was independently associated with higher intent to leave a job (OR, 1.65; 95% CI, 1.04-2.63; P = .03).
  • In the subset of 69 ICUs for which patient data could be linked, clinicians reported received inappropriateness of care in 207 patients, representing 23% (95% CI, 20%-27%) of 883 ICU beds.
  • CONCLUSION: Among a group of European and Israeli ICU clinicians, perceptions of inappropriate care were frequently reported and were inversely associated with factors indicating good teamwork.
  • [MeSH-major] Attitude of Health Personnel. Intensive Care Units / standards. Nurses / psychology. Patient Care / standards. Physicians / psychology
  • [MeSH-minor] Adult. Burnout, Professional. Cross-Sectional Studies. Europe. Female. Humans. Interprofessional Relations. Israel. Job Satisfaction. Male. Organizational Culture. Patient Care Team. Quality of Health Care. Terminal Care / standards. Unnecessary Procedures

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  • [CommentIn] JAMA. 2012 Apr 4;307(13):1370; author reply 1371-2 [22474195.001]
  • [CommentIn] JAMA. 2012 Apr 4;307(13):1370-1; author reply 1371-2 [22474196.001]
  • [CommentIn] Arch Intern Med. 2012 Jun 11;172(11):889-90 [22688994.001]
  • [CommentIn] JAMA. 2011 Dec 28;306(24):2725-6 [22203544.001]
  • (PMID = 22203538.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Investigator] Piers; Azoulay; Ricou; DeKeyser Ganz; Decruyenaere; Benoit; Depuydt P; Piers R; Benoit D; Decruyenaere J; Mauws N; De Cock C; De Neve N; De Decker K; Nonneman B; Swinnen W; Bourgeois M; De laet I; Jans A; Meert AP; Stevens E; Dechamps P; Vallot F; Devriendt J; Laterre PF; Lemaitre F; Norrenberg M; Max A; Lafabrie A; Lemiale V; Azoulay E; Schlemmer B; Mira JP; Zuber B; Bonneton B; Baillat L; Compagnon F; Mégarbane B; Baud F; Antona M; Sharshar T; Annane D; Lautrette A; Souweine B; Legriel S; Bedos JP; Garrouste-Orgeas M; Bruel C; Philippart F; Misset B; Fieux F; Jacob L; Das V; Pallot JL; Rabbat A; Vincent F; Cohen Y; Thirion M; Mentec H; Michalsen A; Weller L; Kubitza S; Schweiger D; Clement R; Mörer O; Kurzweg V; Plattner M; Schneider J; Schoser G; Raanan O; Ben Nun M; Cerchiari E; Petrini F; Cabrini L; Rubulotta G; Conti A; Rabeschi G; Andretto B; Aquilina A; Wujtewicz MA; Misiolek H; Wenski W; Onichimowski D; Machala W; Czajkowska M; Maciejewski D; Szurlej D; Maia P; Coutinho P; Lúzio J; Branco M; Maul E; Esteves F; Faria F; Castelões P; Pereira AA; Barbosa S; Dias C; Ricou B; Zender H; Zürcher R; Sridharan G; Friolet R; Karachristianidou A; Malacrida R; Penati G; Llamas M; Perren A; Pagnamenta A; Reyners AK; Heesink A; Gerritsen R; Sleeswijk M; Lutisan J; Janssen R
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12. |||....... 31%  Nusbaum MR, Frasier PY, Rojas F, Trotter K, Tudor G: Sexual orientation and sexual health care needs: a comparison of women beneficiaries in outpatient military health care settings. J Homosex; 2008;54(3):259-76
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  • [Title] Sexual orientation and sexual health care needs: a comparison of women beneficiaries in outpatient military health care settings.
  • A survey was mailed to women patients from two military outpatient settings, with 1,196 women responding.
  • Larger primary care patient-based studies of sexual health care needs of sexual minorities are needed.
  • [MeSH-major] Ambulatory Care. Health Services Needs and Demand. Heterosexuality. Homosexuality, Female. Hospitals, Military. Military Personnel
  • [MeSH-minor] Adult. Demography. Female. Humans. Middle Aged. Physician-Patient Relations. United States

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  • (PMID = 18825863.001).
  • [ISSN] 0091-8369
  • [Journal-full-title] Journal of homosexuality
  • [ISO-abbreviation] J Homosex
  • [Language] eng
  • [Grant] United States / PHS HHS / / 5-D12-HP00055
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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13. |||....... 31%  Juillière Y, Jourdain P, Roncalli J, Trochu JN, Gravoueille E, Guibert H, Lambert H, Neau S, Spinazze L, Tallec N, Bachèlerie C, Beauvais F, Ertzinger C, Jondeau G, Groupe de travail Insuffisance cardiaque et cardiomyopathies, Société française de cardiologie: [Therapeutic education for cardiac failure patients: the I-care programme]. Arch Mal Coeur Vaiss; 2005 Apr;98(4):300-7
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  • [Title] [Therapeutic education for cardiac failure patients: the I-care programme].
  • [Transliterated title] Education thérapeutique des patients insuffisants cardiaques: le programme I-care.
  • The I-CARE programme consists of an evaluation of the role of therapeutic education in France, creating standardised tools and setting up training sessions for therapeutic education in the context of cardiac failure.
  • The I-CARE programme should allow the expansion of therapeutic education for cardiac failure and improve the multidisciplinary management of this disease which increasingly affects often elderly subjects.
  • [MeSH-major] Heart Failure. Patient Education as Topic. Physician-Patient Relations


14. |||....... 25%  Buysse DJ, Barzansky B, Dinges D, Hogan E, Hunt CE, Owens J, Rosekind M, Rosen R, Simon F, Veasey S, Wiest F: Sleep, fatigue, and medical training: setting an agenda for optimal learning and patient care. Sleep; 2003 Mar 15;26(2):218-25
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  • [Title] Sleep, fatigue, and medical training: setting an agenda for optimal learning and patient care.
  • The difficult issues surrounding discussions of sleep, fatigue, and medical education stem from an ironic biologic truth: physicians share a common physiology with their patients, a physiology that includes an absolute need for sleep and endogenous circadian rhythms governing alertness and performance.
  • We cannot ignore the fact that patients become ill and require medical care at all times of the day and night, but we also cannot escape the fact that providing such care requires that medical professionals, including medical trainees, be awake and functioning at times that are in conflict with their endogenous sleep and circadian physiology.
  • Empiric research addressing the effects of sleep loss on patient safety, education outcomes, and resident health is urgently needed: equally important are the development and assessment of innovative countermeasures to maximize performance and learning.
  • By working together to address the problems of sleep and fatigue in its own trainees, the medical field can provide a valuable legacy to patients and to future generations of healthcare providers--a legacy or optimal medical education, healthy doctors, and healthy patients.
  • [MeSH-major] Education, Medical. Fatigue / complications. Learning. Patient Care. Sleep Disorders / etiology. Teaching / methods

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  • (PMID = 12683483.001).
  • [ISSN] 0161-8105
  • [Journal-full-title] Sleep
  • [ISO-abbreviation] Sleep
  • [Language] eng
  • [Publication-type] Congresses; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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15. ||........ 25%  Vinicor F, Cohen SJ, Mazzuca SA, Moorman N, Wheeler M, Kuebler T, Swanson S, Ours P, Fineberg SE, Gordon EE, et al: DIABEDS: a randomized trial of the effects of physician and/or patient education on diabetes patient outcomes. J Chronic Dis; 1987;40(4):345-56
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  • [Title] DIABEDS: a randomized trial of the effects of physician and/or patient education on diabetes patient outcomes.
  • To examine the effects of intensive patient and/or physician diabetes education on patient health outcomes, a controlled trial was conducted in which internal medicine residents and their 532 diabetic patients were randomly assigned to: routine care; patient education; physician education; or both patient and physician education.
  • Patient outcome data were analyzed either by analysis of covariance on post intervention values (2-hour post-prandial plasma glucose [PPG]; body weight [BW]; blood pressure [BP]; or analysis of variance conducted on change values (fasting plasma glucose [FPG] and glycosylated hemoglobin [A1Hgb]).
  • After patient education, significant improvements were observed in FPG, A1Hgb, BW, and systolic and diastolic BP.
  • The combination of patient plus physician education resulted in the greatest improvements in patients' health outcomes including FPG, A1Hgb, PPG, BW and diastolic BP.
  • Thus, achieving optimal patient outcomes for a chronic disease like diabetes mellitus may require a greater or more effective use of resources than currently estimated.
  • [MeSH-major] Diabetes Mellitus. Internal Medicine / education. Internship and Residency. Patient Education as Topic
  • [MeSH-minor] Clinical Trials as Topic. Female. Humans. Male. Middle Aged. Outcome and Process Assessment (Health Care). Random Allocation

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  • (PMID = 3549757.001).
  • [ISSN] 0021-9681
  • [Journal-full-title] Journal of chronic diseases
  • [ISO-abbreviation] J Chronic Dis
  • [Language] eng
  • [Grant] United States / NIADDK NIH HHS / AM / P60 AM20542
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] ENGLAND
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16. |||....... 29%  Cohen CB: Can autonomy and equity coexist in the ICU? Hastings Cent Rep; 1986 Oct;16(5):39-41
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  • Cohen reviews two collections of essays on ethical issues in critical care medicine: Ethics and Critical Care Medicine, edited by John C.
  • Reidel; 1985), and "Ethical Moments in Critical Care Medicine," a symposium issue of Critical Care Clinics, edited by James P.
  • Some of the topics discussed by the contributors include physician beneficence vs. patient autonomy in critical care decision making; the pressures created by the "rescue ethos" of the critical care setting; the selection of patients for admission to intensive care; the equitable distribution of critical care resources; and the increasing need to factor costs into treatment decisions. E.
  • [MeSH-major] Critical Illness. Decision Making. Health Care Rationing. Intensive Care Units. Patient Care. Resource Allocation
  • [MeSH-minor] Altruism. Beneficence. Cost-Benefit Analysis. Economics. Freedom. Humans. Paternalism. Patient Participation. Patient Selection. Personal Autonomy. Physician-Patient Relations. Physicians. Resuscitation Orders. Social Justice. United States

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  • (PMID = 11643933.001).
  • [ISSN] 0093-0334
  • [Journal-full-title] The Hastings Center report
  • [ISO-abbreviation] Hastings Cent Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] KIE/ 22710
  • [Keywords] KIE ; Health Care and Public Health
  • [General-notes] KIE/ KIE BoB Subject Heading: resource allocation/biomedical technologies
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17. ||........ 22%  Dembelé S, Ouédraogo H, Macq J, Godin I, Kittel F, Dujardin B: [A patient-centered approach to tuberculosis control in Burkina Faso]. Sante; 2008 Jul-Sep;18(3):135-40
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  • [Title] [A patient-centered approach to tuberculosis control in Burkina Faso].
  • [Transliterated title] L'approche centrée sur le patient pour la lutte contre la tuberculose au Burkina Faso.
  • BACKGROUND: The Burkina Faso health system is divided into 55 health districts (DS), each with more than 10 primary care health centers (CSPS) that comprise the first level of the health care system.
  • OBJECTIVE: To evaluate the impact of the patient-centered approach to tuberculosis control on the detection and treatment of tuberculosis.
  • RESULTS: The proportion of patients suspected of tuberculosis who chose sputum sampling in the CSPS was higher in the rural district (Gorom-Gorom) than in the urban one (Pissy): 46% versus 18.7% (p < 0.001).
  • [MeSH-minor] Burkina Faso. Data Interpretation, Statistical. Humans. Patient-Centered Care. Rural Population. Urban Population

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  • (PMID = 19359234.001).
  • [ISSN] 1157-5999
  • [Journal-full-title] Santé (Montrouge, France)
  • [ISO-abbreviation] Sante
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] France
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18. ||........ 20%  Hadji P, Klein S, Häussler B, Kless T, Linder R, Rowinski-Jablokow M, Verheyen F, Gothe H: The bone evaluation study (BEST): patient care and persistence to treatment of osteoporosis in Germany. Int J Clin Pharmacol Ther; 2013 Nov;51(11):868-72
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  • [Title] The bone evaluation study (BEST): patient care and persistence to treatment of osteoporosis in Germany.
  • OBJECTIVE: Data on fracture frequency and medical care of patients with osteoporosis are still insufficient.
  • We assessed fractures, frequencies, and the number of multiple fractures per patient as well as time to follow-up fracture and drug persistence using Kaplan-Meier analysis.
  • RESULTS: Within the observation period, 27% of the osteoporosis patients sustained fractures; of those with fractures, 69% had multiple fractures.
  • For patients with multiple fractures, re-fracture rate after 360 days was between 69% for patients who received parathyroid hormone and 85% for patients who received no anti-osteoporotic medication 360 days before follow-up fracture.
  • In the patient population, persistence rates after 1 year were between 58% for parathyroid hormone and 2% for other osteoporosis-specific drugs (alfacalcidol, fluorides, nandrolone, calcitonin).
  • CONCLUSIONS: In Germany, the number of patients with osteoporosis-attributable fractures is high.
  • Low persistence lead to a relatively high proportion of patients with follow-up fractures.
  • [MeSH-minor] Aged. Female. Germany / epidemiology. Humans. Male. Medication Adherence. Middle Aged. Patient Care. Retrospective Studies

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  • (PMID = 24040854.001).
  • [ISSN] 0946-1965
  • [Journal-full-title] International journal of clinical pharmacology and therapeutics
  • [ISO-abbreviation] Int J Clin Pharmacol Ther
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Bone Density Conservation Agents
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19. ||........ 19%  Amouretti M, Czernichow P, Kerjean A, Hochain P, Nousbaum JB, Rudelli A, Zerbib F, Dupas JL, Gouérou H, Herman H, Colin R: [Management of upper digestive hemorrhage occurring in the community: patterns of patient care in 4 French administrative areas]. Gastroenterol Clin Biol; 2000 Nov;24(11):1003-11
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  • [Title] [Management of upper digestive hemorrhage occurring in the community: patterns of patient care in 4 French administrative areas].
  • [Transliterated title] Prise en charge des hémorragies digestives hautes communautaires. Trajectoires des malades dans 4 départements français.
  • AIMS: To describe patterns of health care management in patients with upper gastrointestinal hemorrhage and to identify factors linked to the different patterns.
  • PATIENTS AND METHODS: We conducted a prospective study of patients over 18 with upper gastrointestinal hemorrhage (inpatients excluded) among all public hospitals and private practice gastroenterologists in 4 French administrative areas (3 in Northern France and one in the South West).
  • RESULTS: One thousand six hundred and two patients were included over a six-month period (1996).
  • An endoscopic procedure was performed in 1532 patients in public (70%) or private (20.5%) hospitals, or at private office (9.5%).
  • Hospitalization was necessary in 78.8% of the patients in university, non university public or private hospitals (38.9, 45.5 and 15.6%, respectively) with a median duration of 6.5 days.
  • Endoscopic hemostasis was performed in 21.4% of the patients, more often in university and no university public hospitals.
  • Surgery was necessary in 4% of the patients.
  • Patients' characteristics did not differ between the 4 areas.
  • On the other hand, health care supply provided in the management of upper gastrointestinal hemorrhage was different in the four French geographical areas.
  • CONCLUSION: a) An initial endoscopic procedure is nearly always performed in patients with an upper gastrointestinal hemorrhage in France; in 1 patient out of 10, endoscopy was performed in a private gastroenterologist office;.
  • c) the geographical variations observed in referral patterns depend in part on health care supply;.
  • d) upper gastrointestinal haemorrhage status could be used as an indicator of the quality of health care organizations.
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Blood Transfusion. Data Collection. Data Interpretation, Statistical. Delivery of Health Care. Endoscopy, Digestive System. France. Health Services Accessibility. Humans. Length of Stay. Middle Aged. Patient Care. Prospective Studies. Quality of Health Care. Time Factors

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  • (PMID = 11139667.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] FRANCE
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20. ||........ 19%  Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW: Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA; 2007 Feb 28;297(8):831-41
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  • [Title] Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care.
  • CONTEXT: Delayed or inaccurate communication between hospital-based and primary care physicians at hospital discharge may negatively affect continuity of care and contribute to adverse events.
  • DATA EXTRACTION: Data from observational studies were extracted on the availability, timeliness, content, and format of discharge communications, as well as primary care physician satisfaction.
  • DATA SYNTHESIS: Direct communication between hospital physicians and primary care physicians occurred infrequently (3%-20%).
  • The availability of a discharge summary at the first postdischarge visit was low (12%-34%) and remained poor at 4 weeks (51%-77%), affecting the quality of care in approximately 25% of follow-up visits and contributing to primary care physician dissatisfaction.
  • Discharge summaries often lacked important information such as diagnostic test results (missing from 33%-63%), treatment or hospital course (7%-22%), discharge medications (2%-40%), test results pending at discharge (65%), patient or family counseling (90%-92%), and follow-up plans (2%-43%).
  • Several interventions, including computer-generated discharge summaries and using patients as couriers, shortened the delivery time of discharge communications.
  • CONCLUSIONS: Deficits in communication and information transfer at hospital discharge are common and may adversely affect patient care.
  • Interventions such as computer-generated summaries and standardized formats may facilitate more timely transfer of pertinent patient information to primary care physicians and make discharge summaries more consistently available during follow-up care.
  • [MeSH-major] Continuity of Patient Care / standards. Hospitalists. Interdisciplinary Communication. Patient Discharge. Physicians, Family
  • [MeSH-minor] Aftercare / standards. Humans. Quality of Health Care. United States

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  • (PMID = 17327525.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] eng
  • [Grant] United States / BHP HRSA HHS / PE / 2-T32-PE10025; United States / NCRR NIH HHS / RR / K12 RR017643; United States / NHLBI NIH HHS / HL / K23 HL077597
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 133
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21. ||........ 18%  Mathoulin-Pélissier S, Bécouarn Y, Belleannée G, Pinon E, Jaffré A, Coureau G, Auby D, Renaud-Salis JL, Rullier E, Regional Aquitaine Group for Colorectal cancer GRACCOR: Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors. BMC Cancer; 2012;12:297
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  • [Title] Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors.
  • BACKGROUND: Colorectal cancer (CRC) care has improved considerably, particularly since the implementation of a quality of care program centered on national evidence-based guidelines.
  • The aim of this research was to identify factors associated with practice variation in CRC patient care.
  • METHODS: CRC patients identified from all cancer centers in South-West France were included.
  • We identified factors associated with three colon cancer practice variations potentially linked to better survival: examination of ≥ 12 lymph nodes (LN), non-use and use of adjuvant chemotherapy for stage II and stage III patients, respectively.
  • RESULTS: We included 1,206 patients, 825 (68%) with colon and 381 (32%) with rectal cancer, from 53 hospitals.
  • Compliance was high for resection, pathology report, LN examination, and chemotherapy use for stage III patients.
  • In colon cancer, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients.
  • 84% of stage US T3T4 rectal cancer patients received pre-operative radiotherapy.
  • Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location); whereas under-use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals.
  • CONCLUSIONS: Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care.
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant / methods. Chemotherapy, Adjuvant / standards. Cohort Studies. Female. France. Hospitals / standards. Humans. Male. Patient Care / methods. Patient Care / standards. Prospective Studies. Quality Assurance, Health Care. Quality Indicators, Health Care

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  • (PMID = 22813349.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3527146
  • [Investigator] Abdiche S; Adhoute X; Arnal JC; Arotçarena R; Auby D; Audemar F; Avril A; Balabaud C; Baldit C; Bancons J; Barandon E; Barberis C; Bayle J; Bayol B; Belliard R; Berthélémy P; Berthoux L; Beyssac R; Blanc JF; Boisseau C; Bonichon N; Bonichon P; Boudinet F; Bouet C; Boutillier P; Breque M; Bretagnol F; Breuillé G; Brocard H; Brudieux E; Brunet R; Buy E; Calabet J; Calès V; Cany L; Carles J; Carles B; Cayla R; Cazals JB; Cazenave JL; Cazenave JL; Cazenave-Mahe JP; Cazorla S; Chacon JB; Champbenoit P; Chastan P; Chaussende C; Chossat I; Claracq M; Collet D; Coomans D; Coquard JL; Cordet F; Couderc B; Couzigou P; Dahan O; Dantin B; Dauba J; David XR; Letout; Debenes B; Delvert D; Deret C; Desprez D; Dohollou N; Dost C; Dromer C; Dubuisson V; Dumas F; Dumora V; Echinard E; El Kohen D; Evrard S; Fitoussi O; Fonck M; Fromenteau C; Gaultier T; Gauriau L; Gheysens B; Goffre B; Gontier R; Griot JB; Guichandut JP; Guichard F; Humbert A; Imbert Y; Jaubert D; Junes F; Kin B; Labat J; Laborde Y; Lamy A; Larregain-Fournier D; Larroude D; Larrue PH; Laurent C; Le Roux G; Le Toux N; Le Trong L; Lecesne R; Ledaguenel P; Lepoutre A; Letout; Levache CB; Lévêque AM; Lotte P; Lariviere I; Loze S; Lupo R; Machané K; Magne E; Magnien F; Mahé P; Mallier N; Mannant PR; Manouvrier JL; Marty F; Masson B; Maton O; Mauriac JC; Minet F; Miremont F; Moussié D; Ndobo F; Nobili S; Noury D; Ogouchi J; Oui B; Pansieri M; Parent Y; Pariente A; Peluchon P; Pichon JF; Prevost B; Puech P; Pujol J; Rallier H; Rault A; Reboul G; Remuzon P; Rémy S; Richard-Molard B; Roussy P; Roux D; SaCunha A; Santoni P; Saric J; Sarkissian M; Schang JC; Simon G; Smith D; Stépani P; Talbi P; Texereau P; Trufflandier N; Turner K; Vendrely V; Vergier JF; Weber F
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22. ||........ 18%  Cooley ME, Short TH, Moriarty HJ: Symptom prevalence, distress, and change over time in adults receiving treatment for lung cancer. Psychooncology; 2003 Oct-Nov;12(7):694-708
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  • The purposes of this study were to describe which symptoms are most distressing, describe the prevalence of symptoms in adults receiving treatment for lung cancer, identify how symptoms change over time, and identify patient-related and clinical characteristics related to symptom distress.
  • Data were available from 117 patients.
  • [MeSH-major] Depressive Disorder, Major / epidemiology. Depressive Disorder, Major / etiology. Lung Neoplasms / psychology. Lung Neoplasms / therapy. Patient Care / adverse effects

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  • [Copyright] Copyright 2003 John Wiley & Sons, Ltd.
  • (PMID = 14502594.001).
  • [ISSN] 1057-9249
  • [Journal-full-title] Psycho-oncology
  • [ISO-abbreviation] Psychooncology
  • [Language] eng
  • [Grant] United States / NINR NIH HHS / NR / T32 NR07035
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
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23. ||........ 18%  Pearson G, Shann F, Barry P, Vyas J, Thomas D, Powell C, Field D: Should paediatric intensive care be centralised? Trent versus Victoria. Lancet; 1997 Apr 26;349(9060):1213-7
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  • [Title] Should paediatric intensive care be centralised? Trent versus Victoria.
  • BACKGROUND: The mortality rate is lower among children admitted to specialist paediatric intensive care units (ICUs) than among those admitted to mixed adult and paediatric units in non-tertiary hospitals.
  • In the UK, however, few children receive intensive care in specialist paediatric units.
  • We compared the ICU mortality rate in children from the area the Trent Health Authority, UK, with the rate in children from Victoria, Australia, where paediatric intensive care is highly centralised.
  • METHODS: We studied all children under 16 years of age from Trent and Victoria who received intensive care between April 1, 1994, and March 31, 1995.
  • FINDINGS: The rates of admission of children to intensive care were similar for Trent and Victoria (1.22 and 1.18 per 1000 children per year), but the mean duration of an ICU stay was 3.93 days for Trent children compared with 2.14 days for children from Victoria.
  • INTERPRETATION: If Trent is representative of the whole country, there are 453 (200-720) excess deaths a year in the UK that are probably due to suboptimal results from paediatric intensive care.
  • [MeSH-major] Centralized Hospital Services. Intensive Care
  • [MeSH-minor] Adolescent. Adult. Catchment Area (Health). Child. Child, Preschool. England. Humans. Infant. Intubation, Intratracheal. Length of Stay. Logistic Models. Mortality. Odds Ratio. Patient Admission. Risk Factors. Severity of Illness Index. Survival Rate. Victoria

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  • [CommentIn] Lancet. 1997 Jul 5;350(9070):67; author reply 67-8 [9217736.001]
  • [CommentIn] Lancet. 1997 Jul 5;350(9070):66; author reply 67-8 [9217734.001]
  • [CommentIn] Lancet. 1997 Jul 5;350(9070):65-6; author reply 67-8 [9217733.001]
  • [CommentIn] Lancet. 1997 Jul 5;350(9070):66-7; author reply 67-8 [9217735.001]
  • [CommentIn] Lancet. 1997 Jul 5;350(9070):65; author reply 67-8 [9217732.001]
  • [CommentIn] Lancet. 1997 Apr 26;349(9060):1187-8 [9130935.001]
  • (PMID = 9130943.001).
  • [ISSN] 0140-6736
  • [Journal-full-title] Lancet
  • [ISO-abbreviation] Lancet
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] ENGLAND
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24. ||........ 18%  Swain MA, Steckel SB: Influencing adherence among hypertensives. Res Nurs Health; 1981 Mar;4(1):213-22
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  • In a 3 x 4 repeated measures analysis of variance design, 115 patients were randomly selected and randomly assigned to one of three treatment modalities (routine clinic care, patient education, and contingency contracting) and were followed over four clinic visits.
  • Patient education was not effective in lowering blood pressures; it produced an untoward outcome, a dropout rate higher than that for patients receiving only routine clinic care.
  • However, contingency contracting was an effective intervention strategy for improving patient knowledge, F (1,59) = 51.32, p less than .0001; adherence to requests for regular medical care, Max L (2) = 25.9, p less than .0001; and decreasing diastolic blood pressures, F (2,49) = 3.39, p less than .05.
  • [MeSH-major] Hypertension / therapy. Patient Compliance
  • [MeSH-minor] Adult. Blood Pressure. Female. Follow-Up Studies. Humans. Male. Outpatient Clinics, Hospital / utilization. Patient Dropouts. Patient Education as Topic. Random Allocation

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  • (PMID = 6908098.001).
  • [ISSN] 0160-6891
  • [Journal-full-title] Research in nursing & health
  • [ISO-abbreviation] Res Nurs Health
  • [Language] eng
  • [Grant] United States / NHLBI NIH HHS / HL / HL 17045
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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25. ||........ 18%  Baumann A, Cuignet-Royer E, Cornet C, Trueck S, Heck M, Taron F, Peignier C, Chastel A, Gervais P, Bouaziz H, Audibert G, Mertes PM: [Interest of evaluation of professional practice for the improvement of the management of postoperative pain with patient controlled analgesia (PCA)]. Ann Fr Anesth Reanim; 2010 Oct;29(10):693-8
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  • [Title] [Interest of evaluation of professional practice for the improvement of the management of postoperative pain with patient controlled analgesia (PCA)].
  • [Transliterated title] Intérêt de l'EPP pour l'amélioration de la prise en charge de la douleur postopératoire par analgésie contrôlée par le patient (ACP).
  • OBJECTIVES: To evaluate the daily practice of postoperative PCA in Nancy University Hospital, in continuity with a quality program of postoperative pain (POP) care conducted in 2003.
  • TYPE OF STUDY: A retrospective audit of patient medical records.
  • MATERIAL AND METHODS: A review of all the medical records of consecutive surgical patients managed by PCA over a 5-week period in six surgical services.
  • RESULTS: Assessment of the hospital means: temperature chart including pain scores and PCA drug consumption, patient information leaflet, PCA protocol, postoperative pre-filled prescription form (PFPF) for post-anaesthesia care including PCA, and optional training of nurses in postoperative pain management.
  • EVALUATION OF PRACTICES: One hundred and fifty-nine files of a total of 176 patients were analyzed (88%).
  • CONCLUSIONS: The usefulness of a pre-filled prescription form for post-anaesthesia care including PCA prescription is demonstrated.
  • [MeSH-major] Analgesia, Patient-Controlled / standards. Pain, Postoperative / drug therapy. Physician's Practice Patterns

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  • [Copyright] Copyright © 2010 Elsevier Masson SAS. All rights reserved.
  • (PMID = 20729031.001).
  • [ISSN] 1769-6623
  • [Journal-full-title] Annales françaises d'anesthèsie et de rèanimation
  • [ISO-abbreviation] Ann Fr Anesth Reanim
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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26. ||........ 18%  Fraser LK, Miller M, Draper ES, McKinney PA, Parslow RC, Paediatric Intensive Care Audit Network: Place of death and palliative care following discharge from paediatric intensive care units. Arch Dis Child; 2011 Dec;96(12):1195-8
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  • [Title] Place of death and palliative care following discharge from paediatric intensive care units.
  • OBJECTIVE: To determine where children die following discharge from paediatric intensive care units (PICUs) in Great Britain and to investigate if this varies by discharge to palliative care.
  • MAIN OUTCOME MEASURES: Place of death by palliative care discharge status.
  • Discharge to palliative care resulted in fewer deaths in hospital (44.1%) (compared to non-palliative care discharges (77.7%)), a greater proportion of deaths were at home (33.3% compared to non-palliative discharges 16.1%) and in a hospice (22.5% compared to non-palliative discharges 5.8%).
  • CONCLUSIONS: Children referred to palliative care services at discharge from PICU are more likely to die in the community (home or hospice) than children not referred to palliative care.
  • [MeSH-major] Child Mortality. Intensive Care Units, Pediatric / statistics & numerical data. Palliative Care / statistics & numerical data. Patient Discharge / statistics & numerical data
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cohort Studies. Female. Great Britain / epidemiology. Home Care Services / statistics & numerical data. Hospice Care / statistics & numerical data. Hospitalization / statistics & numerical data. Humans. Infant. Infant, Newborn. Male. Referral and Consultation / statistics & numerical data

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  • (PMID = 20605865.001).
  • [ISSN] 1468-2044
  • [Journal-full-title] Archives of disease in childhood
  • [ISO-abbreviation] Arch. Dis. Child.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Investigator] Barnes P; Black N; Booth W; Child BB; Chapple J; Chaudhry B; Chisakuta A; Darowski M; Durkin N; Jenkins I; Kerr S; Laing H; Langfield I; Scott LL; Marsh M; McFadzean J; McFaul R; Morris K; Nicholl J; O'Donnell R; Pearson G; Peters M; Ralph T; Reekie L; Rowan K; Rowe S; Sammut D; Smith J; Stack C; Tanner S; Tasker R; Wozniak E; Baines P; Bowers C; Chinanga F; Claydon-Smith K; Colville G; Chisakuta A; Davis P; Durward A; Gymer G; Fraser J; Klonin H; Laing H; Mackerness C; McClelland T; McFadzean J; McLaughlin V; McKinty E; O'Donnell R; Oldham G; Pearson G; Pryor D; Rishton C; Wardhaugh A; White D
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27. ||........ 17%  Crozier S, Santoli F, Outin H, Aegerter P, Ducrocq X, Bollaert PÉ: [Severe stroke: prognosis, intensive care admission and withhold and withdrawal treatment decisions]. Rev Neurol (Paris); 2011 Jun-Jul;167(6-7):468-73
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  • [Title] [Severe stroke: prognosis, intensive care admission and withhold and withdrawal treatment decisions].
  • [Transliterated title] AVC graves : pronostic, critères d'admission en réanimation et décisions de limitations et arrêt de traitements.
  • Resuscitation and mechanical ventilation of these patients remain controversial because of the high mortality and severe disability involved.
  • Studies have shown that DNR orders are relatively frequent in acute stroke: up to 30% of all patients, and 50% of which are given upon admission.
  • Little is known about the decision making process and palliative care in these situations.
  • Other criteria could influence the withhold and withdrawal of treatment decision, such as social conditions and patient values.
  • We have to improve prognosis estimation and our understanding of patient preferences to promote patient-centered care.
  • [MeSH-major] Intensive Care. Patient Admission. Stroke / therapy. Withholding Treatment
  • [MeSH-minor] Brain Ischemia / complications. Cerebral Hemorrhage / complications. Humans. Intensive Care Units. Palliative Care. Prognosis. Respiration, Artificial. Resuscitation Orders

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  • [Copyright] Copyright © 2011 Elsevier Masson SAS. All rights reserved.
  • (PMID = 21565374.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
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28. ||........ 17%  Elliott MN, Kanouse DE, Edwards CA, Hilborne LH: Components of care vary in importance for overall patient-reported experience by type of hospitalization. Med Care; 2009 Aug;47(8):842-9
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  • [Title] Components of care vary in importance for overall patient-reported experience by type of hospitalization.
  • BACKGROUND: Patients are hospitalized for disparate conditions and procedures.
  • Patient experiences with care may depend on hospitalization type (HT).
  • OBJECTIVES: Determine whether the contributions of patient experience composite measures to overall hospital ratings on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey vary by HT.
  • To assess the importance of each composite for each HT, we calculated the simultaneous partial correlations of 7 composite scores with an overall hospital rating, controlling for patient demographics.
  • SUBJECTS: Nineteen thousand seven hundred twenty English- or Spanish-speaking adults with nonpsychiatric primary diagnoses discharged home 12/02-1/03 after an overnight inpatient stay in any of 132 general acute care hospitals in 3 states.
  • MEASURES: Patient-reported doctor communication, nurse communication, staff responsiveness, physical environment, new medicines explained, pain control, and postdischarge information; overall 0 to 10 rating of care.
  • CONCLUSIONS: The importance of patient experience dimensions differs substantially and varies by HT.
  • Quality improvement efforts should target those aspects of patient experience that matter most for each HT.
  • [MeSH-major] Communication. Hospitalization / statistics & numerical data. Patient Satisfaction. Quality of Health Care / classification. Quality of Health Care / organization & administration
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Cross-Sectional Studies. Female. Health Services Research. Humans. Male. Middle Aged. Nurse-Patient Relations. Pain / drug therapy. Pain / prevention & control. Patient Discharge. Patient Education as Topic. Personnel, Hospital. Physician-Patient Relations. Socioeconomic Factors. Young Adult

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  • (PMID = 19584764.001).
  • [ISSN] 1537-1948
  • [Journal-full-title] Medical care
  • [ISO-abbreviation] Med Care
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / 5U18 HS09204; United States / NCCDPHP CDC HHS / DP / U48/DP000056
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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29. ||........ 17%  Sunaert P, Bastiaens H, Nobels F, Feyen L, Verbeke G, Vermeire E, De Maeseneer J, Willems S, De Sutter A: Effectiveness of the introduction of a Chronic Care Model-based program for type 2 diabetes in Belgium. BMC Health Serv Res; 2010;10:207
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  • [Title] Effectiveness of the introduction of a Chronic Care Model-based program for type 2 diabetes in Belgium.
  • BACKGROUND: During a four-year action research project (2003-2007), a program targeting all type 2 diabetes patients was implemented in a well-defined geographical region in Belgium.
  • The implementation of the program resulted in an increase of the overall Assessment of Chronic Illness Care (ACIC) score from 1.45 in 2003 to 5.5 in 2007.
  • The aim of the follow-up study in 2008 was to assess the effect of the implementation of Chronic Care Model (CCM) elements on the quality of diabetes care in a country where the efforts to adapt primary care to a more chronic care oriented system are still at a starting point.
  • METHODS: A quasi-experimental study design involving a control region with comparable geographical and socio-economic characteristics and health care facilities was used to evaluate the effect of the intervention in the region.
  • RESULTS: In total 4,174 type 2 diabetes patients were selected from the research database; 2,425 patients (52.9% women) with a mean age of 67.5 from the intervention region and 1,749 patients (55.7% women) with a mean age of 67.4 from the control region.
  • In 2006 only 26% of the patients had their urine tested for micro-albuminuria and only 36% had consulted an ophthalmologist.
  • CONCLUSION: Although the overall ACIC score increased from 1.45 to 5.5, the improvement in the quality of diabetes care was moderate.
  • Further improvements are needed in the CCM components delivery system design and clinical information systems.
  • But it is clear that, simultaneously, action is needed on the health system level to realize the installation of an accurate quality monitoring system and the necessary preconditions for chronic care delivery in primary care (patient registration, staff support, IT support).
  • [MeSH-minor] Aged. Belgium. Cohort Studies. Databases, Factual. Female. Follow-Up Studies. Humans. Male. Middle Aged. Quality Indicators, Health Care


30. ||........ 16%  Gilmer T, Schneiderman LJ, Teetzel H, Blustein J, Briggs K, Cohn F, Cranford R, Dugan D, Kamatsu G, Young E: The costs of nonbeneficial treatment in the intensive care setting. Health Aff (Millwood); 2005 Jul-Aug;24(4):961-71
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  • [Title] The costs of nonbeneficial treatment in the intensive care setting.
  • Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU).
  • We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge.
  • We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.
  • [MeSH-major] Ethics Consultation / utilization. Hospital Costs / statistics & numerical data. Intensive Care / economics. Intensive Care Units / economics. Life Support Care / economics. Medical Futility
  • [MeSH-minor] Adult. Decision Making. Dissent and Disputes. Female. Humans. Length of Stay. Male. Middle Aged. Patient Discharge. Survival Analysis. United States

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  • [CommentIn] Health Aff (Millwood). 2005 Jul-Aug;24(4):976-9 [16012138.001]
  • (PMID = 16136635.001).
  • [ISSN] 0278-2715
  • [Journal-full-title] Health affairs (Project Hope)
  • [ISO-abbreviation] Health Aff (Millwood)
  • [Language] eng
  • [Grant] United States / PHS HHS / / 1 R01 H510251
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] KIE/ 128580
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach / Health Care and Public Health
  • [General-notes] KIE/ 17 refs.; KIE/ KIE Bib: allowing to die; ethicists and ethics committees; health care/economics; terminal care
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31. ||........ 16%  Sessa C, Roggero E, Pampallona S, Regazzoni S, Ghielmini M, Lang M, Marx B, Neuenschwander H, Pagani O, Vasilievic V, Cavalli F: The last 3 months of life of cancer patients: medical aspects and role of home-care services in southern Switzerland. Support Care Cancer; 1996 May;4(3):180-5
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  • [Title] The last 3 months of life of cancer patients: medical aspects and role of home-care services in southern Switzerland.
  • The clinical data on terminal cancer patients who have died since the establishment of a program of collaboration between community services and the cancer center of Canton of Ticino, southern Switzerland, were retrospectively analyzed to describe the characteristics of patients seen and the effect on them of a home-care program coordinated by the cancer center.
  • The home-care program is based on five geographically grouped community-based domiciliary services, with the addition of one nurse responsible for coordination and one physician from the oncology center.
  • Selection criteria for participation in the home-care program are defined.
  • The main outcome measures were: number of hospitalizations and median hospital stay during the last 3 months of life; reasons for and median length of last hospitalization; place of death of patients who had home care and those who did not.
  • In the group of 993 patients analyzed, the median contact time with the cancer center was 9.5 months (10th percentile: 1 month, 90th percentile: 71 months); the most frequent neoplasm was lung cancer (22%) with the briefest contact time (7.5 months; 10th percentile: 1 month; 90th percentile: 21 months); 13.5% of patients were never hospitalized; half of the patients had a total hospital stay of 24 days or longer and 23% died at home.
  • The sociodemographic and medical characteristics of home-care users were similar to those of the home-care non-users and to those of the overall group.
  • In the group of home-care users (32% of the total) 22% were never hospitalized, half of the patients had a total hospital stay of 17 days or longer, and 43.5% of them died at home.
  • These values were significantly different (P > 0.001) from those reported in the group of home-care non-users.
  • Palliative care, provided at home through community-based domiciliary services, is associated with less frequent and shorter hospitalizations in the last 3 months of life.
  • Medical oncology and palliative treatments should be mutually complementary to improve patients care.
  • Cancer centers should be involved in the planning and coordination of supportive-care domiciliary services.
  • [MeSH-major] Home Care Services. Neoplasms / therapy. Terminal Care
  • [MeSH-minor] Aged. Breast Neoplasms / therapy. Cancer Care Facilities / organization & administration. Community Health Services / organization & administration. Female. Hospitalization. Humans. Length of Stay. Lung Neoplasms / therapy. Male. Medical Oncology / organization & administration. Middle Aged. Palliative Care / organization & administration. Professional-Patient Relations. Retrospective Studies. Switzerland. Treatment Outcome

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  • [CommentIn] Support Care Cancer. 1996 May;4(3):157 [8739645.001]
  • (PMID = 8739649.001).
  • [ISSN] 0941-4355
  • [Journal-full-title] Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
  • [ISO-abbreviation] Support Care Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
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32. ||........ 16%  Amanyire G, Wanyenze R, Alamo S, Kwarisiima D, Sunday P, Sebikaari G, Kamya M, Wabwire-Mangen F, Wagner G: Client and provider perspectives of the efficiency and quality of care in the context of rapid scale-up of antiretroviral therapy. AIDS Patient Care STDS; 2010 Nov;24(11):719-27
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  • [Title] Client and provider perspectives of the efficiency and quality of care in the context of rapid scale-up of antiretroviral therapy.
  • In June-August 2008, we conducted a formative evaluation on ART scale-up and clinic operations at three clinics in Uganda to generate lessons for informing policy and larger public health care systems.
  • Site visits and semistructured interviews with 10 ART clients and 6 providers at each clinic were used to examine efficiency of clinic operations (patient flow, staff allocation to appropriate duties, scheduling of clinic visits, record management) and quality of care (attending to both client and provider needs, and providing support for treatment adherence and retention).
  • Clients reported long waiting times but otherwise general satisfaction with the quality of care.
  • Providers reported good patient adherence and retention, and support mechanisms for clients.
  • Both providers and clients perceive these clinics to be delivering good quality care, despite the recognition of congested clinics and long waiting times.
  • [MeSH-major] Ambulatory Care Facilities. Anti-HIV Agents / therapeutic use. Attitude of Health Personnel. Efficiency, Organizational. HIV Infections / drug therapy. Quality of Health Care
  • [MeSH-minor] Appointments and Schedules. Health Care Surveys. Humans. Interviews as Topic. Office Visits / statistics & numerical data. Patient Care. Time Factors. Uganda

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  • [Cites] AIDS Patient Care STDS. 2007 Nov;21(11):871-88 [18240896.001]
  • [Cites] PLoS One. 2008;3(5):e2204 [18493615.001]
  • [Cites] J Acquir Immune Defic Syndr. 2009 Mar 1;50(3):276-82 [19194316.001]
  • [Cites] AIDS Patient Care STDS. 2010 Feb;24(2):117-26 [20059356.001]
  • [Cites] AIDS. 2010 Jan;24 Suppl 1:S45-57 [20023439.001]
  • [Cites] AIDS Patient Care STDS. 2009 Dec;23(12):1059-66 [20025515.001]
  • [Cites] BMC Public Health. 2009;9:290 [19671185.001]
  • (PMID = 21034243.001).
  • [ISSN] 1557-7449
  • [Journal-full-title] AIDS patient care and STDs
  • [ISO-abbreviation] AIDS Patient Care STDS
  • [Language] eng
  • [Grant] United States / NICHD NIH HHS / HD / 1R24HD056651-D1; United States / NICHD NIH HHS / HD / R24 HD056651
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-HIV Agents
  • [Other-IDs] NLM/ PMC2994592
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33. ||........ 16%  Beydon L, Pelluchon C, Beloucif S, Baghdadi H, Baumann A, Bazin JE, Bizouarn P, Crozier S, Devalois B, Eon B, Fieux F, Frot C, Gisquet E, Guibet Lafaye C, Kentish-Barnes N, Muzard O, Nicolas-Robin A, Lopez MO, Roussin F, Puybasset L, Sfar: [Euthanasia, assisted suicide and palliative care: a review by the Ethics Committee of the French Society of Anaesthesia and Intensive Care]. Ann Fr Anesth Reanim; 2012 Sep;31(9):694-703
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  • [Title] [Euthanasia, assisted suicide and palliative care: a review by the Ethics Committee of the French Society of Anaesthesia and Intensive Care].
  • [Transliterated title] Fin de vie, euthanasie et suicide assisté : une mise au point de la Société française d'anesthésie et de réanimation (Sfar).
  • This issue raises questions for doctors and most especially for anesthetists and intensive care physicians.
  • RESULTS: The current French law addresses most of the end of life issues an intensive care physician might encounter.
  • It is credited for imposing palliative care when therapies have become senseless and are withdrawn.
  • However, this requirement for palliative care is generally applied too late in the course of a fatal illness.
  • On the rare occasions when E/AS is requested, either by the patient or their loved-ones, it often results from a failure to consider that treatments have become senseless and conflict with patient's best interest.
  • Should we address painful end of life and moral suffering issues, by suppressing the subject, i.e. ending the patient's life, when comprehensive palliative care has not first been fully granted to all patients in need of it ?
  • [MeSH-major] Anesthesiology / ethics. Euthanasia / ethics. Palliative Care / ethics. Suicide, Assisted / ethics
  • [MeSH-minor] Ethics Committees. Europe. Family. France. Humans. Intensive Care / ethics. Legislation, Medical. Oregon. Physicians. Societies, Medical. Terminal Care / ethics

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  • [Copyright] Copyright © 2012 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.
  • (PMID = 22922010.001).
  • [ISSN] 1769-6623
  • [Journal-full-title] Annales françaises d'anesthèsie et de rèanimation
  • [ISO-abbreviation] Ann Fr Anesth Reanim
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
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34. ||........ 16%  Peruselli C, Di Giulio P, Toscani F, Gallucci M, Brunelli C, Costantini M, Tamburini M, Paci E, Miccinesi G, Addington-Hall JM, Higginson IJ: Home palliative care for terminal cancer patients: a survey on the final week of life. Palliat Med; 1999 May;13(3):233-41
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  • [Title] Home palliative care for terminal cancer patients: a survey on the final week of life.
  • As part of a large multicentre study on palliative care units in Italy, carried out between 1 January and 30 June 1995, we describe the place, circumstances and 'quality of death' of patients admitted to home palliative care.
  • Data presented refer to 401 patients (67% of the 601 patients randomly selected for evaluation).
  • Of these 401 patients 303 (76%) died at home.
  • Invasive procedures were undertaken on 56% of patients, while in hospital the percentage increased to 75%.
  • Twenty-five per cent of patients were totally pharmacologically sedated during the final 12 h of life.
  • Neither the number of symptoms nor other factors were apparently associated with the decision to sedate the patient.
  • The wide variations in the frequency of sedation among centres suggest that the choice to sedate the patient may reflect the provider's behaviour or services' policy rather than the patients' preference or needs.
  • The definition of common criteria and guidelines for sedation of patients should be one of the topics for discussion among palliative care teams.
  • [MeSH-major] Neoplasms / therapy. Palliative Care / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analgesia. Death. Female. Health Care Surveys. Home Care Services. Humans. Hypnotics and Sedatives / therapeutic use. Italy. Male. Middle Aged. Quality of Life. Terminal Care / methods

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  • (PMID = 10474710.001).
  • [ISSN] 0269-2163
  • [Journal-full-title] Palliative medicine
  • [ISO-abbreviation] Palliat Med
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Hypnotics and Sedatives
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35. ||........ 16%  Davis S, Byers S, Walsh F: Measuring person-centred care in a sub-acute health care setting. Aust Health Rev; 2008 Aug;32(3):496-504
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Measuring person-centred care in a sub-acute health care setting.
  • OBJECTIVE: A more appropriate tool to measure the client experience of person-centred care is required to complement other existing measures of quality.
  • MAIN OUTCOME MEASURE: 20-item Patient-Centred Inpatient Scale (P-CIS) developed by Coyle and Williams (2001).
  • Personalisation and respect dimensions are the main strengths of person-centred care in the health care setting in which the P-CIS was trialled, with personalisation scoring 0.75 and respect scoring 0.77.
  • CONCLUSIONS: The P-CIS demonstrates the potential to be a contributing component that informs the monitoring and improvement of quality person-centred care in Australian inpatient health care settings.
  • [MeSH-major] Homes for the Aged / standards. Patient Satisfaction / statistics & numerical data. Patient-Centered Care / standards. Quality Assurance, Health Care. Subacute Care / standards
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Health Services Research. Humans. Male. Patient Discharge. Qualitative Research. Questionnaires. Victoria

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  • [CommentIn] Aust Health Rev. 2008 Aug;32(3):494-5 [18666877.001]
  • (PMID = 18666878.001).
  • [ISSN] 0156-5788
  • [Journal-full-title] Australian health review : a publication of the Australian Hospital Association
  • [ISO-abbreviation] Aust Health Rev
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Australia
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36. ||........ 16%  Tu W, Zhou XH: A Wald test comparing medical costs based on log-normal distributions with zero valued costs. Stat Med; 1999 Oct 30;18(20):2749-61
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  • Finally, we illustrate the use of the proposed Wald test by analysing a clinical study assessing the effects of a computerized prospective drug utilization intervention on in-patient charges.
  • [MeSH-major] Computer Simulation. Drug Utilization Review / economics. Health Care Costs / statistics & numerical data. Patient Care / economics

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  • [Copyright] Copyright 1999 John Wiley & Sons, Ltd.
  • (PMID = 10521864.001).
  • [ISSN] 0277-6715
  • [Journal-full-title] Statistics in medicine
  • [ISO-abbreviation] Stat Med
  • [Language] eng
  • [Grant] United States / NIMH NIH HHS / MH / R01MH58875; United States / AHRQ HHS / HS / R03HS03543; United States / AHRQ HHS / HS / R29HS08559
  • [Publication-type] Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] ENGLAND
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37. ||........ 15%  Fischer AF, Stevenson DK: The consequences of uncertainty. An empirical approach to medical decision making in neonatal intensive care. JAMA; 1987 Oct 9;258(14):1929-31
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  • [Title] The consequences of uncertainty. An empirical approach to medical decision making in neonatal intensive care.
  • The policy of the Stanford University Medical Center on care for extremely premature neonates has been generally to initiate intensive care "based on a nonprobabilistic paradigm with a goal of saving every infant's life.
  • " Fischer and Stevenson analyzed the mortality rates, weights, gestational ages, and total costs of care for a sample of 68 low birth weight neonates.
  • They also examined the outcomes of care in terms of degree of disability for the 24 surviving infants.
  • They advocate use of an "individualized prognostic strategy" that takes into account the interplay of statistical prediction, the physician's assessment of clinical course, and parental responses when physicians suggest discontinuing aggressive care.
  • [MeSH-major] Critical Care. Decision Support Techniques. Infant, Premature, Diseases / therapy. Patient Selection. Resource Allocation. Risk Assessment. Stress, Psychological
  • [MeSH-minor] Humans. Infant, Newborn. Intensive Care Units, Neonatal. Probability. Social Values. Value of Life. Withholding Treatment

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  • (PMID = 3309387.001).
  • [ISSN] 0098-7484
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / RR-00081
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 25110
  • [Keywords] KIE ; Stanford University Medical Center (major topic) / Death and Euthanasia / Empirical Approach / Health Care and Public Health / Professional Patient Relationship
  • [General-notes] KIE/ KIE BoB Subject Heading: allowing to die/infants; KIE/ KIE BoB Subject Heading: patient care/minors; KIE/ KIE BoB Subject Heading: resource allocation/biomedical technologies; KIE/ KIE BoB Subject Heading: selection for treatment; KIE/ Full author name: Fischer, Allen F; KIE/ Full author name: Stevenson, David K
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38. ||........ 15%  Nathan N, Taam RA, Epaud R, Delacourt C, Deschildre A, Reix P, Chiron R, de Pontbriand U, Brouard J, Fayon M, Dubus JC, Giovannini-Chami L, Bremont F, Bessaci K, Schweitzer C, Dalphin ML, Marguet C, Houdouin V, Troussier F, Sardet A, Hullo E, Gibertini I, Mahloul M, Michon D, Priouzeau A, Galeron L, Vibert JF, Thouvenin G, Corvol H, Deblic J, Clement A, French RespiRare® Group: A national internet-linked based database for pediatric interstitial lung diseases: the French network. Orphanet J Rare Dis; 2012;7:40
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  • After patient's parents' oral consent is obtained, physicians enter the data of children with ILD: identity, social data and environmental data; specific aetiological diagnosis of the ILD if known, genetics, patient visits to the centre, and all medical examinations and tests done for the diagnosis and/or during follow up.
  • Each participating centre has a free access to his own patients' data only, and cross-centre studies require mutual agreement.
  • Physicians may use the system as a daily aid for patient care through a web-linked medical file, backed on this database.
  • A specific aetiology was identified in 149 (72.7%) patients while 56 (27.3%) cases remain undiagnosed.
  • This database is a great opportunity to improve patient care and disease pathogenesis knowledge.
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. France. Government Programs. Humans. Infant. Male. Patient Care. Rare Diseases


39. ||........ 15%  Schneiderman LJ, Gilmer T, Teetzel HD, Dugan DO, Blustein J, Cranford R, Briggs KB, Komatsu GI, Goodman-Crews P, Cohn F, Young EW: Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA; 2003 Sep 3;290(9):1166-72
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  • [Title] Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial.
  • OBJECTIVE: To investigate whether ethics consultations in the intensive care setting reduce the use of life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, as well as the reactions to the consultations of physicians, nurses, and patients/surrogates.
  • SETTING: Adult intensive care units (ICUs) of 7 US hospitals representing a spectrum of institutional characteristics.
  • PATIENTS: Five hundred fifty-one patients in whom value-related treatment conflicts arose during the course of treatment.
  • INTERVENTIONS: Patients were randomly assigned either to an intervention (ethics consultation offered) (n = 278) or to usual care (n = 273).
  • MAIN OUTCOME MEASURES: The primary outcomes were ICU days and life-sustaining treatments in those patients who did not survive to hospital discharge.
  • We examined the same measures in those who did survive to discharge and also compared the overall mortality rates of the intervention and usual care groups.
  • We also interviewed physicians and nurses and patients/surrogates about their views of the ethics consultation.
  • RESULTS: The intervention and usual-care groups showed no difference in mortality.
  • However, ethics consultations were associated with reductions in hospital (-2.95 days, P =.01) and ICU (-1.44 days, P =.03) days and life-sustaining treatments (-1.7 days with ventilation, P =.03) in those patients who ultimately did not survive to discharge.
  • The majority (87%) of physicians, nurses, and patients/surrogates agreed that ethics consultations in the ICU were helpful in addressing treatment conflicts.
  • [MeSH-major] Ethics Consultation. Intensive Care / ethics. Patient Care Planning
  • [MeSH-minor] Adult. Ethics, Clinical. Humans. Intensive Care Units / ethics. Length of Stay. Medical Futility. Patient Care Team. Prospective Studies. United States

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  • [CommentIn] Evid Based Nurs. 2004 Apr;7(2):53 [15106633.001]
  • [CommentIn] JAMA. 2003 Dec 24;290(24):3191; author reply 3191-2 [14693865.001]
  • [CommentIn] JAMA. 2003 Dec 24;290(24):3191; author reply 3191-2 [14693864.001]
  • [CommentIn] ACP J Club. 2004 Mar-Apr;140(2):36 [15122856.001]
  • [CommentIn] JAMA. 2003 Sep 3;290(9):1208-10 [12953005.001]
  • (PMID = 12952998.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / 1 R01 HS10251
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] KIE/ 111153
  • [Keywords] KIE ; Bioethics and Professional Ethics / Death and Euthanasia / Empirical Approach
  • [General-notes] KIE/ 14 refs.; KIE/ KIE Bib: allowing to die; ethicists and ethics committees
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40. |......... 15%  Wolfe F, Kleinheksel SM, Spitz PW, Lubeck DP, Fries JF, Young DY, Mitchell DM, Roth SH: A multicenter study of hospitalization in rheumatoid arthritis: effect of health care system, severity, and regional difference. J Rheumatol; 1986 Apr;13(2):277-84
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  • [Title] A multicenter study of hospitalization in rheumatoid arthritis: effect of health care system, severity, and regional difference.
  • During 1981, centers in Phoenix, Saskatoon, Stanford and Wichita monitored hospitalizations for 816 patients with rheumatoid arthritis.
  • Admissions were related primarily to disease severity, but in US centers, were reduced by a factor of 3 by prepaid health care.
  • Length of stay was shortest in California (7.3 days), and longest in Saskatoon (16.3) where designated arthritis beds and government prepaid health care existed.
  • Charges and length of stay were unrelated to disease severity, but were responsive to health care delivery system, availability of facilities, and geographic and center variation.
  • [MeSH-minor] Arizona. California. Costs and Cost Analysis. Female. Humans. Insurance, Health. Kansas. Length of Stay / economics. Male. Middle Aged. Patient Admission. Saskatchewan

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  • (PMID = 3723493.001).
  • [ISSN] 0315-162X
  • [Journal-full-title] The Journal of rheumatology
  • [ISO-abbreviation] J. Rheumatol.
  • [Language] eng
  • [Grant] United States / NIADDK NIH HHS / AM / AM21393
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] CANADA
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41. |......... 15%  Wenger NS, Lynn J, Oye RK, Liu H, Teno JM, Phillips RS, Desbiens NA, Sehgal A, Kussin P, Taub H, Harrell F, Knaus W: Withholding versus withdrawing life-sustaining treatment: patient factors and documentation associated with dialysis decisions. J Am Geriatr Soc; 2000 May;48(5 Suppl):S75-83
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  • [Title] Withholding versus withdrawing life-sustaining treatment: patient factors and documentation associated with dialysis decisions.
  • OBJECTIVE: We evaluated prospectively the use of acute hemodialysis among hospitalized patients to identify demographic and clinical predictors of and chart documentation concerning dialysis withheld and withdrawn.
  • PATIENTS: Five hundred sixty-five seriously ill hospitalized patients who had not previously undergone dialysis who developed renal failure.
  • MAIN OUTCOME MEASURES: Patient demographics, clinical characteristics, preferences, and prognostic estimates associated with having dialysis withheld rather than initiated and withdrawn rather than continued.
  • RESULTS: Older patient age, cancer diagnosis, and male gender were associated with dialysis withheld rather than withdrawn.
  • Age and gender differences persisted after adjustment for patients' aggressiveness of care preference.
  • Chart documentation of decision-making was lacking more often for patients with dialysis withheld than for dialysis withdrawn.
  • CONCLUSIONS: Measuring the equity of life-sustaining treatment use will require evaluation of care withheld, not just care withdrawn.
  • Older patients and men, after accounting for prognosis and function, are more likely to have dialysis withheld than withdrawn after a trial.
  • Further exploration is needed into this disparity and the inadequate chart documentation for patients with dialysis withheld.
  • [MeSH-major] Acute Kidney Injury / therapy. Decision Making. Euthanasia, Passive. Medical Records. Physician-Patient Relations. Renal Dialysis. Withholding Treatment
  • [MeSH-minor] APACHE. Age Factors. Communication. Decision Support Techniques. Female. Hospitalization. Humans. Insurance, Health. Logistic Models. Male. Middle Aged. Patient Participation. Prognosis. Prospective Studies. Social Class

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  • (PMID = 10809460.001).
  • [ISSN] 0002-8614
  • [Journal-full-title] Journal of the American Geriatrics Society
  • [ISO-abbreviation] J Am Geriatr Soc
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 101303
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach
  • [General-notes] KIE/ Wenger, Neil S; Lynn, Joannne; Oye, Robert K; Liu, Honghu; Teno, Joan M; Phillips, Russell S; Desbiens, Norman A; Sehgal, Ashwini; Kussin, Peter; Taub, H arry; Harrell, Frank; Knaus, William; KIE/ 28 refs.; KIE/ KIE Bib: allowing to die
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42. |......... 15%  Zeng F, O'Leary JF, Sloss EM, Lopez MS, Dhanani N, Melnick G: The effect of medicare health maintenance organizations on hospitalization rates for ambulatory care-sensitive conditions. Med Care; 2006 Oct;44(10):900-7
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  • [Title] The effect of medicare health maintenance organizations on hospitalization rates for ambulatory care-sensitive conditions.
  • OBJECTIVE: The objective of this study was to estimate the effect of Medicare Health Maintenance Organization (HMO) enrollment on hospitalization rates and total inpatient days for ambulatory care-sensitive conditions (ACSCs) after controlling for selection.
  • [MeSH-major] Ambulatory Care. Health Maintenance Organizations / organization & administration. Hospitalization / trends. Medicare / organization & administration
  • [MeSH-minor] Aged. Aged, 80 and over. California. Fee-for-Service Plans. Female. Humans. Male. Medical Audit. Models, Statistical. Patient Discharge

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  • (PMID = 17001260.001).
  • [ISSN] 0025-7079
  • [Journal-full-title] Medical care
  • [ISO-abbreviation] Med Care
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / R01HS10256-01
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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43. |......... 15%  Villars H, Dupuy C, Soler P, Gardette V, Soto ME, Gillette S, Nourhashemi F, Vellas B: A follow-up intervention in severely demented patients after discharge from a special Alzheimer acute care unit: impact on early emergency room re-hospitalization rate. Int J Geriatr Psychiatry; 2013 Nov;28(11):1131-40
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  • [Title] A follow-up intervention in severely demented patients after discharge from a special Alzheimer acute care unit: impact on early emergency room re-hospitalization rate.
  • BACKGROUND: Emergency room (ER) re-hospitalizations are prevalent in severe Alzheimer's disease affected older patients.
  • SETTING: Discharge of severely demented patients from a Special Alzheimer Acute Care Unit.
  • PARTICIPANTS: A total of 390 patients hospitalized in the unit from 2007 through 2009, with at least one of the following characteristics: severe disruptive behavioral and psychological symptoms of dementia (BPSD) (agitation, aggressiveness, and psychotic symptoms), change of living arrangement related to BPSD, exhaustion of the principal caregiver, and discharge of a subject with anosognosia living alone in the community.
  • INTERVENTION: The intervention consisted of an individualized care plan, targeting the problems observed during the hospital stay, implemented by the means of regular telephone contacts (in the first week after discharge, before the end of the first month, and then at 3 and 6 months) between a geriatric team and the patient's caregiver.
  • When required, these calls were followed by a consultation with a physician or psychologist, or by a consultation in the patient's home.
  • Vocal disruptive behavior are more prevalent in re-hospitalized patients (9.64% versus 3.97%, p = 0.05) than in non re-hospitalized patients.
  • Interventions addressing severe dementia affected patients with BPSD are needed, as this is a major issue in the organization of health care systems.
  • [MeSH-major] Dementia / therapy. Emergency Service, Hospital / statistics & numerical data. Patient Readmission / statistics & numerical data
  • [MeSH-minor] Aftercare / organization & administration. Aged. Aged, 80 and over. Female. Follow-Up Studies. Hospital Units / statistics & numerical data. Humans. Male. Patient Discharge

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  • [Copyright] Copyright © 2013 John Wiley & Sons, Ltd.
  • (PMID = 23348897.001).
  • [ISSN] 1099-1166
  • [Journal-full-title] International journal of geriatric psychiatry
  • [ISO-abbreviation] Int J Geriatr Psychiatry
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Keywords] NOTNLM ; Alzheimer's disease / behavioral and psychological symptoms of dementia / emergency room re-hospitalization / severe dementia
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44. |......... 15%  Schlesinger M, Dorwart RA, Epstein SS: Managed care constraints on psychiatrists' hospital practices: bargaining power and professional autonomy. Am J Psychiatry; 1996 Feb;153(2):256-60
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  • [Title] Managed care constraints on psychiatrists' hospital practices: bargaining power and professional autonomy.
  • OBJECTIVE: The increasing involvement of insurers and hospitals in monitoring patient care is encroaching on the psychiatrist's autonomy in making clinical decisions.
  • They were questioned about whether the hospital or insurers had pressured them to change their inpatient practices or had attempted to discourage admission of certain types of patients.
  • RESULTS: More than three quarters of those surveyed reported pressure from insurers for early discharge; nearly two-thirds said hospitals limited length of stay; and about half had been discouraged from admitting severely ill patients, the uninsured, or Medicaid recipients.
  • Severely ill patients and those with little or no insurance are more likely than others to be affected by these limits on psychiatrists' autonomy.
  • [MeSH-major] Hospitalization. Managed Care Programs. Mental Disorders / therapy. Psychiatry / organization & administration

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  • [CommentIn] Am J Psychiatry. 1997 Mar;154(3):443 [9054810.001]
  • (PMID = 8561208.001).
  • [ISSN] 0002-953X
  • [Journal-full-title] The American journal of psychiatry
  • [ISO-abbreviation] Am J Psychiatry
  • [Language] eng
  • [Grant] United States / NIMH NIH HHS / MH / MH-01177; United States / NIMH NIH HHS / MH / MH-40316
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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45. |......... 15%  Maltoni M, Miccinesi G, Morino P, Scarpi E, Bulli F, Martini F, Canzani F, Dall'Agata M, Paci E, Amadori D: Prospective observational Italian study on palliative sedation in two hospice settings: differences in casemixes and clinical care. Support Care Cancer; 2012 Nov;20(11):2829-36
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  • [Title] Prospective observational Italian study on palliative sedation in two hospice settings: differences in casemixes and clinical care.
  • PURPOSE: Palliative sedation (PS) has been defined as the use of sedative medications to relieve intolerable suffering from refractory symptoms by a reduction in patient consciousness.
  • It is sometimes necessary in end-of-life care when patients present refractory symptoms.
  • METHODS: This observational longitudinal cohort study was conducted over a period of 9 months on 327 patients consecutively admitted to two 11-bed Italian hospices (A and B) with different casemixes in terms of median patient age (hospice A, 66 years vs. hospice B, 73 years; P = 0.005), mean duration of hospice stay (hospice A, 13.5 days vs. hospice B, 18.3 days; P = 0.005), and death rate (hospice A, 57.2% vs. hospice B, 89.9%; P < 0.0001).
  • Sedated patients constituted 22% of the total admissions and 31.9% of deceased patients, which did not prove to be significantly different in the two hospices after adjustment for casemix.
  • RESULTS: Patient involvement in clinical decision-making about sedation was significantly higher in hospice B (59.3% vs. 24.4%; P = 0.007).
  • The maximum level of sedation (RASS, -5) was necessary in only 58.3% of sedated patients.
  • Overall survival in sedated and nonsedated patients was superimposable, with a trend in favor of sedated patients.
  • [MeSH-major] Hospice Care / methods. Hypnotics and Sedatives / administration & dosage. Palliative Care / methods. Terminal Care / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Cohort Studies. Decision Making. Diagnosis-Related Groups. Female. Humans. Italy. Length of Stay. Longitudinal Studies. Male. Middle Aged. Neoplasms / pathology. Patient Participation. Prospective Studies. Young Adult

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  • (PMID = 22361826.001).
  • [ISSN] 1433-7339
  • [Journal-full-title] Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
  • [ISO-abbreviation] Support Care Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Hypnotics and Sedatives
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46. |......... 15%  Narain P, Rubenstein LZ, Wieland GD, Rosbrook B, Strome LS, Pietruszka F, Morley JE: Predictors of immediate and 6-month outcomes in hospitalized elderly patients. The importance of functional status. J Am Geriatr Soc; 1988 Sep;36(9):775-83
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  • [Title] Predictors of immediate and 6-month outcomes in hospitalized elderly patients. The importance of functional status.
  • This article presents results of a prospective multivariate study of hospitalized elderly patients at an acute-care Veterans Administration (VA) hospital to identify factors on hospital admission predictive of several short- and long-term outcomes: in-hospital and 6-month mortality, immediate and delayed nursing home admission, length of hospital stay, and 6-month rehospitalization.
  • All patients aged 70 years and over admitted to acute-care beds on the medical service wards during a 1-year period were included in the study (N = 396).
  • These data may be helpful in improving discharge planning, in resource allocation, and in targeting patients for different specialized geriatric programs.
  • [MeSH-major] Hospitalization. Outcome and Process Assessment (Health Care)
  • [MeSH-minor] Activities of Daily Living. Aged. Disease. Female. Follow-Up Studies. Forecasting. Humans. Length of Stay. Male. Mortality. Nursing Homes. Patient Discharge. Patient Readmission. Prospective Studies

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  • (PMID = 3411059.001).
  • [ISSN] 0002-8614
  • [Journal-full-title] Journal of the American Geriatrics Society
  • [ISO-abbreviation] J Am Geriatr Soc
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] UNITED STATES
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47. |......... 14%  Pettinati HM, Meyers K, Jensen JM, Kaplan F, Evans BD: Inpatient vs outpatient treatment for substance dependence revisited. Psychiatr Q; 1993;64(2):173-82
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  • [Title] Inpatient vs outpatient treatment for substance dependence revisited.
  • Further examination of these studies revealed shortcomings such as the use of random assignment designs which excluded psychiatrically-complicated patients.
  • Carrier Foundation's inpatient/outpatient study of private psychiatric patients with alcohol and/or cocaine dependence includes a patient-treatment matching design to address weaknesses in the existing literature.
  • Patients with high psychiatric severity and/or a poor social support system are predicted to have a better outcome in inpatient treatment, while patients with low psychiatric severity and/or a good social support system may do well as outpatients without incurring the higher costs of inpatient treatment.
  • While the determination of long-term follow-up status of early treatment failures is currently underway, this finding underscores the potential risk of early treatment failure in outpatient compared to inpatient substance abuse treatment programs and the importance of addressing the issue of early attrition in conducting outcome analyses.
  • [MeSH-major] Hospitalization. Psychotropic Drugs. Street Drugs. Substance-Related Disorders / rehabilitation
  • [MeSH-minor] Ambulatory Care. Combined Modality Therapy. Humans. Substance Abuse Treatment Centers

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  • (PMID = 8391147.001).
  • [ISSN] 0033-2720
  • [Journal-full-title] The Psychiatric quarterly
  • [ISO-abbreviation] Psychiatr Q
  • [Language] eng
  • [Grant] United States / NIAAA NIH HHS / AA / AA07831
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Psychotropic Drugs; 0 / Street Drugs
  • [Number-of-references] 22
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48. |......... 14%  Frank RG, Salkever DS, Mullann F: Hospital ownership and the care of uninsured and Medicaid patients: findings from the National Hospital Discharge Survey 1979-1984. Health Policy; 1990 Jan-Feb;14(1):1-11
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  • [Title] Hospital ownership and the care of uninsured and Medicaid patients: findings from the National Hospital Discharge Survey 1979-1984.
  • Previous studies of the share of the burden of uncompensated care borne by various provider groups present opposing findings.
  • On the whole the results of the survey tend to support the argument that private non-profit hospitals do indeed render greater public services in treating indigent patients than do for-profit hospitals.
  • [MeSH-minor] Data Collection. Evaluation Studies as Topic. Hospitals, Proprietary / utilization. Hospitals, Public / utilization. Hospitals, Voluntary / utilization. Patient Discharge / statistics & numerical data. United States

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  • (PMID = 10106593.001).
  • [ISSN] 0168-8510
  • [Journal-full-title] Health policy (Amsterdam, Netherlands)
  • [ISO-abbreviation] Health Policy
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / HS05614
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] NETHERLANDS
  • [Other-IDs] KIE/ 32616
  • [Keywords] KIE ; Medicaid (major topic) / Empirical Approach / Health Care and Public Health / National Hospital Discharge Survey
  • [General-notes] KIE/ 10 fn.; KIE/ KIE BoB Subject Heading: health care/economics; KIE/ Full author name: Frank, Richard G; KIE/ Full author name: Salkever, David S; KIE/ Full author name: Mullan, Fitzhugh
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49. |......... 14%  Harwood RH, Goldberg SE, Whittamore KH, Russell C, Gladman JR, Jones RG, Porock D, Lewis SA, Bradshaw LE, Elliot RA, Medical Crises in Older People Study Group (MCOP): Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit. Trials; 2011;12:123
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  • [Title] Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit.
  • BACKGROUND: Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences.
  • Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers.
  • We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective.
  • METHODS/DESIGN: We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care.
  • Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'.
  • The evaluation design has been adapted to accommodate pressures on bed management and patient flows.
  • If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards.
  • Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected.
  • Quality of care and patient experience are assessed in a non-participant observer study.
  • The primary outcome is days spent at home (for those admitted from home), or days spent in the same care home (if admitted from a care home).
  • Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of life, cognitive function, disability, behavioural and psychological symptoms, carer strain and carer satisfaction with hospital care.
  • Analyses will comprise comparisons of process, outcomes and costs between the specialist unit and standard care treatment groups.
  • [MeSH-major] Confusion / therapy. Delirium / therapy. Dementia / therapy. Emergency Service, Hospital. Health Services for the Aged. Hospital Units. Hospitals, General. Mental Health Services. Patient Admission. Research Design
  • [MeSH-minor] Age Factors. Aged. Caregivers / psychology. Cognition. Cost-Benefit Analysis. Disability Evaluation. England. Hospital Costs. Humans. Length of Stay. Patient Discharge. Patient Readmission. Psychiatric Status Rating Scales. Quality of Life. Questionnaires. Time Factors. Treatment Outcome

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  • [Cites] J Neuropsychiatry Clin Neurosci. 2001 Spring;13(2):229-42 [11449030.001]
  • [Cites] QJM. 2001 Oct;94(10):521-6 [11588210.001]
  • [Cites] Lancet. 2001 Nov 10;358(9293):1586-92 [11716885.001]
  • [Cites] Cochrane Database Syst Rev. 2002;(1):CD000197 [11869570.001]
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  • (PMID = 21569471.001).
  • [ISSN] 1745-6215
  • [Journal-full-title] Trials
  • [ISO-abbreviation] Trials
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT01136148
  • [Grant] United Kingdom / Department of Health / / RP-PG-0407-10147
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3117715
  • [Investigator] Schneider J; Conroy S; Avery A; Jurgens F; Edmans J; Gordon A; Robbins B; Dyas J; Logan P; Quinn C; Boardman H; Franklin M
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50. |......... 14%  Simon ST, Higginson IJ, Harding R, Daveson BA, Gysels M, Deliens L, Echteld MA, Radbruch L, Toscani F, Krzyzanowski DM, Costantini M, Downing J, Ferreira PL, Benalia A, Bausewein C, PRISMA: Enhancing patient-reported outcome measurement in research and practice of palliative and end-of-life care. Support Care Cancer; 2012 Jul;20(7):1573-8
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  • [Title] Enhancing patient-reported outcome measurement in research and practice of palliative and end-of-life care.
  • PURPOSE: Patient-reported outcome measurement (PROM) plays an increasing role in palliative and end-of-life (EOL) care but their use in EOL care and research remains varied and inconsistent.
  • We aimed to facilitate pan-European collaboration to improve PROMs in palliative and EOL care and research.
  • METHODS: The study includes a workshop with experts experienced in using PROMs in clinical care and research from Europe, North America, and Africa.
  • CONCLUSION: PROMs must be based on rigorous scientific methods and respond to patient complexity.
  • Coordinated pan-European collaboration including researchers and clinicians is required to develop and attain quality care and systematic research in outcome measurement in palliative and EOL care.
  • [MeSH-major] Cooperative Behavior. Outcome Assessment (Health Care) / methods. Palliative Care / methods. Terminal Care / methods
  • [MeSH-minor] Biomedical Research / methods. Europe. Humans. International Cooperation. Quality Assurance, Health Care

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  • (PMID = 22391595.001).
  • [ISSN] 1433-7339
  • [Journal-full-title] Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
  • [ISO-abbreviation] Support Care Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Investigator] Harding R; Higginson IJ; Bausewein C; Albers G; Antunes B; Pinto AB; Bausewein C; Bechinger-English D; Benalia H; Bradley L; Ceulemans L; Daveson BA; Deliens L; Derycke N; de Vlieger M; Dillen L; Downing J; Echteld M; Evans N; Haugen DF; Flood L; Gikaara N; Gomes B; Gysels M; Hall S; Harding R; Higginson IJ; Kaasa S; Koffman J; Ferreira PL; Menten J; Calanzani NM; Murtagh F; Onwuteaka-Philipsen B; Pasman R; Pettenati F; Pool R; Powell T; Ribbe M; Sigurdardottir K; Simon S; Toscani F; van den Eynden B; van der Steen J; Vanden Berghe P; van Iersel T; Deliens L; McIntyre P; Abesadze I; Bausewein C; Adis C; Müller-Busch C; Radbruch L; Simon S; Voltz R; Hegedus K; Larkin P; Brunelli C; Costantini M; Toscani F; Echteld M; Haugen DF; Krzyzanowski D; Krajnik M; Medicum C; Ferreira PL; Antunes B; Gysels M; Eychmüller S; Downing J; Higginson I; Harding R; Daveson B; Gomes B; Benalia H; Beynon T; Bisset M
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51. |......... 14%  Harrison J, Marshall S, Marshall P, Marshall J, Creed F: Day hospital vs. home treatment--a comparison of illness severity and costs. Soc Psychiatry Psychiatr Epidemiol; 2003 Oct;38(10):541-6
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  • BACKGROUND: Acute home treatment services, providing short-term intensive input as an alternative to in-patient admission, have been recommended by the Department of Health as part of a spectrum of care.
  • The lack of research evidence for such services is in contrast to acute day hospital care which has been better researched, but not widely adopted.
  • This paper compares the patients treated in a randomised controlled trial (RCT) of day hospital vs. in-patient care with patients treated several years later in the home treatment service which developed from the original acute day hospital.
  • METHOD: In the original RCT, patients were randomised at the point of admission to day hospital or in-patient care.
  • Secondary care costs for the home treatment sample (including in-patient, home treatment and out-patient costs) were intermediate between the costs for the day hospital and in-patient samples from the RCT, but the differences were not statistically significant.
  • CONCLUSIONS: Extending the remit of an acute day hospital to provide 24-h care and a choice of treatment location is associated with an increase in the severity of illness treated.
  • The impact on costs is unclear and the total cost of the new service may not be significantly less than in-patient care.
  • [MeSH-major] Day Care / economics. Home Care Services, Hospital-Based / economics. Hospitalization / economics
  • [MeSH-minor] Adolescent. Adult. Aged. Cost-Benefit Analysis. Female. Health Care Costs. Health Services Research. Humans. Male. Middle Aged. Netherlands. Patient Admission / statistics & numerical data. Severity of Illness Index

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  • (PMID = 14564381.001).
  • [ISSN] 0933-7954
  • [Journal-full-title] Social psychiatry and psychiatric epidemiology
  • [ISO-abbreviation] Soc Psychiatry Psychiatr Epidemiol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] Germany
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52. |......... 14%  Hofmann JC, Wenger NS, Davis RB, Teno J, Connors AF Jr, Desbiens N, Lynn J, Phillips RS: Patient preferences for communication with physicians about end-of-life decisions. SUPPORT Investigators. Study to Understand Prognoses and Preference for Outcomes and Risks of Treatment. Ann Intern Med; 1997 Jul 1;127(1):1-12
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  • [Title] Patient preferences for communication with physicians about end-of-life decisions. SUPPORT Investigators. Study to Understand Prognoses and Preference for Outcomes and Risks of Treatment.
  • BACKGROUND: Physicians are frequently unaware of patient preferences for end-of-life care.
  • Identifying and exploring barriers to patient-physician communication about end-of-life issues may help guide physicians and their patients toward more effective discussions.
  • OBJECTIVE: To examine correlates and associated outcomes of patient communication and patient preferences for communication with physicians about cardiopulmonary resuscitation and prolonged mechanical ventilation.
  • SETTING: Five tertiary care hospitals.
  • PATIENTS: 1832 (85%) of 2162 eligible patients completed interviews.
  • MEASUREMENTS: Surveys of patient characteristics and preferences for end-of-life care; perceptions of prognosis, decision making, and quality of life; and patient preferences for communication with physicians about end-of-life decisions.
  • RESULTS: Fewer than one fourth (23%) of seriously ill patients had discussed preferences for cardiopulmonary resuscitation with their physicians.
  • Of patients who had not discussed their preferences for resuscitation, 58% were not interested in doing so.
  • Of patients who had not discussed and did not want to discuss their preferences, 25% did not want resuscitation.
  • In multivariable analyses, patient factors independently associated with not wanting to discuss preferences for cardiopulmonary resuscitation included being of an ethnicity other than black (adjusted odds ratio [OR], 1.48 [95% CI, 1.10 to 1.99), not having an advance directive (OR, 1.35 [CI, 1.04 to 1.76]), estimating an excellent prognosis (OR, 1.72 [CI, 1.32 to 2.59]), reporting fair to excellent quality of life (OR, 1.36 [CI, 1.05 to 1.76]), and not desiring active involvement in medical decisions (OR, 1.33 [CI, 1.07 to 1.65]).
  • A majority of patients who have not discussed preferences for end-of-life care do not want to do so.
  • For patients who do not want to discuss their preferences, as well as patients with an unmet need for such discussions, failure to discuss preferences for cardiopulmonary resuscitation and mechanical ventilation may result in unwanted interventions.
  • [MeSH-major] Advance Care Planning. Communication. Patient Satisfaction. Physician-Patient Relations. Terminal Care / psychology
  • [MeSH-minor] Adult. Cardiopulmonary Resuscitation. Decision Making. Female. Humans. Male. Middle Aged. Multivariate Analysis. Outcome Assessment (Health Care). Prognosis. Prospective Studies. Quality of Life. Respiration, Artificial. Withholding Treatment

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  • [CommentIn] Ann Intern Med. 1998 Feb 15;128(4):319; author reply 319-20 [9471939.001]
  • [CommentIn] Ann Intern Med. 1998 Feb 15;128(4):319; author reply 319-20 [9471938.001]
  • (PMID = 9214246.001).
  • [ISSN] 0003-4819
  • [Journal-full-title] Annals of internal medicine
  • [ISO-abbreviation] Ann. Intern. Med.
  • [Language] eng
  • [Grant] United States / BHP HRSA HHS / PE / 5T32PE11001
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 55325
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach / Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT)
  • [General-notes] KIE/ KIE BoB Subject Heading: allowing to die/attitudes; KIE/ KIE BoB Subject Heading: resuscitation orders; KIE/ KIE BoB Subject Heading: terminal care; KIE/ For the SUPPORT Investigators; KIE/ Full author name: Hofmann, Jan C; KIE/ Full author name: Wenger, Neil S; KIE/ Full author name: Davis, Roger B; KIE/ Full author name: Teno, Joan; KIE/ Full author name: Connors, Alfred F; KIE/ Full author name: Desbiens, Norman; KIE/ Full author name: Lynn, Joanne; KIE/ Full author name: Phillips, Russell S
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53. |......... 14%  Chung F, Yuan H, Yin L, Vairavanathan S, Wong DT: Elimination of preoperative testing in ambulatory surgery. Anesth Analg; 2009 Feb;108(2):467-75
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  • We conducted a randomized, single-blind, prospective, controlled pilot study to determine whether indicated preoperative testing can be eliminated without increasing the perioperative incidence of adverse events in selected patients undergoing ambulatory surgery.
  • METHODS: One thousand sixty-one eligible patients were randomized either to have indicated preoperative testing or no preoperative testing.
  • In the indicated testing group, patients received indicated preoperative testing: a complete blood count, electrolytes, blood glucose, creatinine, electrocardiogram, and chest radiograph according to the Ontario Preoperative Testing Grid as per current practice, whereas in the no testing group, no testing was ordered.
  • The investigators, data collectors, and patient outcome reviewers were blinded to the group assignment.
  • RESULTS: Patients' age, gender, American Society of Anesthesiologists status, type of surgery, and anesthesia were similar between the two groups.
  • A larger study is needed to demonstrate that indicated testing may be safely eliminated in selected patients undergoing ambulatory surgery without increasing perioperative complications.
  • [MeSH-major] Ambulatory Surgical Procedures. Preoperative Care

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  • [CommentIn] Anesth Analg. 2009 Feb;108(2):393-4 [19151262.001]
  • (PMID = 19151274.001).
  • [ISSN] 1526-7598
  • [Journal-full-title] Anesthesia and analgesia
  • [ISO-abbreviation] Anesth. Analg.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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54. |......... 14%  Ventura MR, Waligora-Serafin B, Crosby F: Research priorities for the care of the veteran patient. Mil Med; 1989 Jan;154(1):32-5
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  • [Title] Research priorities for the care of the veteran patient.
  • The purpose of this project was to identify research priorities for the care of the veteran patient as identified by 367 various members of the Veterans Administration Nursing Service using the Delphi technique.
  • Highest mean scores were obtained for items relating to interventions to decrease repeated admissions, care of the terminally ill, patient compliance, patient education, staffing, care planning, continuity post-hospitalization, quality nursing care, staff satisfaction, health promotion, and nursing intervention to assist patients and family in coping with illnesses.
  • [MeSH-major] Clinical Nursing Research. Delphi Technique. Hospitals, Veterans. Nursing Research. Patient Care Planning. Questionnaires

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  • (PMID = 2493603.001).
  • [ISSN] 0026-4075
  • [Journal-full-title] Military medicine
  • [ISO-abbreviation] Mil Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] UNITED STATES
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55. |......... 14%  Bautista MK, Meuleman JR, Shorr RI, Beyth RJ: Description and students' perceptions of a required geriatric clerkship in postacute rehabilitative care. J Am Geriatr Soc; 2009 Sep;57(9):1685-91
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  • [Title] Description and students' perceptions of a required geriatric clerkship in postacute rehabilitative care.
  • This article describes medical students' evaluation of a geriatric clerkship in postacute rehabilitative care settings.
  • This was a cross-sectional study of fourth-year medical students who completed a mandatory 2-week rotation at a postacute care facility.
  • Students were provided with three instructional methods: Web-based interactive learning modules; small-group sessions with geriatric faculty; and Geriatric Interdisciplinary Care Summary (GICS), a grid that students used to formulate comprehensive interdisciplinary care plans for their own patients.
  • After the rotation, students evaluated the overall clerkship, patient care activities, and usefulness of the three instructional methods using a 5-point Likert scale (1=poor to 5=excellent) and listed their area of future specialty.
  • Even for students whose career choice was not primary care, geriatrics was a good model for interdisciplinary care training and could serve as a model for other disciplines.
  • [MeSH-minor] Accidental Falls / prevention & control. Activities of Daily Living / classification. Aged. Alzheimer Disease / rehabilitation. Comprehensive Health Care. Computer-Assisted Instruction. Cooperative Behavior. Cross-Sectional Studies. Curriculum. Disability Evaluation. Education. Female. Florida. Humans. Interdisciplinary Communication. Male. Patient Care. Problem-Based Learning. Rehabilitation Centers. Social Environment

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  • [Cites] Cyberpsychol Behav. 2003 Aug;6(4):389-95 [14511451.001]
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  • (PMID = 19682134.001).
  • [ISSN] 1532-5415
  • [Journal-full-title] Journal of the American Geriatrics Society
  • [ISO-abbreviation] J Am Geriatr Soc
  • [Language] eng
  • [Grant] United States / PHS HHS / / 1K01 HP00154-01; United States / NIA NIH HHS / AG / 30-AG028740; United States / NCRR NIH HHS / RR / K-30 RR022258; United States / NIA NIH HHS / AG / P30 AG028740; United States / NIA NIH HHS / AG / P30 AG028740-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS136444; NLM/ PMC2783336
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56. |......... 13%  Reintam A, Parm P, Redlich U, Tooding LM, Starkopf J, Köhler F, Spies C, Kern H: Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia. BMC Gastroenterol; 2006;6:19
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  • [Title] Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia.
  • BACKGROUND: While gastrointestinal problems are common in ICU patients with multiple organ failure, gastrointestinal failure has not been given the consideration other organ systems receive.
  • METHODS: A retrospective analysis of adult patients (n = 2588) admitted to three different ICUs (two ICUs at the university hospital Charité-Universitätsmedizin Berlin, Germany and one at Tartu University Clinics, Estonia) during the year 2002 was performed.
  • In Tartu, the data documented in the patients' charts was retrospectively transferred into a similar database.
  • GIF was defined as documented gastrointestinal problems (food intolerance, gastrointestinal haemorrhage, and/or ileus) in the patient data at any period of their ICU stay.
  • RESULTS: GIF was identified in 252 patients (9.7% of all patients).
  • Only 20% of GIF patients were identifiable at admission.
  • GIF was related to significantly higher mortality (43.7% vs. 5.3% in patients without GIF), as well as prolonged length of ICU stay (10 vs. 2 days) and mechanical ventilation (8 vs. 1 day), p < 0.001, respectively.
  • Patients' profile (emergency surgical or medical), APACHE II and SOFA scores and the use of catecholamines at admission were identified as independent risk factors for the development of GIF.
  • [MeSH-major] Gastrointestinal Diseases / epidemiology. Intensive Care / statistics & numerical data. Intensive Care Units / statistics & numerical data

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  • [Cites] Asian Cardiovasc Thorac Ann. 2004 Sep;12(3):250-3 [15353466.001]
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  • (PMID = 16792799.001).
  • [ISSN] 1471-230X
  • [Journal-full-title] BMC gastroenterology
  • [ISO-abbreviation] BMC Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1513588
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57. |......... 13%  Killaspy H, Kingett S, Bebbington P, Blizard R, Johnson S, Nolan F, Pilling S, King M: Randomised evaluation of assertive community treatment: 3-year outcomes. Br J Psychiatry; 2009 Jul;195(1):81-2
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  • The only randomised controlled trial to test high-fidelity assertive community treatment (ACT) in the UK (the Randomised Evaluation of Assertive Community Treatment (REACT) study) found no advantage over usual care from community mental health teams in reducing the need for in-patient care and in other clinical outcomes, but participants found ACT more acceptable and engaged better with it.
  • This paper reports on participants' service contact, in-patient service use and adverse events 36 months after randomisation.
  • [MeSH-minor] Behavior Therapy / methods. Follow-Up Studies. Great Britain. Humans. Length of Stay. Patient Care Team. Program Evaluation

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  • [CommentIn] Br J Psychiatry. 2010 Jan;196(1):77-8; author reply 78-9 [20044668.001]
  • [CommentIn] Br J Psychiatry. 2009 Jul;195(1):5-6 [19567887.001]
  • [CommentIn] Br J Psychiatry. 2010 Jan;196(1):78; author reply 78-9 [20044670.001]
  • (PMID = 19567902.001).
  • [ISSN] 1472-1465
  • [Journal-full-title] The British journal of psychiatry : the journal of mental science
  • [ISO-abbreviation] Br J Psychiatry
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] England
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58. |......... 13%  King M, Llewellyn H, Leurent B, Owen F, Leavey G, Tookman A, Jones L: Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care. Psychooncology; 2013 Nov;22(11):2505-12
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  • [Title] Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care.
  • OBJECTIVES: Despite growing research interest in spirituality and health, and recommendations on the importance of spiritual care in advanced cancer and palliative care, relationships between spiritual belief and psychological health near death remain unclear.
  • We investigated (i) relationships between strength of spiritual beliefs and anxiety and depression, intake of psychotropic/analgesic medications and survival in patients with advanced disease; and (ii) whether the strength of spiritual belief changes as death approaches.
  • METHODS: We conducted a prospective cohort study of 170 patients receiving palliative care at home, 97% of whom had a diagnosis of advanced cancer.
  • Mortality data were collected up to 34 months after the first patient was recruited.
  • CONCLUSION: Results suggest that although religious and spiritual beliefs might increase marginally as death approaches, they do not affect levels of anxiety or depression in patients with advanced cancer.
  • [MeSH-major] Neoplasms / psychology. Neoplasms / therapy. Palliative Care / psychology. Patients / psychology. Quality of Life. Religion. Spirituality
  • [MeSH-minor] Activities of Daily Living. Adaptation, Psychological. Aged. Anxiety. Culture. Depression. Female. Humans. London / epidemiology. Male. Middle Aged. Prospective Studies. Questionnaires. Regression Analysis. Socioeconomic Factors. Terminal Care. Time Factors. Treatment Outcome

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  • [Copyright] © 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.
  • (PMID = 23775823.001).
  • [ISSN] 1099-1611
  • [Journal-full-title] Psycho-oncology
  • [ISO-abbreviation] Psychooncology
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / / C1432/A8254; United Kingdom / Marie Curie Cancer Care / / MCCC-FCO-11-U
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Keywords] NOTNLM ; cancer / end-of-life / oncology / religion / spirituality / wellbeing
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59. |......... 13%  Grundmann H, Bärwolff S, Tami A, Behnke M, Schwab F, Geffers C, Halle E, Göbel UB, Schiller R, Jonas D, Klare I, Weist K, Witte W, Beck-Beilecke K, Schumacher M, Rüden H, Gastmeier P: How many infections are caused by patient-to-patient transmission in intensive care units? Crit Care Med; 2005 May;33(5):946-51
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  • [Title] How many infections are caused by patient-to-patient transmission in intensive care units?
  • OBJECTIVE: The proportion of intensive care unit (ICU)-acquired infections that are a consequence of nosocomial cross-transmission between patients in tertiary ICUs is unknown.
  • PATIENTS: All patients admitted for >/=48 hrs.
  • MEASUREMENT: ICU-acquired infections were ascertained during daily bedside patient and chart reviews.
  • Isolation of indistinguishable isolates in two or more patients defined potential transmission episodes.
  • MAIN RESULTS: During 28,498 patient days, 431 ICU-acquired infections and 141 episodes of nosocomial transmissions were identified.
  • A total of 278 infections were caused by the ten species that were genotyped, and 41 of these (14.5%) could be associated with transmissions between patients.
  • CONCLUSION: Infections acquired during treatment in modern tertiary ICUs are common, but a causative role of direct patient-to-patient transmission can only be ascertained for a minority of these infections on the basis of routine microbiological investigations.
  • [MeSH-major] Bacterial Infections / transmission. Cross Infection / transmission. Intensive Care Units / statistics & numerical data

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  • [CommentIn] Crit Care Med. 2005 May;33(5):1147-8 [15891354.001]
  • (PMID = 15891318.001).
  • [ISSN] 0090-3493
  • [Journal-full-title] Critical care medicine
  • [ISO-abbreviation] Crit. Care Med.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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60. |......... 13%  Korthuis PT, Saha S, Fleishman JA, McGrath MM, Josephs JS, Moore RD, Gebo KA, Hellinger J, Beach MC, HIV Research Network: Impact of patient race on patient experiences of access and communication in HIV care. J Gen Intern Med; 2008 Dec;23(12):2046-52
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  • [Title] Impact of patient race on patient experiences of access and communication in HIV care.
  • BACKGROUND: Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes.
  • OBJECTIVE: To explore associations between race and HIV-infected patients' experiences of access and communication.
  • PARTICIPANTS: Nine hundred and fifteen HIV-infected adults receiving care at 14 U.S. HIV clinics.
  • MEASUREMENTS: Dependent variables included patients' reports of travel time to their HIV care site and waiting time to see their HIV provider (access) and ratings of their HIV providers on always listening, explaining, showing respect, and spending enough time with them (communication).
  • We used multivariate logistic regression to estimate associations between patient race and dependent variables, and random effects models to estimate site-level contributions.
  • RESULTS: Patients traveled a median 30 minutes (range 1-180) and waited a median 20 minutes (range 0-210) to see their provider.
  • Adjusting for HIV care site attenuated this association.
  • HIV care sites that provide services to a greater proportion of blacks and Hispanics may be more difficult to access for all patients.
  • The majority of patients rated provider communication favorably.
  • CONCLUSIONS: We observed racial disparities in patients' experience of access to care but not in patient-provider communication.
  • Efforts to make care more patient-centered for minority HIV-infected patients should focus more on improving access to HIV care in minority communities than on improving cross-cultural patient-provider interactions.
  • [MeSH-major] Communication. Continental Population Groups / psychology. HIV Infections / ethnology. HIV Infections / psychology. Health Services Accessibility. Physician-Patient Relations

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  • (PMID = 18830770.001).
  • [ISSN] 1525-1497
  • [Journal-full-title] Journal of general internal medicine
  • [ISO-abbreviation] J Gen Intern Med
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / 1-K08-HS13903; United States / PHS HHS / / 290-01-0012; United States / NIDA NIH HHS / DA / K23 DA019809; United States / NIDA NIH HHS / DA / K23-DA019809; United States / NIDA NIH HHS / DA / K24 DA000432; United States / NIAAA NIH HHS / AA / R01 AA016893; United States / NIDA NIH HHS / DA / R01 DA011602
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2596522
  • [Investigator] Rutstein R; Corales R; Hellinger J; Allen S; Sklar P; Gebo K; Moore R; Beil R; Hanau L; Nemechek P; Korthuis PT; Keiser P; Gaur A; Sharp V; Somboonwit C; Spector S; Mathews WC; Cohn J; Hellinger F; Fleishman J; Fraser I; Kroliczak A; Mills R; Mulvey K; Roth P; Moore R; Keruly J; Gebo K; Hicks P; Ridoré M
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61. |......... 13%  Metnitz B, Schaden E, Moreno R, Le Gall JR, Bauer P, Metnitz PG, ASDI Study Group: Austrian validation and customization of the SAPS 3 Admission Score. Intensive Care Med; 2009 Apr;35(4):616-22
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  • PATIENTS AND SETTING: Data on a total of 2,060 patients consecutively admitted to 22 intensive care units in Austria from October 2, 2006 to February 28, 2007.
  • The original SAPS 3 Admission Score overestimated hospital mortality in Austrian intensive care patients through all strata of the severity-of-illness.
  • CONCLUSIONS: The SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients.
  • [MeSH-major] Patient Admission. Questionnaires
  • [MeSH-minor] Aged. Austria. Critical Care / standards. Critical Care / statistics & numerical data. Data Collection / standards. Demography. Female. Hospital Mortality / trends. Humans. Intensive Care / standards. Intensive Care Units / statistics & numerical data. Length of Stay / statistics & numerical data. Male. Predictive Value of Tests. Prognosis. Quality Assurance, Health Care / standards. Reproducibility of Results

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  • (PMID = 18846365.001).
  • [ISSN] 1432-1238
  • [Journal-full-title] Intensive care medicine
  • [ISO-abbreviation] Intensive Care Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
  • [Publication-country] United States
  • [Investigator] Sagmüller G; Schwameis F; Pichler B; Ernst F; Bauer T; Sterrer F; Trimmel H; Klimscha W; Linemayr D; Schuh J; Sprinzl G; Dörre K; Trimmel H; Frank G; Malle H; Schindler I; Fitzal S; Schuster R; Locker G; Schneller H; Artmann H; Schuberth O
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62. |......... 13%  Holguin F, Folch E, Redd SC, Mannino DM: Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest; 2005 Oct;128(4):2005-11
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  • STUDY OBJECTIVES: COPD is one of the leading causes of mortality and morbidity in the United States, yet little is known about the prevalence of comorbid conditions and mortality in hospitalized patients with COPD.
  • RESULTS: During 1979 to 2001, there were an estimated total of 47,404,700 hospital discharges (8.5% of all hospitalizations in adults > 25 years old) of patients with COPD; 37,540,374 discharges (79.2%) were made with COPD as a secondary diagnosis, and 9,864,278 discharges (20.8%) were made with COPD as the primary diagnosis.
  • [MeSH-minor] Adult. Comorbidity. Health Surveys. Heart Failure / epidemiology. Humans. Myocardial Ischemia / epidemiology. Patient Discharge. Pneumonia / epidemiology. Respiratory Insufficiency / epidemiology. United States / epidemiology

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  • (PMID = 16236848.001).
  • [ISSN] 0012-3692
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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63. |......... 13%  Covinsky KE, Landefeld CS, Teno J, Connors AF Jr, Dawson N, Youngner S, Desbiens N, Lynn J, Fulkerson W, Reding D, Oye R, Phillips RS: Is economic hardship on the families of the seriously ill associated with patient and surrogate care preferences? SUPPORT Investigators. Arch Intern Med; 1996 Aug 12-26;156(15):1737-41
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  • [Title] Is economic hardship on the families of the seriously ill associated with patient and surrogate care preferences? SUPPORT Investigators.
  • BACKGROUND: Serious illness often causes economic hardship for patients' families.
  • However, it is not known whether this hardship is associated with a preference for the goal of care to focus on maximizing comfort instead of maximizing life expectancy or whether economic hardship might give rise to disagreement between patients and surrogates over the goal of care.
  • METHODS: We performed a cross-sectional study of 3158 seriously ill patients (median age, 63 years; 44% women) at 5 tertiary medical centers with 1 of 9 diagnoses associated with a high risk of mortality.
  • Two months after their index hospitalization, patients and surrogates were surveyed about patients' preferences for the primary goal of care: either care focused on extending life or care focused on maximizing comfort.
  • Patients and surrogates were also surveyed about the financial impact of the illness on the patient's family.
  • RESULTS: A report of economic hardship on the family as a result of the illness was associated with a preference for comfort care over life-extending care (odds ratio, 1.26; 95% confidence interval, 1.07-1.48) in an age-stratified bivariate analysis.
  • Similarly, in a multivariable analysis controlling for patient demographics, illness severity, functional dependency, depression, anxiety, and pain, economic hardship on the family remained associated with a preference for comfort care over life-extending care (odds ratio, 1.31; 95% confidence interval, 1.10-1.57).
  • Economic hardship on the family did not affect either the frequency or direction of patient-surrogate disagreements about the goal of care.
  • CONCLUSIONS: In patients with serious illness, economic hardship on the family is associated with preferences for comfort care over life-extending care.
  • However, economic hardship on the family does not appear to be a factor in patient-surrogate disagreements about the goal of care.
  • [MeSH-major] Caregivers / economics. Cost of Illness. Disease / economics. Family. Patients
  • [MeSH-minor] Aged. Consensus. Cross-Sectional Studies. Dissent and Disputes. Female. Group Processes. Humans. Life Expectancy. Male. Middle Aged. Terminal Care / economics

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  • (PMID = 8694674.001).
  • [ISSN] 0003-9926
  • [Journal-full-title] Archives of internal medicine
  • [ISO-abbreviation] Arch. Intern. Med.
  • [Language] eng
  • [Grant] United States / NIA NIH HHS / AG / 1K08AG00714-01
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 51581
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach / Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT)
  • [General-notes] KIE/ KIE BoB Subject Heading: allowing to die; KIE/ KIE BoB Subject Heading: terminal care; KIE/ For the SUPPORT Investigators; KIE/ Full author name: Covinsky, Kenneth E; KIE/ Full author name: Landefeld, C Seth; KIE/ Full author name: Teno, Joan; KIE/ Full author name: Connors, Alfred F; KIE/ Full author name: Dawson, Neal; KIE/ Full author name: Youngner, Stuart; KIE/ Full author name: Desbiens, Norman; KIE/ Full author name: Lynn, Joanne; KIE/ Full author name: Fulkerson, William; KIE/ Full author name: Reding, Douglas; KIE/ Full author name: Oye, Robert; KIE/ Full author name: Phillips, Russell S
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64. |......... 13%  Aujesky D, Roy PM, Verschuren F, Righini M, Osterwalder J, Egloff M, Renaud B, Verhamme P, Stone RA, Legall C, Sanchez O, Pugh NA, N'gako A, Cornuz J, Hugli O, Beer HJ, Perrier A, Fine MJ, Yealy DM: Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. Lancet; 2011 Jul 2;378(9785):41-8
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  • [Title] Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial.
  • BACKGROUND: Although practice guidelines recommend outpatient care for selected, haemodynamically stable patients with pulmonary embolism, most treatment is presently inpatient based.
  • We aimed to assess non-inferiority of outpatient care compared with inpatient care.
  • We randomly assigned patients with acute, symptomatic pulmonary embolism and a low risk of death (pulmonary embolism severity index risk classes I or II) with a computer-generated randomisation sequence (blocks of 2-4) in a 1:1 ratio to initial outpatient (ie, discharged from hospital ≤24 h after randomisation) or inpatient treatment with subcutaneous enoxaparin (≥5 days) followed by oral anticoagulation (≥90 days).
  • We included all enrolled patients in the primary analysis, excluding those lost to follow-up.
  • FINDINGS: Between February, 2007, and June, 2010, we enrolled 344 eligible patients.
  • Only one (0·6%) patient in each treatment group died within 90 days (95% UCL 2·1%; p=0·005), and two (1·2%) of 171 outpatients and no inpatients had major bleeding within 14 days (95% UCL 3·6%; p=0·031).
  • INTERPRETATION: In selected low-risk patients with pulmonary embolism, outpatient care can safely and effectively be used in place of inpatient care.
  • FUNDING: Swiss National Science Foundation, Programme Hospitalier de Recherche Clinique, and the US National Heart, Lung, and Blood Institute.
  • [MeSH-major] Ambulatory Care. Hospitalization. Pulmonary Embolism / drug therapy
  • [MeSH-minor] Acute Disease. Administration, Oral. Anticoagulants / administration & dosage. Anticoagulants / adverse effects. Enoxaparin / administration & dosage. Enoxaparin / adverse effects. Female. Health Resources / utilization. Hemorrhage / chemically induced. Humans. Injections, Subcutaneous. Length of Stay. Male. Middle Aged. Outcome Assessment (Health Care). Patient Readmission. Patient Satisfaction. Recurrence


65. |......... 13%  Subramanian U, Hopp F, Lowery J, Woodbridge P, Smith D: Research in home-care telemedicine: challenges in patient recruitment. Telemed J E Health; 2004;10(2):155-61
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  • [Title] Research in home-care telemedicine: challenges in patient recruitment.
  • This study reports challenges in recruiting patients for a randomized controlled trial of homecare telemedicine.
  • Descriptive statistics on patient eligibility for home-care telemedicine services and patient refusals for participation are provided.
  • Of 302 home-care patients reviewed, 197 (65.2%) did not meet inclusion criteria.
  • The most common reasons for study exclusion were patients either needing <2 visits per month (n = 59, 30%) or >3 skilled nurse visits per week (n = 46, 23.4%).
  • Of the eligible patients (n = 105), 79 persons (75.2%) refused participation.
  • The most common reasons for refusals were lack of perceived addition benefit of telemedicine (n = 27, 34.2%), and that routine health care was sufficient (n = 23, 29.1%).
  • Higher than expected proportions of patients did not meet chosen eligibility criteria or refused to participate.
  • These results should be helpful in designing home-care telemedicine programs and clinical trials.
  • [MeSH-major] Home Care Services / organization & administration. Patient Selection. Telemedicine

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  • (PMID = 15319045.001).
  • [ISSN] 1530-5627
  • [Journal-full-title] Telemedicine journal and e-health : the official journal of the American Telemedicine Association
  • [ISO-abbreviation] Telemed J E Health
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
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66. |......... 13%  Takeda A, Taylor SJ, Taylor RS, Khan F, Krum H, Underwood M: Clinical service organisation for heart failure. Cochrane Database Syst Rev; 2012;9:CD002752
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  • Several different disease management interventions (clinical service organisation interventions) for patients with CHF have been proposed.
  • OBJECTIVES: To update the previously published review which assessed the effectiveness of disease management interventions for patients with CHF.
  • SELECTION CRITERIA: Randomised controlled trials (RCTs) with at least six months follow up, comparing disease management interventions specifically directed at patients with CHF to usual care.
  • (1) case management interventions (intense monitoring of patients following discharge often involving telephone follow up and home visits);.
  • The components, intensity and duration of the interventions varied, as did the 'usual care' comparator provided in different trials.Case management interventions were associated with reduction in all cause mortality at 12 months follow up, OR 0.66 (95% CI 0.47 to 0.91, but not at six months.
  •   AUTHORS' CONCLUSIONS: Amongst CHF patients who have previously been admitted to hospital for this condition there is now good evidence that case management type interventions led by a heart failure specialist nurse reduces CHF related readmissions after 12 months follow up, all cause readmissions and all cause mortality.
  • [MeSH-major] Aftercare / organization & administration. Case Management / organization & administration. Heart Failure / therapy. Patient Readmission / statistics & numerical data

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  • [CommentIn] Ann Intern Med. 2013 Jan 15;158(2):JC11 [23318333.001]
  • [UpdateOf] Cochrane Database Syst Rev. 2005;(2):CD002752 [15846638.001]
  • (PMID = 22972058.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Grant] United Kingdom / Department of Health / /
  • [Publication-type] Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
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67. |......... 13%  Asplund K, Jonsson F, Eriksson M, Stegmayr B, Appelros P, Norrving B, Terént A, Asberg KH, Riks-Stroke Collaboration: Patient dissatisfaction with acute stroke care. Stroke; 2009 Dec;40(12):3851-6
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  • [Title] Patient dissatisfaction with acute stroke care.
  • BACKGROUND AND PURPOSE: Riks-Stroke, the Swedish Stroke Register, was used to explore patient characteristics and stroke services as determinants of patient dissatisfaction with acute in-hospital care.
  • METHODS: All 79 hospitals in Sweden admitting acute stroke patients participate in Riks-Stroke.
  • During 2001 to 2007, 104,876 patients (87% of survivors) responded to a follow-up questionnaire 3 months after acute stroke; this included questions on satisfaction with various aspects of stroke care.
  • RESULTS: The majority (>90%) were satisfied with acute in-hospital stroke care.
  • Patient who were dependent regarding activities of daily living, felt depressed, or had poor self-perceived general health were more likely to be dissatisfied.
  • Dissatisfaction with global acute stroke care was linked to dissatisfaction with other aspects of care, including rehabilitation and support by community services.
  • Patients treated in stroke units were less often dissatisfied than patients in general wards, as were patients who had been treated in a small hospital (vs medium or large hospitals) and patient who had participated in discharge planning.
  • In multivariate analyses, the strongest predictor of dissatisfaction with acute care was poor outcome (dependency regarding activities of daily living, depressed mood, poor self-perceived health).
  • CONCLUSIONS: Dissatisfaction with in-hospital acute stroke care is part of a more extensive complex comprising poor functional outcome, depressive mood, poor self-perceived general health, and dissatisfaction not only with acute care but also with health care and social services at large.
  • Several aspects of stroke care organization are associated with a lower risk of dissatisfaction.
  • [MeSH-major] Emergency Medical Services / trends. Patient Satisfaction / statistics & numerical data. Quality of Health Care / trends. Stroke / therapy
  • [MeSH-minor] Activities of Daily Living / psychology. Acute Disease. Aged. Attitude to Health. Cost of Illness. Depression / epidemiology. Female. Hospital Units / statistics & numerical data. Hospital Units / trends. Hospitals, Community / statistics & numerical data. Hospitals, Community / trends. Humans. Independent Living / statistics & numerical data. Independent Living / trends. Male. Medical Staff / statistics & numerical data. Medical Staff / trends. Outcome Assessment (Health Care). Physical Therapy Department, Hospital / statistics & numerical data. Physical Therapy Department, Hospital / trends. Self-Assessment. Social Support. Social Work / statistics & numerical data. Social Work / trends. Treatment Outcome

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  • (PMID = 19850895.001).
  • [ISSN] 1524-4628
  • [Journal-full-title] Stroke; a journal of cerebral circulation
  • [ISO-abbreviation] Stroke
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Investigator] Söderström UB; Jonsson L; Eklund B; Ostman BN; Christensen D; Hallenborg I; Wall AL; Koivisto AL; Larsson EM; Fröjd M; Parhans L; Högardh I; Grändeby H; Persson CE; Eriksson B; Laska AC; Von Arbin M; Schill O; Ingverud G; Linder J; Sunnergren AC; Eriksson H; Grüttner CO; Johansson K; Nutti C; Juuso B; Karlsson L; Pettersson A; Andersson C; Thorin B; Karlsson M; Ekholm E; Westerholm I; Persson C; Berglund B; Stenbäck B; Johansson MB; Högvall-Wallin E; Hjelm H; Karlsson K; Olsen E; Pettersson A; Rosengren I; Johansson CB; Larsson L; Magnusson I; Axelsson M; Johansson L; Wahlgren N; Tyrén AH; Stockel-Falk A; Eriksson L; Karlsson S; Andersson BM; Persson C; Berglund M; Hedlund A; Thoresson AB; Knutsson G; Borg CG; Roland I; Eriksson A; Anttonen K; Johansson M; Nease K; Nyman E; Karlsson P; Holmqvist L; Persson T; Vennström A; Hansson K; Aristoy M; Olmebäck C; Kentää Y; Jansson C; Boije AC; Bertilsson M; Boije I; Gibner EB; Karlsson M; Bengtsson MH; Lövgren BL; Pehrson S; Berglund M; Göransson A; Ljungberg K; Andmarken E; Eliasson Y; Axelsson T; Rosengren A; Andersson C; Lokander M; Andersson M; Svensson A; Persson AK; Gustavsson M; Ingvarsson K; Berg M; Rantanen I; Lundberg E; Marbäck M; Snellman E; Söderberg U; Lindfors P; Sörman L; Antonsson J; Gullbratt C; Bergman EL; Holmström M; Olofsson H; Brännvall K; Bengtsson M; Bertholds E; Elgåsen AC; Berglund A; Berg A; Schantz-Eyre C; Egerton M; Davidsson I; Velander S; Perduv P; Anzén M; Lundgren AL; Högvall B; Halvardsson AL; Ekelin A; Dittmer L; Holm M; Baaz L; Pessah-Rasmussen H; Ljungberg J; Olofsson A; Fransson M; Backlund R; Thyr IM; Nilsson L; Bertilsson AG; Martinsson M; Ericsson B; Hammarstedt E; Johansson E; Eriksson L; Sannas ML; Nilsson L; Borland A; Westberg-Bysell A; Smedberg E; Lindström A; Persson G; Appelros P; Asplund K; Asberg KH; Norrving B; Stegmayr B; Terént A; Eriksson M; Johansson AB; Jonsson F; Wallin S
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68. |......... 13%  Goodlin SJ, Hauptman PJ, Arnold R, Grady K, Hershberger RE, Kutner J, Masoudi F, Spertus J, Dracup K, Cleary JF, Medak R, Crispell K, Piña I, Stuart B, Whitney C, Rector T, Teno J, Renlund DG: Consensus statement: Palliative and supportive care in advanced heart failure. J Card Fail; 2004 Jun;10(3):200-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Consensus statement: Palliative and supportive care in advanced heart failure.
  • BACKGROUND: A consensus conference was convened to define the current state and important gaps in knowledge and needed research on "Palliative and Supportive Care in Advanced Heart Failure."
  • CONCLUSIONS: The conference identified gaps in current knowledge, practice, and research relating to prognostication, symptom management, and supportive care for advanced heart failure (HF).
  • (1) although supportive care should be integrated throughout treatment of patients with advanced HF, data are needed to understand how to best decrease physical and psychosocial burdens of advanced HF and to meet patient and family needs;.
  • (2) prognostication in advanced HF is difficult and data are needed to understand which patients will benefit from which interventions and how best to counsel patients with advanced HF;.
  • (3) research is needed to identify which interventions improve quality of life and best achieve the outcomes desired by patients and family members;.
  • (4) care should be coordinated between sites of care, and barriers to evidence-based practice must be addressed programmatically; and (5) more research is needed to identify the content and technique of communicating prognosis and treatment options with patients with advanced HF; physicians caring for patients with advanced HF must develop skills to better integrate the patient's preferences into the goals of care.
  • [MeSH-major] Heart Failure / therapy. Palliative Care
  • [MeSH-minor] Counseling. Decision Making. Health Care Costs. Humans. Outcome Assessment (Health Care). Patient Care Team. Quality of Life

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  • (PMID = 15190529.001).
  • [ISSN] 1071-9164
  • [Journal-full-title] Journal of cardiac failure
  • [ISO-abbreviation] J. Card. Fail.
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / R13 HS13804-01
  • [Publication-type] Consensus Development Conference; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 64
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69. |......... 13%  Fine MJ, Smith DN, Singer DE: Hospitalization decision in patients with community-acquired pneumonia: a prospective cohort study. Am J Med; 1990 Dec;89(6):713-21
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  • [Title] Hospitalization decision in patients with community-acquired pneumonia: a prospective cohort study.
  • PURPOSE: To identify a low-risk subset of patients with community-acquired pneumonia that could safely be treated in the ambulatory setting; and to assess how clinicians make the hospitalization decision.
  • PATIENTS AND METHODS: We performed a prospective, observational study of 280 ambulatory and hospitalized adults with clinical and radiographic evidence of pneumonia.
  • Patients were followed to assess all potential morbid complications and 6-week mortality.
  • Physicians responsible for managing these patients were surveyed to assess the reasons for treating in a hospital or ambulatory setting and the therapies that dictate hospitalization.
  • RESULTS: Sixty-one percent (170 of 280) of patients did not have an indication for admission at presentation using modified Appropriateness Evaluation Protocol criteria (a severe vital sign abnormality, alteration in mental status, suppurative complication, arterial hypoxemia, severe laboratory abnormality, or an acute coexistent medical problem requiring admission independent of the pneumonia).
  • Among these 170 patients, 38% had a complicated course defined as death within 6 weeks, development of a new suppurative or medical complication due to pneumonia, intensive care unit admission, persistent fever or use of intravenous fluids or oxygen beyond 3 days, hospitalization lasting more than 3 days, or subsequent hospitalization in patients initially treated in the ambulatory setting.
  • Physicians most often relied on the general clinical appearance of the patient when making the triage decision, and most commonly cited intravenous antibiotics and chest physical therapy as treatments requiring hospitalization.
  • CONCLUSIONS: If validated, our findings could improve physicians' assessment of prognosis, and may identify a low-risk subset of patients with community-acquired pneumonia who could safely be managed in the ambulatory setting.
  • [MeSH-major] Ambulatory Care. Decision Making. Hospitalization. Pneumonia / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cohort Studies. Female. Follow-Up Studies. Humans. Male. Middle Aged. Outcome and Process Assessment (Health Care). Patient Admission. Prospective Studies. Regression Analysis. Risk Factors. Triage

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  • [CommentIn] Am J Med. 1991 Aug;91(2):207-8 [1867251.001]
  • (PMID = 2252039.001).
  • [ISSN] 0002-9343
  • [Journal-full-title] The American journal of medicine
  • [ISO-abbreviation] Am. J. Med.
  • [Language] eng
  • [Grant] United States / BHP HRSA HHS / PE / 2 D28 PE51006-04
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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70. |......... 13%  Mollica RF, Blum JD, Redlich F: Equity and the psychiatric care of the black patient, 1950 to 1975. J Nerv Ment Dis; 1980 May;168(5):279-86
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  • [Title] Equity and the psychiatric care of the black patient, 1950 to 1975.
  • The psychiatric treatment of the black patient in a Northeastern industrial region in 1975 is compared with the treatment patterns existing for black patients in 1950.
  • This survey reveals that black patients in 1975, as compared to 1950, continued to utilize almost exclusively the state hospital for inpatient care.
  • In addition, in 1975, black patients were receiving previously nonexistent outpatient services at the regional community mental health center.

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  • (PMID = 7365493.001).
  • [ISSN] 0022-3018
  • [Journal-full-title] The Journal of nervous and mental disease
  • [ISO-abbreviation] J. Nerv. Ment. Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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71. |......... 13%  McGilton K, Irwin-Robinson H, Boscart V, Spanjevic L: Communication enhancement: nurse and patient satisfaction outcomes in a complex continuing care facility. J Adv Nurs; 2006 Apr;54(1):35-44
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  • [Title] Communication enhancement: nurse and patient satisfaction outcomes in a complex continuing care facility.
  • AIMS: This paper presents an evaluation of a communication enhancement intervention on staff and patients in a complex continuing care facility.
  • BACKGROUND: The importance of effective communication as a fundamental element of nursing has been emphasized and is regarded as integral to the provision of quality patient care.
  • For people residing in complex continuing care (similar to long-term care facilities), opportunities for socialization occur primarily during interactions or communication with staff, and these interactions have been found to be limited.
  • METHODS: Twenty-one nursing staff members (Registered Nurses, Registered Practical Nurses and healthcare aides) working in a complex continuing care environment and 16 patients participated in this study, conducted in the summer of 2003.
  • Data were collected from patients and nurses at baseline, 5 weeks into the intervention and at 10 weeks after the intervention.
  • Nurse outcome variables included nurses' job satisfaction and their relationships with patients; patient outcome variables included two measures of patient satisfaction with care.
  • RESULTS: Nursing staff felt closer to their patients (F(2,40) = 3.0, P = 0.045) following the intervention and reported higher levels of job satisfaction (F(2,40) = 4.1, P = 0.02).
  • No changes were found in the level of patient satisfaction with care.
  • CONCLUSIONS: Our results suggest that nursing staff can feel better about their job and about their patients as they enhance their communication skills.
  • Understanding the barriers to finding time to talk with patients for a few minutes a day, outside of direct hands-on caregiving, requires further exploration.
  • [MeSH-major] Communication. Nurse-Patient Relations
  • [MeSH-minor] Attitude of Health Personnel. Attitude to Health. Education, Nursing, Continuing / methods. Empathy. Female. Humans. Job Satisfaction. Long-Term Care / psychology. Male. Middle Aged. Nursing Care / psychology. Patient Satisfaction. Quality of Health Care. Social Perception

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  • (PMID = 16553689.001).
  • [ISSN] 0309-2402
  • [Journal-full-title] Journal of advanced nursing
  • [ISO-abbreviation] J Adv Nurs
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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72. |......... 12%  Salanitro AH, Safford MM, Houston TK, Williams JH, Ovalle F, Payne-Foster P, Allison JJ, Estrada CA: Patient complexity and diabetes quality of care in rural settings. J Natl Med Assoc; 2011 Mar;103(3):234-40
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  • [Title] Patient complexity and diabetes quality of care in rural settings.
  • PURPOSE: Even though pay-for-performance programs are being rapidly implemented, little is known about how patient complexity affects practice-level performance assessment in rural settings.
  • We sought to determine the association between patient complexity and practice-level performance in the rural United States.
  • BASIC PROCEDURES: Using baseline data from a trial aimed at improving diabetes care, we determined factors associated with a practice's proportion of patients having controlled diabetes (hemoglobin A1c<or=7%): patient socioeconomic factors, clinical factors, difficulty with self-testing of blood glucose, and difficulty with keeping appointments.
  • MAIN FINDINGS: Rural primary care practices (n=135) in 11 southeastern states provided information for 1641 patients with diabetes.
  • For practices in the best quartile of observed control, 76.1% of patients had controlled diabetes vs 19.3% of patients in the worst quartile.
  • After controlling for other variables, proportions of diabetes control were 10% lower in those practices whose patients had the greatest difficulty with either self testing or appointment keeping (p<.05 for both).
  • PRINCIPAL CONCLUSIONS: Basing public reporting and resource allocation on quality assessment that does not account for patient characteristics may further harm this vulnerable group of patients and physicians.
  • [MeSH-major] Diabetes Mellitus / therapy. Physician's Practice Patterns / statistics & numerical data. Primary Health Care / standards. Quality of Health Care. Rural Health Services / standards

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  • (PMID = 21671526.001).
  • [ISSN] 0027-9684
  • [Journal-full-title] Journal of the National Medical Association
  • [ISO-abbreviation] J Natl Med Assoc
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / 5R18DK065001; United States / NIDDK NIH HHS / DK / R18 DK065001-04; United States / NCRR NIH HHS / RR / UL1 RR031982; United States / NCRR NIH HHS / RR / UL1 RR031982-02
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hemoglobin A, Glycosylated; 0 / Hypoglycemic Agents; 0 / Insulin
  • [Other-IDs] NLM/ NIHMS313984; NLM/ PMC3156053
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73. |......... 12%  Johnson K, Pearce F, Westenskow D, Ogden LL, Farnsworth S, Peterson S, White J, Slade T: Clinical evaluation of the Life Support for Trauma and Transport (LSTAT) platform. Crit Care; 2002 Oct;6(5):439-46
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  • INTRODUCTION: The Life Support for Trauma and Transport (LSTAT trade mark ) is a self-contained, stretcher-based miniature intensive care unit designed by the United States Army to provide care for critically injured patients during transport and in remote settings where resources are limited.
  • Subsequently, 10 consenting adult patients were placed on the LSTAT after surgery for postoperative care in the recovery room.
  • Questionnaires about aspects of LSTAT functionality were completed by nine nurses who cared for the patients placed on the LSTAT.
  • All clinicians reported that they were able to manage the simulated patients properly with the LSTAT.
  • Nursing staff reported that the LSTAT provided adequate equipment to care for the patients monitored during recovery from surgery and were able to detect critical changes in vital signs in a timely manner.
  • DISCUSSION: Preliminary evaluation of the LSTAT in simulated and postoperative environments demonstrated that the LSTAT provided appropriate equipment to detect and manage critical events in patient care.
  • [MeSH-major] Attitude of Health Personnel. Life Support Care / instrumentation. Patient Simulation. Transportation of Patients
  • [MeSH-minor] Adult. Biomedical Engineering. Critical Care. Equipment Design. Heart Diseases / diagnosis. Heart Diseases / therapy. Humans. Postoperative Period. Questionnaires. Respiratory Distress Syndrome, Adult / diagnosis. Respiratory Distress Syndrome, Adult / therapy

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  • (PMID = 12398785.001).
  • [ISSN] 1364-8535
  • [Journal-full-title] Critical care (London, England)
  • [ISO-abbreviation] Crit Care
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC130145
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74. |......... 12%  Pugh MJ, Rosen AK, Montez-Rath M, Amuan ME, Fincke BG, Burk M, Bierman A, Cunningham F, Mortensen EM, Berlowitz DR: Potentially inappropriate prescribing for the elderly: effects of geriatric care at the patient and health care system level. Med Care; 2008 Feb;46(2):167-73
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  • [Title] Potentially inappropriate prescribing for the elderly: effects of geriatric care at the patient and health care system level.
  • BACKGROUND: Many studies have identified patient characteristics associated with potentially inappropriate prescribing in the elderly (PIPE), however, little attention has been directed toward how health care system factors such as geriatric care may affect this patient safety issue.
  • OBJECTIVE: This study examines the association between geriatric care and PIPE in a community dwelling elderly population.
  • SUBJECTS: Veterans age > or =65 years who received health care in the VA system during Fiscal Years (FY99-00), and also received at medications from the Veterans Administration in FY00.
  • Geriatric care penetration was calculated as the proportion of patients within a facility who received at least 1 geriatric outpatient clinic or inpatient visit.
  • ANALYSES: Logistic regression models with generalized estimating equations were used to assess the relationship between geriatric care and PIPE after controlling for patient and health care system characteristics.
  • RESULTS: Patients receiving geriatric care were less likely to have PIPE exposure (odds ratio, 0.64; 95% confidence interval, 0.59-0.73).
  • There was also a weak effect for geriatric care penetration, with a trend for patients in low geriatric care penetration facilities having higher risk for PIPE regardless of individual geriatric care exposure (odds ratio, 1.14; 95% confidence interval, 0.99-1.30).
  • CONCLUSIONS: Although geriatric care is associated with a lower risk of PIPE, additional research is needed to determine if heterogeneity in the organization and delivery of geriatric care resulted in the weak effect of geriatric care penetration, or whether this is a result of low power.
  • [MeSH-major] Drug Therapy / standards. Drug Utilization Review. Geriatrics / standards. Health Services for the Aged / standards. Physician's Practice Patterns / statistics & numerical data. Quality of Health Care

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  • (PMID = 18219245.001).
  • [ISSN] 0025-7079
  • [Journal-full-title] Medical care
  • [ISO-abbreviation] Med Care
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
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75. |......... 12%  Crofts JF, Bartlett C, Ellis D, Winter C, Donald F, Hunt LP, Draycott TJ: Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors. Qual Saf Health Care; 2008 Feb;17(1):20-4
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  • [Title] Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors.
  • OBJECTIVE: To explore the effect of training on patient-actor perception of care during simulated obstetric emergencies.
  • Local training used patient-actors and low-fidelity part-task trainers whereas simulation centre training used full-bodied computerised manikins and high-fidelity part-task trainers.
  • Patient-actors scored their care after each simulation using a patient-actor perception score (communication, safety, respect).
  • Perception of safety and communication during postpartum haemorrhage was significantly improved following training with patient-actors compared with training with manikins (safety p = 0.048, communication p = 0.035).
  • Teamwork training offered no additional benefit to patient-actors' perception of their care.
  • CONCLUSIONS: All multiprofessional training improved patient-actor perception of care.
  • Training using a patient-actor may be better at improving perception of safety and communication than training with a computerised manikin simulator.
  • [MeSH-major] Emergency Medicine / education. Manikins. Obstetrics / education. Patient Satisfaction. Patient Simulation
  • [MeSH-minor] Clinical Competence. Communication. Great Britain. Humans. Midwifery / education. Physician-Patient Relations. Professional-Patient Relations. Questionnaires. Statistics, Nonparametric

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  • (PMID = 18245215.001).
  • [ISSN] 1475-3901
  • [Journal-full-title] Quality & safety in health care
  • [ISO-abbreviation] Qual Saf Health Care
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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76. |......... 12%  Toraman F, Evrenkaya S, Yuce M, Göksel O, Karabulut H, Alhan C: Fast-track recovery in noncoronary cardiac surgery patients. Heart Surg Forum; 2005;8(1):E61-4
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  • [Title] Fast-track recovery in noncoronary cardiac surgery patients.
  • However, data based on an objective scoring system are lacking for the impact of these protocols on patients undergoing cardiac surgery other than isolated CABG.
  • METHODS: Between March 1999 and March 2003, 299 consecutive patients who underwent open cardiac surgery other than isolated CABG were analyzed to evaluate the safety and efficacy of fast-track recovery.
  • The parameters evaluated as predictors of mortality, ie, delayed extubation (>360 minutes), intensive care unit (ICU) discharge (>24 hours), increased length of hospital stay (>5 days), and red blood cell transfusion, were determined by regression analysis.
  • Standard perioperative data were collected prospectively for every patient.
  • RESULTS: Seventy-two percent of the patients were extubated within 6 hours, 87% were discharged from the ICU within 24 hours, and 60% were discharged from the hospital within 5 days.
  • No red blood cells were transfused in 67% of the patients.
  • CONCLUSIONS: This study confirms the safety and efficacy of the fast-track recovery protocol in patients undergoing open cardiac surgery other than isolated CABG.
  • [MeSH-major] Cardiac Surgical Procedures. Clinical Protocols. Heart Diseases / surgery. Postoperative Care
  • [MeSH-minor] Chest Tubes. Diabetes Complications. Drainage. Emergency Medical Services. Erythrocyte Transfusion. Female. Heart Failure / complications. Humans. Intensive Care Units. Length of Stay. Male. Patient Discharge. Peripheral Vascular Diseases / complications. Pulmonary Disease, Chronic Obstructive / complications. Recovery of Function. Time Factors. Ventilator Weaning


77. |......... 12%  Weninger P, Trimmel H, Nau T, Aldrian S, König F, Vécsei V: [Polytrauma and air rescue. A retrospective analysis of trauma care in eastern Austria exemplified by an urban trauma center]. Unfallchirurg; 2005 Jul;108(7):559-66
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  • [Title] [Polytrauma and air rescue. A retrospective analysis of trauma care in eastern Austria exemplified by an urban trauma center].
  • OBJECTIVE: The aim of this study was a retrospective analysis of polytraumatized patients who were treated by a helicopter emergency medical service (HEMS) crew.
  • This study was performed to evaluate the level of prehospital care provided for severely injured patients.
  • METHODS: From September 1992 to April 2001 data of 386 patients treated in the Department of Traumatology of the University of Vienna were collected.
  • A total of 104 patients (26.9%) were transported by helicopter directly from the accident scene.
  • RESULTS: The mean Injury Severity Score (ISS) was 36.9: 70 (67.3%) patients were male and 34 (32.7%) female; the median age was 36.1 years.
  • The mean period between trauma and trauma emergency room was 0.73 h; 77 (74.0%) patients were intubated and mechanically ventilated at the scene and all patients received analgosedation.
  • The mean length of intensive care was 8.6 days and the mortality rate was 19.2% within the first 24 h.
  • For the patients' further course of treatment, the choice of a trauma center seems to be important, too.
  • [MeSH-major] Air Ambulances / utilization. Critical Care / utilization. Multiple Trauma / mortality. Multiple Trauma / therapy. Quality Assurance, Health Care. Risk Assessment / methods. Trauma Centers / utilization
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Austria / epidemiology. Child. Child, Preschool. Female. Humans. Incidence. Infant. Male. Middle Aged. Patient Admission / statistics & numerical data. Retrospective Studies. Risk Factors. Urban Population / statistics & numerical data

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  • (PMID = 15959746.001).
  • [ISSN] 0177-5537
  • [Journal-full-title] Der Unfallchirurg
  • [ISO-abbreviation] Unfallchirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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78. |......... 12%  Lee EK, Yuan F, Hirsh DA, Mallory MD, Simon HK: A clinical decision tool for predicting patient care characteristics: patients returning within 72 hours in the emergency department. AMIA Annu Symp Proc; 2012;2012:495-504
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  • [Title] A clinical decision tool for predicting patient care characteristics: patients returning within 72 hours in the emergency department.
  • The primary purpose of this study was to develop a clinical tool capable of identifying discriminatory characteristics that can predict patients who will return within 72 hours to the Pediatric emergency department (PED).
  • We studied 66,861 patients who were discharged from the EDs during the period from May 1 2009 to December 31 2009.
  • We used a classification model to predict return visits based on factors extracted from patient demographic information, chief complaint, diagnosis, treatment, and hospital real-time ED statistics census.
  • The analysis involves using a subset of the patient cohort for training and establishment of the predictive rule, and blind predicting the return of the remaining patients.
  • Among the predictive rules, the most frequent discriminatory factors identified include diagnosis (> 97%), patient complaint (>97%), and provider type (> 57%).
  • For Level 1 patients, critical readmission factors include patient complaint (>57%), time when the patient arrived until he/she got an ED bed (> 64%), and type/number of providers (>50%).
  • For Level 4/5 patients, physician diagnosis (100%), patient complaint (99%), disposition type when patient arrives and leaves the ED (>30%), and if patient has lab test (>33%) appear to be significant.
  • The model was demonstrated to be consistent and predictive across multiple PED sites.The resulting tool could enable ED staff and administrators to use patient specific values for each of a small number of discriminatory factors, and in return receive a prediction as to whether the patient will return to the ED within 72 hours.
  • This provides an opportunity for improving care and offering additional care or guidance to reduce ED readmission.
  • [MeSH-major] Decision Support Techniques. Emergency Service, Hospital / organization & administration. Patient Readmission

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  • (PMID = 23304321.001).
  • [ISSN] 1942-597X
  • [Journal-full-title] AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
  • [ISO-abbreviation] AMIA Annu Symp Proc
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3540516
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79. |......... 12%  Davidoff G, Schultz JS, Lieb T, Andrews K, Wardner J, Hayes C, Ward M, Karunas R, Maynard F: Rehospitalization after initial rehabilitation for acute spinal cord injury: incidence and risk factors. Arch Phys Med Rehabil; 1990 Feb;71(2):121-4
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  • Many acute spinal cord injury (SCI) patients require rehospitalization after discharge from initial rehabilitation.
  • Previous studies of rehospitalization for these patients have been cross-sectional with respect to time since injury (in years), and have not allowed for comparison of patients with equal exposure to the risk of medical complications once they have reentered the community.
  • To examine the incidence, cause, and monetary cost of rehospitalizations during the first year after discharge from initial rehabilitative care (day 365), the medical records of 88 consecutive, acute SCI patients who completed initial rehabilitation at a regional model SCI care system were reviewed.
  • Cases were excluded from the study if the patient was lost to follow-up before day 365.
  • All readmissions to the regional SCI care system during the follow-up period were reviewed for primary diagnosis, length of stay (LOS), and hospital charges incurred.
  • Thirty-four patients (39%) were readmitted at least once by day 365.
  • Univariate comparisons between the characteristics of patients who were readmitted vs those who were not indicated that the readmitted group was less educated (11.8 +/- 2.1 years vs 12.9 +/- 0.3 years, p less than 0.05) and had a substantially longer initial rehabilitation LOS (88.9 +/- 6.6 days vs 72.9 +/- 5.1 days, p less than 0.05).
  • Readmissions were less common among patients who were discharged at Frankel class C or D (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
  • [MeSH-major] Patient Readmission. Spinal Cord Injuries / rehabilitation

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  • (PMID = 2302044.001).
  • [ISSN] 0003-9993
  • [Journal-full-title] Archives of physical medicine and rehabilitation
  • [ISO-abbreviation] Arch Phys Med Rehabil
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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80. |......... 12%  Bhutta ZA, Khan I, Salat S, Raza F, Ara H: Reducing length of stay in hospital for very low birthweight infants by involving mothers in a stepdown unit: an experience from Karachi (Pakistan). BMJ; 2004 Nov 13;329(7475):1151-5
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  • PROBLEM: Clinical care of infants with a very low birth weight (less than 1500 g) in developing countries can be labour intensive and is often associated with a prolonged stay in hospital.
  • The Aga Khan University Medical Center in Karachi, Pakistan, established a neonatal intensive care unit in 1987.
  • STRATEGIES FOR CHANGE: A stepdown unit was established in September 1994, with mothers providing all basic nursing care for their infants before being discharged under supervision.
  • LESSONS LEARNT: Our results indicate that it is possible to involve mothers in the active care of their very low birthweight infants before discharge.
  • [MeSH-major] Infant, Premature. Infant, Very Low Birth Weight. Length of Stay. Perinatal Care / methods
  • [MeSH-minor] Female. Hospitals, Maternity / utilization. Humans. Infant Mortality. Infant, Newborn. Male. Mothers. Pakistan. Patient Readmission / statistics & numerical data. Prognosis. Regression Analysis

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  • (PMID = 15539671.001).
  • [ISSN] 1756-1833
  • [Journal-full-title] BMJ (Clinical research ed.)
  • [ISO-abbreviation] BMJ
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC527694
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81. |......... 12%  Burge P, Ouellette-Kuntz H, Saeed H, McCreary B, Paquette D, Sim F: Acute psychiatric inpatient care for people with a dual diagnosis: patient profiles and lengths of stay. Can J Psychiatry; 2002 Apr;47(3):243-9
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  • [Title] Acute psychiatric inpatient care for people with a dual diagnosis: patient profiles and lengths of stay.
  • OBJECTIVE: This study describes characteristics of psychiatry inpatients with developmental disabilities (DD) and their admissions to psychiatry wards in 2 acute care hospitals.
  • A comparison sample of admissions of patients without DD was chosen.
  • Associations between length of stay and other covariates were explored within the sample of patient admissions with DD.
  • The median length of stay for patients with DD was 8 days, which did not differ meaningfully from the comparison sample.
  • Our finding that male patients with DD have longer lengths of stay than do female patients in the same sample has not been reported in previous research.
  • [MeSH-major] Intellectual Disability / epidemiology. Length of Stay / statistics & numerical data. Mental Disorders / epidemiology. Patient Admission / statistics & numerical data

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  • (PMID = 11987475.001).
  • [ISSN] 0706-7437
  • [Journal-full-title] Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • [ISO-abbreviation] Can J Psychiatry
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Canada
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82. |......... 12%  Jackson BE, Suzuki S, Coultas D, Su F, Lingineni R, Singh KP, Bartolucci A, Bae S: Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data. Int J Chron Obstruct Pulmon Dis; 2011;6:563-71
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  • [Title] Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data.
  • The purpose of this manuscript is to further explore the geographic disparity of COPD hospitalization rates in Texas by examining county-level factors affecting access to care.
  • PATIENTS AND METHODS: The study is a cross-sectional analysis of the 2007 Texas Health Care Information Council, Texas, demographer population projections and the 2009 Area Resource File (ARF).
  • Indicators of access to care included: type of safety-net facility and number of pulmonary specialists in a county.
  • There are a number of factors that may contribute to these variations in hospitalization rates, such as racial/ethnic distribution, types and quality of services provided, and the level of rurality, which creates greater distances to care and lower concentration of hospitals and pulmonary specialists.
  • [MeSH-major] Community Health Centers / statistics & numerical data. Healthcare Disparities / statistics & numerical data. Hospitalization / statistics & numerical data. Inpatients / statistics & numerical data. Patient Safety / statistics & numerical data. Pulmonary Disease, Chronic Obstructive / therapy. Residence Characteristics / statistics & numerical data. Rural Health Services / statistics & numerical data
  • [MeSH-minor] Adolescent. Adult. Aged. Cross-Sectional Studies. Female. Health Services Accessibility / statistics & numerical data. Humans. Male. Middle Aged. Multivariate Analysis. Patient Discharge / statistics & numerical data. Pulmonary Medicine / statistics & numerical data. Regression Analysis. Texas. Young Adult


83. |......... 12%  Albers G, Harding R, Pasman HR, Onwuteaka-Philipsen BD, Hall S, Toscani F, Ribbe MW, Deliens L, PRISMA: What is the methodological rigour of palliative care research in long-term care facilities in Europe? A systematic review. Palliat Med; 2012 Jul;26(5):722-33
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  • [Title] What is the methodological rigour of palliative care research in long-term care facilities in Europe? A systematic review.
  • BACKGROUND: The European population is rapidly ageing, resulting in increasing numbers of older people dying in long-term care facilities.
  • There is an urgent need for palliative care in long-term care facilities.
  • AIM: The aim of this study was to systematically review the literature on palliative care research in long-term care facilities in Europe with respect to how the palliative care populations were described, and to determine the study designs and patient outcome measures utilized.
  • The search strategy included searches of PubMed, Embase and PsychINFO databases from 2000 up to May 2010, using search terms related to 'palliative care' and 'end-of-life care' combined with search terms related to 'long-term care'.
  • We selected articles that reported studies on patient outcome data of palliative care populations residing in a long-term care facility in Europe.
  • RESULTS: This review demonstrated that there are few, and mainly descriptive, European studies on palliative care research in long-term care facilities.
  • None of these studies described their study population specifically as a palliative care or end-of-life care population.
  • CONCLUSION: To improve future research on palliative care in long-term care facilities, agreement on what can be considered as palliative care in long-term care facilities and, the availability of well-developed and tested measurement instruments is needed to provide more evidence, and to make future research more comparable.
  • [MeSH-major] Health Services Research / methods. Long-Term Care. Palliative Care
  • [MeSH-minor] Europe. Humans. Outcome Assessment (Health Care) / methods

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  • (PMID = 21697265.001).
  • [ISSN] 1477-030X
  • [Journal-full-title] Palliative medicine
  • [ISO-abbreviation] Palliat Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Investigator] Antunes B; Pinto AB; Bausewein C; Bechinger-English D; Benalia H; Bennett E; Bradley L; Ceulemans L; Daveson BA; Derycke N; de Vlieger M; Dillen L; Downing J; Evans N; Haugen DF; Flood L; Gikaara N; Gomes B; Gysels M; Higginson IJ; Kaasa S; Koffman J; Ferreira PL; Menaca A; Menten J; Calanzani NM; Murtagh F; Pettenati F; Pool R; Powell RA; Sigurdardottir K; Simon S; van den Eynden B; Van den Berghe P; van Iersel T
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84. |......... 12%  Sterkers Y, Varlet-Marie E, Marty P, Bastien P, ANOFEL Toxoplasma-PCR Quality Control Group: Diversity and evolution of methods and practices for the molecular diagnosis of congenital toxoplasmosis in France: a 4-year survey. Clin Microbiol Infect; 2010 Oct;16(10):1594-602
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  • [MeSH-major] Molecular Diagnostic Techniques / methods. Parasitology / methods. Patient Care / methods. Polymerase Chain Reaction / methods. Toxoplasmosis, Congenital / diagnosis. Toxoplasmosis, Congenital / therapy

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  • [Copyright] © 2010 The Authors. Journal Compilation © 2010 European Society of Clinical Microbiology and Infectious Diseases.
  • (PMID = 19886905.001).
  • [ISSN] 1469-0691
  • [Journal-full-title] Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
  • [ISO-abbreviation] Clin. Microbiol. Infect.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] France
  • [Investigator] Cimon B; Millet P; Quinio D; Vergnaud M; Bretagne S; Botterel F; Bonnin A; Dalle F; Pelloux H; Brenier-Pinchart MP; Delhaes L; Dardé ML; Peyron F; Franck J; Fortier B; Miegeville M; Yera H; Thulliez P; Brun S; Paris L; Roux P; Villena I; Gangneux JP; Robert-Gangneux F; Flori P; Filisetti D; Bessières MH; Cassaing S; Duong TH
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85. |......... 12%  Chen F, Mercado C, Yermilov I, Puig M, Ko CY, Kahn KL, Ganz PA, Gibbons MM: Improving breast cancer quality of care with the use of patient navigators. Am Surg; 2010 Oct;76(10):1043-6
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  • [Title] Improving breast cancer quality of care with the use of patient navigators.
  • The continuum of breast cancer care requires multidisciplinary efforts.
  • Patient navigators, who perform outreach, coordination, and education, have been shown to improve some areas of care.
  • Our objective is to report on the impact of a patient navigator program on breast cancer quality of care at a public hospital.
  • One hundred consecutive newly diagnosed patients with breast cancer (Stages I to III) were identified (2005 to 2007).
  • Forty-nine patients were treated before the use of navigators and 51 after program implementation.
  • Nine breast cancer quality indicators were used to evaluate quality of care.
  • Overall adherence to the quality indicators improved from 69 to 86 per cent with the use of patient navigators (P < 0.01).
  • Patient navigators appear to improve breast cancer quality of care in a public hospital.
  • In populations in which cultural, linguistic, and financial barriers are prevalent, navigator programs can be effective in narrowing the observed gaps in the quality of cancer care.
  • [MeSH-major] Breast Neoplasms / surgery. Patient Advocacy. Quality Indicators, Health Care

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  • (PMID = 21105605.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R25 CA 87949
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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86. |......... 12%  Uhlmann RF, Pearlman RA: Perceived quality of life and preferences for life-sustaining treatment in older adults. Arch Intern Med; 1991 Mar;151(3):495-7
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  • Patients and physicians were independently administered a questionnaire regarding patient quality of life and preferences for cardiopulmonary resuscitation and mechanical ventilation for the patient.
  • Physicians rated patients' global quality of life, physical comfort, mobility, depression, anxiety, and family relationships significantly worse than did patients.
  • Nearly all perceptions of patients' quality of life were significantly associated with physicians' perceptions, but not patients' treatment preferences.
  • Patient-physician agreement on patient global quality of life was not significantly associated with agreement regarding treatment preferences.
  • We conclude that primary physicians generally consider their older outpatients' quality of life to be worse than do the patients.
  • Furthermore, physicians' estimations of patient quality of life are significantly associated with physicians' attitudes toward life-sustaining treatment for the patients.
  • For the patients, however, perceived quality of life does not appear to be associated with their preferences for life-sustaining treatment.
  • [MeSH-major] Aged / psychology. Life Support Care. Outpatients / psychology. Physicians, Family / psychology. Quality of Life. Social Values. Withholding Treatment

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  • (PMID = 2001131.001).
  • [ISSN] 0003-9926
  • [Journal-full-title] Archives of internal medicine
  • [ISO-abbreviation] Arch. Intern. Med.
  • [Language] eng
  • [Grant] United States / NIA NIH HHS / AG / KO8 AG00265; United States / PHS HHS / / R01 H505303
  • [Publication-type] Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 33048
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach
  • [General-notes] KIE/ KIE BoB Subject Heading: allowing to die/attitudes; KIE/ KIE BoB Subject Heading: resuscitation orders; KIE/ Full author name: Uhlmann, Richard F; KIE/ Full author name: Pearlman, Robert A
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87. |......... 12%  Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, Roberts C, Hill E, Wiersma D, Bond GR, Huxley P, Tyrer P: Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technol Assess; 2001;5(21):1-75
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  • [Title] Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care.
  • ***ACUTE DAY HOSPITAL VERSUS ADMISSION FOR ACUTE PSYCHIATRIC DISORDERS*** BACKGROUND: Inpatient treatment is an expensive way of caring for people with acute psychiatric disorders.
  • OBJECTIVE: The aim of this review was to assess the effectiveness and feasibility of day hospital versus inpatient care for people with acute psychiatric disorders.
  • METHODS - STUDY SELECTION: Eligible studies were randomised controlled trials of day hospital versus inpatient care for people with acute psychiatric disorders.
  • Studies were excluded if they were primarily concerned with elderly people, children, or patients with a diagnosis of organic brain disease or substance abuse.
  • Trialists were asked to provide individual patient data.
  • Individual patient data were therefore sought so that outcomes could be re-analysed using a common format.
  • RESULTS: Nine trials met the inclusion criteria (involving 1568 randomised patients and 2268 assessed for suitability of day hospital treatment).
  • Individual patient data were obtained for four trials (involving 594 people).
  • A sensitivity analysis of combined data suggested that day hospital treatment was feasible for at worst 23.2% (n = 2268; 95% CI, 21.2 to 25.2) and at best 37.5% (n = 1768; 95% CI, 35.2 to 39.8) of those currently admitted to inpatient care.
  • Individual patient data from three trials showed no difference in the number of days in hospital (combining day hospital days and inpatient days) between day hospital patients and controls (n = 465; weighted mean difference (WMD) = -0.38 days/ month; 95% CI, -1.32 to 0.55).
  • However, compared with controls, patients randomised to day hospital care spent significantly more days in day hospital care (n = 265; WMD = 2.34 days/month; 95% CI, 1.97 to 2.70) and significantly fewer days in inpatient care (n = 265; WMD = -2.75 days/month; 95% CI, -3.63 to -1.87).
  • There was no difference between readmission rates for day hospital and control patients (n = 667; RR = 0.91; 95% CI, 0.72 to 1.15).
  • Individual patient data from three trials showed a significant time-treatment interaction, indicating a more rapid improvement in mental state (n = 407; c2 = 9.66; p = 0.002), but not social functioning (n = 295; c2 = 0.006; p = 0.941) amongst day hospital patients.
  • Four of five trials demonstrated that day hospital care was cheaper than inpatient care (with overall cost reductions ranging from 20.9% to 36.9%).
  • CONCLUSIONS: Acute day hospitals are an attractive option in situations where demand for inpatient care is high and facilities exist that are suitable for conversion.
  • They are a less attractive option when demand for inpatient care is low and where effective alternatives already exist.
  • It is important to examine how acute day hospital care can be most effectively integrated into a modern community-based psychiatric service.
  • OBJECTIVES: The overall objective of this review was to assess the effectiveness of PVT and SEm relative to each other and to standard care (in hospital or the community) for people with severe mental disorders.
  • CONCLUSIONS: The main finding was that SEm was more effective than PVT for patients suffering from a severe mental disorder who wanted to work.
  • There was no evidence that PVT was more effective than standard community care or hospital care.
  • ***DAY HOSPITAL VERSUS OUTPATIENT CARE FOR PATIENTS WITH PSYCHIATRIC DISORDERS*** BACKGROUND: This review considers the use of day hospitals as an alternative to outpatient care.
  • Two typesof day hospital provision are covered: "day treatment programmes" and "day care centres".
  • Day treatment programmes are day hospitals that are used to enhance the treatment of patients with anxiety or depressive disorders who have failed to respond to outpatient care.
  • Day care centres are day hospitals that offer structured support to patients with long-term severe mental disorders who would otherwise be treated in an outpatient clinic.
  • OBJECTIVES: There were two objectives: first, to assess the effectiveness of day treatment programmes versus outpatient care for people with non-psychotic disorders; and, secondly, to assess the effectiveness of day care centres versus outpatient care for people with severe long-term disorders.
  • METHODS - STUDY SELECTION: Eligible studies were randomised controlled trials comparing day hospital care (either a day treatment programme or a day care centre) with outpatient care.
  • Studies were ineligible if they were largely restricted to patients who were aged under 18 or over 65 years or who had a primary diagnosis of substance abuse or organic brain disorder.
  • Trialists were asked to provide individual patient data.
  • RESULTS: There was evidence from two of the five trials identified suggesting that day treatment programmes were superior to continuing outpatient care in terms of improving psychiatric symptoms.
  • There was no evidence to suggest that day treatment programmes were better or worse than outpatient care on any other clinical or social outcome variable or on costs. (ABSTRACT TRUNCATED)
  • [MeSH-major] Day Care. Hospitalization. Mental Disorders
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Outcome Assessment (Health Care). Psychiatric Status Rating Scales. Randomized Controlled Trials as Topic. Rehabilitation, Vocational

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  • (PMID = 11532238.001).
  • [ISSN] 1366-5278
  • [Journal-full-title] Health technology assessment (Winchester, England)
  • [ISO-abbreviation] Health Technol Assess
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Number-of-references] 66
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88. |......... 12%  Kirkpatrick AW, Rizoli S, Ouellet JF, Roberts DJ, Sirois M, Ball CG, Xiao ZJ, Tiruta C, Meade M, Trottier V, Zhu G, Chagnon F, Tien H, Canadian Trauma Trials Collaborative and the Research Committee of the Trauma Association of Canada: Occult pneumothoraces in critical care: a prospective multicenter randomized controlled trial of pleural drainage for mechanically ventilated trauma patients with occult pneumothoraces. J Trauma Acute Care Surg; 2013 Mar;74(3):747-54; discussion 754-5
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  • [Title] Occult pneumothoraces in critical care: a prospective multicenter randomized controlled trial of pleural drainage for mechanically ventilated trauma patients with occult pneumothoraces.
  • BACKGROUND: Patients with an occult pneumothoraces (OPTXs) may be at risk of tension pneumothoraces (TPTXs) without drainage or pleural drainage complications if treated.
  • All subsequent care and method of pleural drainage was per attending physician discretion.
  • RESULTS: Ninety severely injured patients (mean [SD], Injury Severity Score [ISS], 33 [11]) were studied at four centers: Calgary (55), Toronto (27), Quebec (6), and Sherbrooke (3).
  • There was no difference in mortality or intensive care unit (ICU), ventilator, or hospital days between groups.
  • One observed patient (2%) undergoing PPV at enrollment had a TPTX, which was treated with urgent tube thoracostomy without sequelae.
  • CONCLUSION: Our results suggest that OPTXs may be safely observed in hemodynamically stable patients undergoing PPV just for an operation, although one third of those requiring a week or more of ICU care received drainage, and TPTXs still occur.
  • [MeSH-major] Chest Tubes. Critical Care. Drainage / methods. Pneumothorax / surgery. Positive-Pressure Respiration / methods. Thoracostomy / methods. Wounds, Nonpenetrating / complications

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  • (PMID = 23425731.001).
  • [ISSN] 2163-0763
  • [Journal-full-title] The journal of trauma and acute care surgery
  • [ISO-abbreviation] J Trauma Acute Care Surg
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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89. |......... 12%  Kuzma AM, Meli Y, Meldrum C, Jellen P, Butler-Lebair M, Koczen-Doyle D, Rising P, Stavrolakes K, Brogan F: Multidisciplinary care of the patient with chronic obstructive pulmonary disease. Proc Am Thorac Soc; 2008 May 1;5(4):567-71
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  • [Title] Multidisciplinary care of the patient with chronic obstructive pulmonary disease.
  • The National Emphysema Treatment Trial used a multidisciplinary team approach to implement the maximum medical care protocol, including adjustment of medications and outpatient pulmonary rehabilitation for all patients and nutritional and psychological counseling as needed.
  • This article discusses the benefits of such an approach in the care of the patient with chronic obstructive pulmonary disease.
  • Team member roles complement each other and contribute to the goal of providing the highest-quality medical care.
  • The primary focus of the team is to reinforce the medical plan and to provide patient education and support.
  • This article reviews the elements of the initial patient assessment and the functional and nutritional assessment.
  • Patient education focuses on medication use, recognition and management of chronic obstructive pulmonary disease exacerbation symptoms, smoking cessation, advance directives, and travel.
  • [MeSH-major] Delivery of Health Care, Integrated. Pulmonary Disease, Chronic Obstructive / therapy
  • [MeSH-minor] Activities of Daily Living. Advance Directives. Disability Evaluation. Humans. Nutritional Support. Oxygen Inhalation Therapy. Patient Care Planning. Patient Education as Topic. Social Support. Travel

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  • (PMID = 18453373.001).
  • [ISSN] 1546-3222
  • [Journal-full-title] Proceedings of the American Thoracic Society
  • [ISO-abbreviation] Proc Am Thorac Soc
  • [Language] eng
  • [Grant] United States / NHLBI NIH HHS / HR / N01HR76101; United States / NHLBI NIH HHS / HR / N01HR76102; United States / NHLBI NIH HHS / HR / N01HR76103; United States / NHLBI NIH HHS / HR / N01HR76104; United States / NHLBI NIH HHS / HR / N01HR76105; United States / NHLBI NIH HHS / HR / N01HR76106; United States / NHLBI NIH HHS / HR / N01HR76107; United States / NHLBI NIH HHS / HR / N01HR76108; United States / NHLBI NIH HHS / HR / N01HR76109; United States / NHLBI NIH HHS / HR / N01HR76110; United States / NHLBI NIH HHS / HR / N01HR76111; United States / NHLBI NIH HHS / HR / N01HR76112; United States / NHLBI NIH HHS / HR / N01HR76113; United States / NHLBI NIH HHS / HR / N01HR76114; United States / NHLBI NIH HHS / HR / N01HR76115; United States / NHLBI NIH HHS / HR / N01HR76116; United States / NHLBI NIH HHS / HR / N01HR76118; United States / NHLBI NIH HHS / HR / N01HR76119
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 39
  • [Other-IDs] NLM/ PMC2645337
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90. |......... 12%  Schmidt U, Oldershaw A, Jichi F, Sternheim L, Startup H, McIntosh V, Jordan J, Tchanturia K, Wolff G, Rooney M, Landau S, Treasure J: Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial. Br J Psychiatry; 2012 Nov;201(5):392-9
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  • [Title] Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial.
  • METHOD: Seventy-two adult out-patients with anorexia nervosa or eating disorder not otherwise specified were recruited from a specialist eating disorder service in the UK.
  • RESULTS: At baseline, patients randomised to MANTRA were significantly less likely to be in a partner relationship than those receiving SSCM (3/34 v. 10/36; P<0.05).
  • Patients in both treatments improved significantly in terms of eating disorder and other outcomes, with no differences between groups.
  • However, MANTRA patients were significantly more likely to require additional in-patient or day-care treatment than those receiving SSCM (7/34 v. 0/37; P = 0.004).
  • This study confirms SSCM as a useful treatment for out-patients with anorexia nervosa.
  • The novel treatment, MANTRA, designed for this patient group may need adaptations to fully exploit its potential.
  • [MeSH-major] Ambulatory Care / methods. Anorexia Nervosa / therapy. Psychotherapy / methods


91. |......... 12%  Janssens U, Burchardi H, Duttge G, Erchinger R, Gretenkort P, Mohr M, Nauck F, Rothärmel S, Salomon F, Schmucker P, Simon A, Stopfkuchen H, Valentin A, Weiler N, Neitzke G: [Change in therapy target and therapy limitations in intensive care medicine. Position paper of the Ethics Section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine]. Anaesthesist; 2013 Jan;62(1):47-52
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  • [Title] [Change in therapy target and therapy limitations in intensive care medicine. Position paper of the Ethics Section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine].
  • The task of physicians is to maintain life, to protect and re-establish health as well as to alleviate suffering and to accompany the dying until death, under consideration of the self-determination rights of patients.
  • Increasingly more and differentiated options for this are becoming available in intensive care medicine.
  • This process of decision-making is determined by answering the following question: when and under which circumstances is induction or continuation of intensive care treatment justified?
  • In addition to the indications, the advance directive of the patient is the deciding factor.
  • The ascertainment of the patient directive is achieved in a graded process depending on the state of consciousness of the patient.
  • [MeSH-major] Intensive Care / ethics

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  • [CommentIn] Anaesthesist. 2013 Jun;62(6):490 [23946959.001]
  • [CommentIn] Anaesthesist. 2013 Jun;62(6):489-90 [23754482.001]
  • (PMID = 23377458.001).
  • [ISSN] 1432-055X
  • [Journal-full-title] Der Anaesthesist
  • [ISO-abbreviation] Anaesthesist
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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92. |......... 12%  Patel NJ, Deshmukh A, Pant S, Singh V, Patel N, Arora S, Shah N, Chothani A, Savani GT, Mehta K, Parikh V, Rathod A, Badheka AO, Lafferty J, Kowalski M, Mehta JL, Mitrani RD, Viles-Gonzalez JF, Paydak H: Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation; 2014 Jun 10;129(23):2371-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The main objective of this study is to examine the trends of AF-related hospitalizations in the United States and to compare patient characteristics, outcomes, and comorbid diagnoses.
  • Overall AF hospitalizations increased by 23% from 2000 to 2010, particularly in patients ≥65 years of age.
  • The mortality rate was highest in the group of patients ≥80 years of age (1.9%) and in the group of patients with concomitant heart failure (8.2%).
  • [MeSH-major] Atrial Fibrillation / mortality. Atrial Fibrillation / therapy. Health Care Costs. Hospitalization / trends

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  • [Copyright] © 2014 American Heart Association, Inc.
  • [CommentIn] Circulation. 2014 Jun 10;129(23):2361-3 [24842944.001]
  • (PMID = 24842943.001).
  • [ISSN] 1524-4539
  • [Journal-full-title] Circulation
  • [ISO-abbreviation] Circulation
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; atrial fibrillation / cost / hospitalization
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93. |......... 11%  Mold F, Ellis B, de Lusignan S, Sheikh A, Wyatt JC, Cavill M, Michalakidis G, Barker F, Majeed A, Quinn T, Koczan P, Avanitis T, Gronlund TA, Franco C, McCarthy M, Renton Z, Chauhan U, Blakey H, Kataria N, Jones S, Rafi I: The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol. Inform Prim Care; 2012;20(4):271-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.
  • BACKGROUND: Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR).
  • International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place.
  • Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.
  • OBJECTIVE: To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.
  • [MeSH-major] Electronic Health Records / organization & administration. Internet. Patient Access to Records. Patient Safety. Quality of Health Care / organization & administration
  • [MeSH-minor] Ambulatory Care / organization & administration. Humans. Inservice Training. Outcome Assessment (Health Care). Patient Compliance

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  • (PMID = 23890339.001).
  • [ISSN] 1476-0320
  • [Journal-full-title] Informatics in primary care
  • [ISO-abbreviation] Inform Prim Care
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
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94. |......... 11%  Pell C, Meñaca A, Were F, Afrah NA, Chatio S, Manda-Taylor L, Hamel MJ, Hodgson A, Tagbor H, Kalilani L, Ouma P, Pool R: Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi. PLoS One; 2013;8(1):e53747
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  • [Title] Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.
  • BACKGROUND: Antenatal care (ANC) is a key strategy to improve maternal and infant health.
  • General ideas about pregnancy care - checking the foetus' position or monitoring its progress - motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers.
  • [MeSH-major] Prenatal Care / statistics & numerical data
  • [MeSH-minor] Female. Gestational Age. Ghana. Health Care Surveys. Health Communication. Health Knowledge, Attitudes, Practice. Humans. Kenya. Malawi. Male. Patient Acceptance of Health Care. Pregnancy. Qualitative Research. Reproductive History. Risk Factors

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  • [Cites] Lancet. 2001 May 19;357(9268):1565-70 [11377643.001]
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  • (PMID = 23335973.001).
  • [ISSN] 1932-6203
  • [Journal-full-title] PloS one
  • [ISO-abbreviation] PLoS ONE
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3546008
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95. |......... 11%  Madden JM, Soumerai SB, Lieu TA, Mandl KD, Zhang F, Ross-Degnan D, Health maintenance organization: Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures. N Engl J Med; 2002 Dec 19;347(25):2031-8
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  • We also examined expenditures for hospitalizations and home-based care.
  • Average HMO expenditures on hospital and home-based services decreased by $90 per delivery with the early-discharge program and increased by $100 after the mandate.
  • [MeSH-major] Health Expenditures / statistics & numerical data. Health Maintenance Organizations / economics. Infant Care / statistics & numerical data. Length of Stay / legislation & jurisprudence. Postnatal Care / economics
  • [MeSH-minor] Adult. Emergency Service, Hospital / statistics & numerical data. Emergency Service, Hospital / utilization. Female. Home Care Services / economics. Home Care Services / utilization. Hospitalization / economics. Humans. Infant, Newborn. Male. Massachusetts. Patient Discharge / legislation & jurisprudence. Patient Readmission / statistics & numerical data

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  • [Copyright] Copyright 2002 Massachusetts Medical Society
  • [CommentIn] N Engl J Med. 2003 Apr 17;348(16):1602-3; author reply 1602-3 [12700385.001]
  • [CommentIn] N Engl J Med. 2003 Apr 17;348(16):1602-3; author reply 1602-3 [12701609.001]
  • (PMID = 12490685.001).
  • [ISSN] 1533-4406
  • [Journal-full-title] The New England journal of medicine
  • [ISO-abbreviation] N. Engl. J. Med.
  • [Language] eng
  • [Grant] United States / AHRQ HHS / HS / 5R01HS10060; United States / PHS HHS / / H16MC00050
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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96. |......... 11%  Altschuler A, Collins B, Lewis JD, Velayos F, Allison JE, Hutfless S, Liu L, Herrinton LJ: Gastroenterologists' attitudes and self-reported practices regarding inflammatory bowel disease. Inflamm Bowel Dis; 2008 Jul;14(7):992-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: The purpose was to assess organization-, physician-, and patient-based aspects of inflammatory bowel disease (IBD) practice variation within an integrated care delivery system and the extent to which physicians are interested in adopting a chronic care model and/or nurse assistance to manage IBD patients.
  • METHODS: As part of an observational cohort study to understand variation in IBD care and outcomes, we conducted semistructured, open-ended interviews with 17 gastroenterologists and 1 gastroenterology registered nurse at 6 clinics in an integrated care delivery system.
  • 1) patient education and choices, including health education and patient use of complementary and alternative medicine;.
  • 2) decisions about diagnosis and treatment, including practice guidelines, conferring with colleagues, using infliximab, and medical hospitalization; and 3) organizational aspects of care, including primary care involvement with IBD and MD attitudes toward ancillary support.
  • CONCLUSIONS: Standardized algorithms on care for IBD patients do not exist, but opportunities may exist to improve IBD care by: having initial work-ups and management of patients in remission in primary care; creating and maintaining opportunities for gastroenterologists to confer with colleagues and acknowledged local experts; and having nurse coordination for medications and labs and/or some type of specialty IBD clinic for high-need patients.
  • [MeSH-minor] Cohort Studies. Complementary Therapies. Decision Making. Humans. Interviews as Topic. Nurses. Patient Care / methods. Patient Education as Topic

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  • (PMID = 18300277.001).
  • [ISSN] 1536-4844
  • [Journal-full-title] Inflammatory bowel diseases
  • [ISO-abbreviation] Inflamm. Bowel Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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97. |......... 11%  Jean-Claude M, Emmanuelle P, Juliette H, Michèle B, Gérard D, Eric F, Xavier H, Bertrand L, Jean-Fabien Z, Yves P, Gérard N: Clinical and economic impact of malnutrition per se on the postoperative course of colorectal cancer patients. Clin Nutr; 2012 Dec;31(6):896-902
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  • [Title] Clinical and economic impact of malnutrition per se on the postoperative course of colorectal cancer patients.
  • BACKGROUND & AIMS: To assess the medico-economic impact of malnutrition in patients who underwent surgery for colorectal cancer.
  • METHODS: We performed post-hoc analyses of data from the Alves et al. prospective study.
  • Using standard criteria of malnutrition, 2 groups were created a posteriori: Well-nourished (WN) and Mal-nourished (MN) patients.
  • RESULTS: 453 patients were included in the analyses.
  • MN patients had a mean LOS 3.41 days significantly longer than WN patients (p = 0.017).
  • In MN patients, the cost of hospital stay was increased by around 3360 €, creating an annual impact of 10,159,436 € for French non-profit hospitals.
  • CONCLUSIONS: Malnutrition in colorectal cancer surgical patients is associated with an increased LOS resulting in significant budget impact.
  • Further studies are needed to investigate this impact and the related cost-benefit of perioperative specialized nutritional support and implementation of the ERAS protocol in this homogeneous category of patients.
  • [MeSH-major] Colorectal Neoplasms / economics. Health Care Costs. Hospitalization / economics. Malnutrition / economics
  • [MeSH-minor] Aged. Aged, 80 and over. Cost-Benefit Analysis. Female. Humans. Length of Stay / economics. Male. Middle Aged. Nutritional Status. Patient Discharge / economics. Postoperative Period. Prospective Studies. Treatment Outcome

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  • [Copyright] Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
  • (PMID = 22608918.001).
  • [ISSN] 1532-1983
  • [Journal-full-title] Clinical nutrition (Edinburgh, Scotland)
  • [ISO-abbreviation] Clin Nutr
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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98. |......... 11%  Greaves F, Pape UJ, King D, Darzi A, Majeed A, Wachter RM, Millett C: Associations between Internet-based patient ratings and conventional surveys of patient experience in the English NHS: an observational study. BMJ Qual Saf; 2012 Jul;21(7):600-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Associations between Internet-based patient ratings and conventional surveys of patient experience in the English NHS: an observational study.
  • OBJECTIVE: Unsolicited web-based comments by patients regarding their healthcare are increasing, but controversial.
  • The relationship between such online patient reports and conventional measures of patient experience (obtained via survey) is not known.
  • The authors examined hospital level associations between web-based patient ratings on the National Health Service (NHS) Choices website, introduced in England during 2008, and paper-based survey measures of patient experience.
  • The authors also aimed to compare these two methods of measuring patient experience.
  • DESIGN: The authors performed a cross-sectional observational study of all (n=146) acute general NHS hospital trusts in England using data from 9997 patient web-based ratings posted on the NHS Choices website during 2009/2010.
  • Hospital trust level indicators of patient experience from a paper-based survey (five measures) were compared with web-based patient ratings using Spearman's rank correlation coefficient.
  • The authors compared the strength of associations among clinical outcomes, patient experience survey results and NHS Choices ratings.
  • RESULTS: Web-based ratings of patient experience were associated with ratings derived from a national paper-based patient survey (Spearman ρ=0.31-0.49, p<0.001 for all).
  • Associations with clinical outcomes were at least as strong for online ratings as for traditional survey measures of patient experience.
  • CONCLUSIONS: Unsolicited web-based patient ratings of their care, though potentially prone to many biases, are correlated with survey measures of patient experience.
  • They may be useful tools for patients when choosing healthcare providers and for clinicians to improve the quality of their services.
  • [MeSH-major] Data Collection / methods. Health Care Surveys / utilization. Health Status Indicators. Hospitals / statistics & numerical data. Internet / utilization. Patient Satisfaction
  • [MeSH-minor] Choice Behavior. Cross-Sectional Studies. England. Female. Humans. Interprofessional Relations. Male. National Health Programs. Organizational Culture. Patient Discharge / statistics & numerical data. Patient Discharge / trends. Patient Readmission / statistics & numerical data. Patient Readmission / trends. Personhood. Qualitative Research. State Medicine

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  • (PMID = 22523318.001).
  • [ISSN] 2044-5423
  • [Journal-full-title] BMJ quality & safety
  • [ISO-abbreviation] BMJ Qual Saf
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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99. |......... 11%  Hamel MB, Teno JM, Goldman L, Lynn J, Davis RB, Galanos AN, Desbiens N, Connors AF Jr, Wenger N, Phillips RS: Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Ann Intern Med; 1999 Jan 19;130(2):116-25
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  • [Title] Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.
  • BACKGROUND: Patient age may influence decisions to withhold life-sustaining treatments, independent of patients' preferences for or ability to benefit from such treatments.
  • PATIENTS: 9105 hospitalized adults who had one of nine illnesses associated with an average 6-month mortality rate of 50%.
  • Adjustment was made for sociodemographic characteristics, prognoses, baseline function, patients' preferences for life-extending care, and physicians' understanding of patients' preferences for life-extending care.
  • RESULTS: The median patient age was 63 years; 44% of patients were women, and 53% survived to 180 days.
  • Physicians underestimated older patients' preferences for life-extending care; adjustment for this underestimation resulted in an attenuation of the association between age and decisions to withhold treatments.
  • CONCLUSION: Even after adjustment for differences in patients' prognoses and preferences, older age was associated with higher rates of decisions to withhold ventilator support, surgery, and dialysis.
  • [MeSH-major] Age Factors. Euthanasia, Passive. Life Support Care. Patient Selection. Withholding Treatment
  • [MeSH-minor] Activities of Daily Living. Aged. Aged, 80 and over. Attitude of Health Personnel. Dementia. Female. General Surgery. Humans. Male. Middle Aged. Multivariate Analysis. Patient Satisfaction. Physicians / psychology. Prejudice. Prognosis. Proportional Hazards Models. Prospective Studies. Renal Dialysis. Respiration, Artificial

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  • (PMID = 10068357.001).
  • [ISSN] 0003-4819
  • [Journal-full-title] Annals of internal medicine
  • [ISO-abbreviation] Ann. Intern. Med.
  • [Language] eng
  • [Grant] United States / NIA NIH HHS / AG / K08 AG0075-02
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Other-IDs] KIE/ 62556
  • [Keywords] KIE ; Death and Euthanasia / Empirical Approach / Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT)
  • [General-notes] KIE/ KIE BoB Subject Heading: allowing to die; KIE/ KIE BoB Subject Heading: selection for treatment; KIE/ For the SUPPORT Investigators; KIE/ Full author name: Hamel, Mary Beth; KIE/ Full author name: Teno, Joan M; KIE/ Full author name: Goldman, Lee; KIE/ Full author name: Lynn, Joanne; KIE/ Full author name: Davis, Roger B; KIE/ Full author name: Galanos, Anthony N; KIE/ Full author name: Desbiens, Norman; KIE/ Full author name: Connors, Alfred F; KIE/ Full author name: Wenger, Neil; KIE/ Full author name: Phillips, Russell S
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100. |......... 11%  Schiøtz M, Price M, Frølich A, Søgaard J, Kristensen JK, Krasnik A, Ross MN, Diderichsen F, Hsu J: Something is amiss in Denmark: a comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente. BMC Health Serv Res; 2011;11:347
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  • BACKGROUND: As many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts.
  • Prior work indicates that chronic care coordination is poor in the DHS, especially in comparison with care in Kaiser Permanente (KP), an integrated delivery system based in the United States.
  • We investigated population rates of hospitalisation and readmission rates for ambulatory care sensitive, chronic medical conditions in the two systems.
  • Reductions in hospitalisations also could improve patient welfare and free considerable resources for use towards preventing disease exacerbations.
  • These conclusions may also apply for similar public systems such as the US Medicare system, the NHS and other systems striving to improve the integration of care for persons with chronic conditions.
  • [MeSH-major] Benchmarking / methods. Delivery of Health Care, Integrated / standards. Health Maintenance Organizations. Hospitalization / statistics & numerical data. Patient Readmission / statistics & numerical data. Preventive Health Services. Quality Improvement / trends
  • [MeSH-minor] Aged. Ambulatory Care / statistics & numerical data. Angina, Stable / diagnosis. Angina, Stable / prevention & control. Angina, Stable / therapy. Cohort Studies. Denmark. Female. Health Status Indicators. Heart Failure / diagnosis. Heart Failure / prevention & control. Heart Failure / therapy. Humans. Hypertension / diagnosis. Hypertension / prevention & control. Hypertension / therapy. Length of Stay / statistics & numerical data. Length of Stay / trends. Male. Pulmonary Disease, Chronic Obstructive / diagnosis. Pulmonary Disease, Chronic Obstructive / prevention & control. Pulmonary Disease, Chronic Obstructive / therapy

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  • (PMID = 22192270.001).
  • [ISSN] 1472-6963
  • [Journal-full-title] BMC health services research
  • [ISO-abbreviation] BMC Health Serv Res
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3258291
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