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Illness And Wait Time

Moritz Köhnen, Jörg Dirmaier, Martin Härter
Mental disorders are common and impairing for both affected individuals and society. Despite the great burden of mental disorders and a comparably well-developed mental health care system in Germany, mental disorders are still treated insufficiently. Additionally, access barriers such as long waiting times for outpatient treatment impede utilization of mental health care services. E-mental health interventions are considered as promising options to reduce access barriers and to overcome gaps in the mental health care system...
March 2019: Fortschritte der Neurologie-Psychiatrie
R-D Berndt, P Preik, C Takenga
BACKGROUND: Health care for the increasing number of patients with chronic illnesses has become a major challenge to the politics of public health, especially in rural areas. Follow-up care for those patients requires a great amount of resources. Apart from managing appointments, patients often have to accept long journeys and waiting times. OBJECTIVE: Implementation of teledermatology solutions, providing telemedicine care for patients with skin diseases in structurally weak regions...
March 15, 2019: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Wendy Balliet, Abby S Kazley, Emily Johnson, Lauren Holland-Carter, Stacey Maurer, Jennifer Correll, Nicole Marlow, Kenneth Chavin, Prabhakar Baliga
BACKGROUND: Kidney transplantation improves survival and quality of life for patients with end-stage kidney disease (ESKD). However, there is a shortage of donated organs, resulting in long wait times and the potential for death before a donor is found. Non-directed (also called altruistic) living kidney donation is a growing type of donation; however, few studies have examined the values and motivation of individuals evaluated to be a non-directed donor. OBJECTIVES: This qualitative study explores the motivations and values of individuals evaluated for non-directed donation...
March 13, 2019: Journal of Renal Care
Mark Tambe Keboa, Richard Hovey, Belinda Nicolau, Shahrokh Esfandiari, Franco Carnevale, Mary Ellen Macdonald
OBJECTIVE: To understand the oral healthcare experiences of humanitarian migrants in Montreal and their perceptions of ways to improve access to oral healthcare. METHODS: We used focused ethnography informed by a public health model of the dental care process. The adapted McGill Illness Narrative Interview (MINI) guided interviews of a purposeful sample of humanitarian migrants who received or needed dental care in Montreal. Each interview (50-60 min) was audio-recorded for verbatim transcription...
March 8, 2019: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Marianne K Thygesen, Gunnar Baatrup, Christina Petersen, Niels Qvist, Rasmus Kroijer, Morten Kobaek-Larsen
BACKGROUND: The standard investigation in colorectal cancer screening (optical colonoscopy [OC]) has a less invasive alternative with the colon capsule endoscopy (CCE). The experiences of screening individuals are needed to support a decision aid (DA) and to provide a patient view in future health technology assessments (HTA). We aimed to explore the experiences of CCE at home and OC in an outpatient clinic by screening participants who experienced both investigations on the same bowel preparation...
March 1, 2019: Acta Oncologica
Shannon Fortin Ensign, Katie Baca-Motes, Steven R Steinhubl, Eric J Topol
Many barriers to primary healthcare accessibility in the United States exist including an increased opportunity cost associated with seeking primary care. New models of healthcare delivery aimed at addressing these problems are emerging. The potential impact that on-demand primary care physician house calls services can have on healthcare accessibility, patient care, and satisfaction by both patients and physicians is poorly characterized.We performed a retrospective observational analysis on data from 13,849 patients who utilized Heal, Inc, an application (app)-based, on-demand house calls platform between August 2016 and July 2017...
February 2019: Medicine (Baltimore)
V Koivukangas, A Saarela, S Meriläinen, H Wiik
BACKGROUND AND AIMS: Emergency surgery represents an essential aspect of surgical care, but little is known about realization of the planned emergency class. Different systems such as NCEPOD classification and Timing of Acute Care Surgery classification have been developed for the timing of the emergency surgery. The aim of the study was to find out how well planned urgency class is being implemented. MATERIALS AND METHODS: The planned and realized waiting times for all emergency surgeries were studied during the 6-month period in the Oulu University Hospital...
February 20, 2019: Scandinavian Journal of Surgery: SJS
Stéphane Gaudry, Jean-Pierre Quenot, Alexandre Hertig, Saber Davide Barbar, David Hajage, Jean-Damien Ricard, Didier Dreyfuss
Acute kidney injury (AKI) affects many intensive care unit patients and is responsible for increased morbidity and mortality. Although life-saving in many situations, renal replacement therapy (RRT) may be associated with complications and the appropriate timing of its initiation is still the subject of intense debate. An early initiation strategy can prevent some metabolic complications whereas a delayed one may allow for renal function recovery in some patients without need for this costly and potentially dangerous technique...
February 20, 2019: American Journal of Respiratory and Critical Care Medicine
Nathalie V Kizirian, Kirsten I Black, Loretta Musgrave, Charlotte Hespe, Adrienne Gordon
BACKGROUND: Preconception care (PCC) defines health interventions prior to conception aimed at improving pregnancy and infant outcomes. AIM: To explore the understanding and provision of PCC by general practitioners (GPs) within the Sydney Local Health District. MATERIALS AND METHODS: A questionnaire developed with GPs assessed structure and content of PCC provided, attitudes toward PCC and perceived barriers and facilitators. RESULTS: One hundred and ten GPs completed the survey: 84% reported that GPs should be the main providers of PCC; however, only 53% were aware of PCC guidelines...
February 17, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Marina Cecilia Vera, María Eugenia Biancardi, Hebe Bottai, María Cristina Lugano, Ariel Darío Quiroga, Gerardo Bruno Pisani, Alejandra Beatriz Quintana
BACKGROUND: the shortage of donors of hepatocyte transplantation therapy led to the use of so-called marginal donors. Some donors may have a hepatic illnesses that is associated with hepatic preneoplasia with foci of altered hepatocytes (FAH). AIMS: to determine whether recipients developed FAH upon transplantation with hepatocytes from a preneoplastic liver and whether FAH progresses to a preneoplastic hepatocyte-derived tumor (PHDT), up to 60 days after transplantation...
February 15, 2019: Revista Española de Enfermedades Digestivas
J F Ebert, L Huibers, B Christensen, M B Christensen, F K Lippert
OBJECTIVE: Acute out-of-hours (OOH) healthcare is challenged by potentially long waiting time for callers in acute need of medical aid. OOH callers must usually wait in line, even when contacting for highly urgent or life-threatening conditions. We tested an emergency access button (EAB), which allowed OOH callers to bypass the waiting line if they perceived their health problem as severe. We aimed to investigate EAB use and patient characteristics associated with this use. DESIGN: Comparative intervention study...
February 2, 2019: Scandinavian Journal of Primary Health Care
Darryl Maybery, Melinda Goodyear, Andrea Reupert, Jade Sheen, Warren Cann, Brendan O'Hanlon, Rose Cuff
Let's Talk About Children is a manualised intervention for parents with a mental illness that aims to impact positively on family dynamics. Previous evaluations focused on parents with an affective disorder. The purpose of this study was to evaluate the intervention for parents with various mental illnesses and explore parents' self-reported views regarding the impact of the intervention. A quasi-experimental approach was employed to compare outcomes for parents who received Let's Talk About Children plus treatment as usual ( n = 20) with a wait list control (treatment as usual) group ( n = 19), using family functioning and parenting stress questionnaires...
January 30, 2019: Clinical Child Psychology and Psychiatry
Susan S Li, Rebecca Miller, Dmitry Tumin, William C L Stewart, Joseph D Tobias, Don Hayes
BACKGROUND: The Lung Allocation Score (LAS) prioritizes lung transplant (LTx) candidates with poor transplant-free survival and expected survival benefit from LTx. Although patients with the highest LAS have the shortest waiting time, mortality benefit is unclear in this group, raising criticism that LAS inappropriately prioritizes critically ill candidates. We aim to identify a threshold above which increasing LAS values do not predict increasing survival benefit. METHODS: The United Network for Organ Sharing Registry was queried for first-time adult LTx candidates with LAS ≥30 between May 2005 and December 2016...
January 18, 2019: Chest
Jörn von Wietersheim, Jamie Dwayne Knoblauch, Juan Valdes-Stauber, Cornelia Albani, Martin von Wachter, Joachim Hartmann, Edit Rottler, Marc Jarczok, Michael Hölzer, Harald Gündel
INTRODUCTION: Waiting times for the admission into a so called psychosomatic hospital in Germany prevent the necessary immediate treatment. They lead to further incapacity for work and chronic manifestation of the disease. It is reported that most psychosomatic hospitals have waiting times, but there are no studies on data on that. Therefore, it was the aim of this study to access prospectively in a defined region, how long it takes for the patients to get an outpatient preliminary talk and thereafter, how long they have to wait for their admission...
January 16, 2019: Psychotherapie, Psychosomatik, Medizinische Psychologie
Amílcar Magaço, Kathryn Dovel, Fabian Cataldo, Pedroso Nhassengo, Risa Hoffman, Lucas Nerua, José Tique, Mohomed Saide, Aleny Couto, Francisco Mbofana, Eduardo Gudo, Rosa Marlene Cuco, Sérgio Chicumbe
HIV test-and-treat programmes are being implemented throughout sub-Saharan Africa, enrolling HIV-positive clients into antiretroviral treatment (ART) immediately after diagnosis, regardless of clinical stage or CD4 count. This study conducted in Mozambique examined what influenced clients who tested HIV-positive in the context of test-and-treat to make ART initiation decisions. Eighty in-depth interviews with HIV-positive clients and nine focus group discussions with health care workers were completed across 10 health facilities...
January 14, 2019: Culture, Health & Sexuality
B A Stott, S Moosa
BACKGROUND: Primary health care worldwide faces large numbers of patients daily. Poor waiting times, low patient satisfaction and staff burnout are some problems facing such facilities. Limited research has been done on sorting patients in non-emergency settings in Africa. This research looked at community health centres (CHCs) in Gauteng Province, South Africa where queues appear to be poorly managed and patients waiting for hours. This study explores the views of clinicians in CHCs across Gauteng on sorting systems in the non-emergency ambulatory setting...
January 7, 2019: BMC Family Practice
Sarah Stankiewicz, Craig Larsen, Francesca Sullivan, Cristina Zullo, Suzanne C Pugh, Miroslav Kopp
BACKGROUND: ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication, higher rates of complications, and increased mortality. METHODS: In an attempt to improve patient flow and reduce time spent in the emergency department for patients requiring admission to the surgical intensive care unit (SICU), the emergency department, trauma service, and SICU collaborated on a guideline...
December 11, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
H X Shi, J Z Wu, G B Chen, B Z Zhu, W Y Yan, L Chen, Y J Xiao, L Y Zhang
Objective: To assess the effectiveness in optimizing resources and shortening critical children's waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Daria J O'Reilly, Gord Blackhouse, Sheri Burns, James M Bowen, Natasha Burke, Jeff Mehltretter, Nancy M Waite, Sherilyn Kd Houle
Objective: The aim of this study was to evaluate the impact of pharmacist administration of influenza vaccine in Ontario on: 1) vaccination-associated costs related to the number of people vaccinated; 2) annual influenza-related outcomes and costs; and 3) change in productivity costs. Methods: Using available data for Ontario, the total number of vaccinations given by providers in the 2011/12 influenza season (pre) was compared to the 2013/14 influenza season (post)...
2018: ClinicoEconomics and Outcomes Research: CEOR
Kapil Dev Soni, Gaurav Kaushik, Amit Gupta, Vishwajeet Singh, Subodh Kumar, Sushma Sagar
Introduction: Emergency department (ED) overcrowding with critically ill trauma patients has been a major concern globally. It has been shown that longer stays in the hospital before Intensive Care Unit (ICU) admission have a higher mortality rate. Objective: The objective of this study was to find whether the delay in ICU admission from ED is associated with significant mortality in a trauma patient. Methods: A prospective trauma registry data of 232 patients collected from the ED of JPNATC trauma center between September 2015 and March 2016 were used in the study...
July 2018: Journal of Emergencies, Trauma, and Shock
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