scholarly journals Corrigendum to Institutional Factors Contribute to Variation in Intubation Rates in Status Epilepticus

2020 ◽  
Vol 10 (2) ◽  
pp. 155-155
Keyword(s):  
Status Epilepticus ◽  
Nationwide Inpatient Sample ◽  
Personal Information ◽  
Data Use ◽  
Healthcare Research ◽  
Online Version ◽  
Institutional Factors ◽  
Restricted Access ◽  
Number Of Patients ◽  
Inpatient Database

Guterman EL, Burke JF, Josephson SA, and Betjemann JP. Institutional Factors Contribute to Variation in Intubation Rates in Status Epilepticus, The Neurohospitalist. 2019;9:133-139. DOI: 10.1177/1941874418819349 In this article, the supplemental table S1 included cells where the number of patients was < 10 which is in violation of the HCUP data use agreement. A revised online version of the supplemental material that is in compliance with the AHRQ guidelines has been posted online. This article is an analysis of the Nationwide Inpatient Sample (NIS), a large, restricted-access, publicly available dataset and the State Inpatient Database (SID), a restricted-access, publicly available dataset that are maintained by the Agency for Healthcare Research and Quality (AHRQ). One of the provisions of the Data Use Agreement (DUA), which the author signed when purchasing the data, is that no data involving less than or equal to 10 observations are to be published. This measure was put in place by AHRQ to protect individual patients’ privacy and to prevent the potential disclosure of personal information. In the manuscript, there are two tabulated cells in the supplemental table S1 that are in violation of this provision. This represents an oversight on the authors’ part and an inadvertent failure to comply with the Data Use Agreement, for which they apologize. While they are fully confident that nothing in the paper could be used to identify individuals or their personal information, the fact remains that the disclosures are in violation of the AHRQ guidelines

scholarly journals An Environmental Scan of Ambulatory Care Quality Indicators for Patients With Advanced Kidney Disease Currently Used in Canada

2021 ◽  
Vol 8 ◽  
pp. 205435812199109
Author(s):  
Jay Hingwala ◽  
Amber O. Molnar ◽  
Priyanka Mysore ◽  
Samuel A. Silver
Keyword(s):  
Kidney Disease ◽  
Ambulatory Care ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Healthcare Research ◽  
Care Quality ◽  
Institute Of Medicine ◽  
Environmental Scan ◽  
Number Of Patients ◽  
Ambulatory Patients

Background: Quality indicators can be used to identify gaps in care and drive frontline improvement activities. These efforts are important to prevent adverse events in the increasing number of ambulatory patients with advanced kidney disease in Canada, but it is unclear what indicators exist and the components of health care quality they measure. Objective: We sought to identify, categorize, and evaluate quality indicators currently in use across Canada for ambulatory patients with advanced kidney disease. Design: Environmental scan of quality indicators currently being collected by various organizations. Setting: We assembled a 16-member group from across Canada with expertise in nephrology and quality improvement. Patients: Our scan included indicators relevant to patients with chronic kidney disease in ambulatory care clinics. Measurements: We categorized the identified quality indicators using the Institute of Medicine and Donabedian frameworks. Methods: A 4-member panel used a modified Delphi process to evaluate the indicators found during the environmental scan using the American College of Physicians/Agency for Healthcare Research and Quality criteria. The ratings were then shared with the full panel for further comments and approval. Results: The environmental scan found 28 quality indicators across 7 provinces, with 8 (29%) rated as “necessary” to distinguish high-quality from poor-quality care. Of these 8 indicators, 3 were measured by more than 1 province (% of patients on a statin, number of patients receiving a preemptive transplant, and estimated glomerular filtration rate at dialysis start); no indicator was used by more than 2 provinces. None of the indicators rated as necessary measured timely or equitable care, nor did we identify any measures that assessed the setting in which care occurs (ie, structure measures). Limitations: Our list cannot be considered as an exhaustive list of available quality indicators at hand in Canada. Our work focused on quality indicators for nephrology providers and programs, and not indicators that can be applied across primary and specialty providers. We also focused on indicator constructs and not the detailed definitions or their application. Last, our panel does not represent the views of other important stakeholders. Conclusions: Our environmental scan provides a snapshot of the scope of quality indicators for ambulatory patients with advanced kidney disease in Canada. This catalog should inform indicator selection and the development of new indicators based on the identified gaps, as well as motivate increased pan-Canadian collaboration on quality measurement and improvement. Trial registration: Not applicable as this article is not a systematic review, nor does it report results of a health intervention on human participants.

Attributable Cost of Clostridium difficile Infection in Pediatric Patients

2017 ◽  
Vol 38 (12) ◽  
pp. 1472-1477 ◽  
Author(s):  
Preeti Mehrotra ◽  
Jisun Jang ◽  
Courtney Gidengil ◽  
Thomas J. Sandora
Keyword(s):  
Logistic Regression ◽  
Clostridium Difficile ◽  
Propensity Score ◽  
Regression Model ◽  
Generalized Linear Model ◽  
Logistic Regression Model ◽  
Propensity Scores ◽  
Healthcare Research ◽  
Design And Methods ◽  
Inpatient Database

OBJECTIVESThe attributable cost of Clostridium difficile infection (CDI) in children is unknown. We sought to determine a national estimate of attributable cost and length of stay (LOS) of CDI occurring during hospitalization in children.DESIGN AND METHODSWe analyzed discharge records of patients between 2 and 18 years of age from the Agency for Healthcare Research and Quality (AHRQ) Kids’ Inpatient Database. We created a logistic regression model to predict CDI during hospitalization based on demographic and clinical characteristics. Predicted probabilities from the logistic regression model were then used as propensity scores to match 1:2 CDI to non-CDI cases. Charges were converted to costs and compared between patients with CDI and propensity-score–matched controls. In a sensitivity analysis, we adjusted for LOS as a confounder by including it in both the propensity score and a generalized linear model predicting cost.RESULTSWe identified 8,527 pediatric hospitalizations (0.53%) with a diagnosis of CDI and 1,597,513 discharges without CDI. In our matched cohorts, the attributable cost of CDI occurring during a hospitalization ranged from $1,917 to $8,317, depending on whether model was adjusted for LOS. When not adjusting for LOS, CDI-associated hospitalizations cost 1.6 times more than non-CDI associated hospitalizations. Attributable LOS of CDI was approximately 4 days.CONCLUSIONSClostridium difficile infection in hospitalized children is associated with an economic burden similar to adult estimates. This finding supports a continued focus on preventing CDI in children as a priority. Pediatric CDI cost analyses should account for LOS as an important confounder of cost.Infect Control Hosp Epidemiol 2017;38:1472–1477

scholarly journals Institutional Factors Contribute to Variation in Intubation Rates in Status Epilepticus

2018 ◽  
Vol 9 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Elan L. Guterman ◽  
James F. Burke ◽  
S. Andrew Josephson ◽  
John P. Betjemann
Keyword(s):  
Status Epilepticus ◽  
Institutional Factors

The Prevalence and Impact of Status Epilepticus Secondary to Intracerebral Hemorrhage: Results from the US Nationwide Inpatient Sample

2018 ◽  
Vol 28 (3) ◽  
pp. 353-361
Author(s):  
Amol Mehta ◽  
Benjamin E. Zusman ◽  
Lori A. Shutter ◽  
Ravi Choxi ◽  
Ahmed Yassin ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Intracerebral Hemorrhage ◽  
Nationwide Inpatient Sample ◽  
The Us

scholarly journals Attitudes and Knowledge of Adolescents in Jordan Regarding the Ethics of Social Media Data Use for Research Purposes

2020 ◽  
Vol 15 (1-2) ◽  
pp. 87-96
Author(s):  
Hiba Wazeer Al Zou’bi ◽  
Moawiah Khatatbeh ◽  
Karem H. Alzoubi ◽  
Omar F. Khabour ◽  
Wael K. Al-Delaimy
Keyword(s):  
Social Media ◽  
Informed Consent ◽  
Online Survey ◽  
Personal Information ◽  
Data Use ◽  
Ethical Aspects ◽  
Social Media Data ◽  
Attitudes And Knowledge ◽  
Media Data ◽  
Research Studies

This study assessed the awareness and attitudes of adolescents in Jordan concerning the ethics of using their social media data for scientific studies. Using an online survey, 393 adolescents were recruited (mean age: 17.2 years ± 1.8). The results showed that 88% of participants were using their real personal information on social media sites, with males more likely to provide their information than females. More than two thirds of participants (72.5%) were aware that researchers may use their data for research purposes, with the majority believing that informed consent must be obtained from both the adolescents and their parents. However, more than three quarters of those surveyed (76%) did not trust the results of research that depended on collecting data from social media. These findings suggest that adolescents in Jordan understood most of the ethical aspects related to the utilization of their data from social media websites for research studies.

Outcomes Assessment of Multi-Level Sleep Surgery in Syndromic Versus Non-Syndromic Children

2020 ◽  
Vol 129 (6) ◽  
pp. 556-564
Author(s):  
Suqrat Munawar ◽  
Alexander P. Marston ◽  
Terral Patel ◽  
Shaun A. Nguyen ◽  
David R. White
Keyword(s):  
Length Of Stay ◽  
Sleep Disordered Breathing ◽  
Healthcare Research ◽  
Chi Square ◽  
Sleep Surgery ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Potential Risks ◽  
Multi Level ◽  
Inpatient Database

Objectives: Analyze the differences in length of stay, cost, disposition, and demographics between syndromic and non-syndromic children undergoing multi-level sleep surgery. Methods: Children with sleep disordered breathing or obstructive sleep apnea that had undergone sleep surgeries were isolated from the 1997 to 2012 editions of the Kids’ Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Children were then classified as syndromic or non-syndromic and stratified by level of sleep surgery (tonsillectomy & adenoidectomy, tonsillectomy & adenoidectomy plus other site surgery, other site surgery). Length of stay and cost were reported with Kruskal–Wallis one-way analysis of variance, disposition with binomial logistic regression, and demographics with chi-square. Results: Syndromic children compared to non-syndromic children were more likely to have surgery beyond just tonsillectomy & adenoidectomy and also had a longer length of stay, higher total cost and non-routine disposition (all P < .001). Syndromic children undergoing tonsillectomy and adenoidectomy plus other site surgery had a longer length of stay compared to syndromic children undergoing tonsillectomy & adenoidectomy (6.00 days vs 3.63 days, P < .001). However, no similar statistically significant difference in length of stay was found in non-syndromic children (2.01 days vs 2.87 days, P > .05). Conclusion: The potential risks/benefits need to be weighed carefully before undertaking sleep surgery in syndromic children. They experience a longer length of stay, higher cost, and non-routine disposition when compared to non-syndromic children. This is especially true when considering the transition from tonsillectomy & adenoidectomy to tonsillectomy & adenoidectomy plus other site surgery, as syndromic children experience a longer length of stay and non-syndromic children do not.

Estimating the Attributable Disease Burden and Effects of Interhospital Patient Sharing on Clostridium difficile Infections

2019 ◽  
Vol 40 (6) ◽  
pp. 656-661 ◽  
Author(s):  
Daniel K. Sewell ◽  
Jacob E. Simmering ◽  
Samuel Justice ◽  
Sriram V. Pemmaraju ◽  
Alberto M. Segre ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Disease Burden ◽  
Local Level ◽  
Intervention Strategies ◽  
Directed Network ◽  
Patient Transfers ◽  
Network Autocorrelation ◽  
Monthly Average ◽  
Number Of Patients ◽  
Inpatient Database

AbstractObjective:To estimate the burden of Clostridium difficile infections (CDIs) due to interfacility patient sharing at regional and hospital levels.Design:Retrospective observational study.Methods:We used data from the Healthcare Cost and Utilization Project California State Inpatient Database (2005–2011) to identify 26,878,498 admissions and 532,925 patient transfers. We constructed a weighted, directed network among the hospitals by defining an edge between 2 hospitals to be the monthly average number of patients discharged from one hospital and admitted to another on the same day. We then used a network autocorrelation model to study the effect of the patient sharing network on the monthly average number of CDI cases per hospital, and we estimated the proportion of CDI cases attributable to the network.Results:We found that 13% (95% confidence interval [CI], 7.6%–18%) of CDI cases were due to diffusion through the patient-sharing network. The network autocorrelation parameter was estimated at 5.0 (95% CI, 3.0–6.9). An increase in the number of patients transferred into and/or an increased CDI rate at the hospitals from which those patients originated led to an increase in the number of CDIs in the receiving hospital.Conclusions:A minority but substantial burden of CDI infections are attributable to hospital transfers. A hospital’s infection control may thus be nontrivially influenced by its neighboring hospitals. This work adds to the growing body of evidence that intervention strategies designed to minimize HAIs should be done at the regional rather than local level.

Inpatient epidemiology and economic burden of granulomatosis with polyangiitis: a 10-year study of the national inpatient sample

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3685-3689 ◽  
Author(s):  
Patompong Ungprasert ◽  
Matthew J Koster ◽  
Wisit Cheungpasitporn ◽  
Karn Wijarnpreecha ◽  
Charat Thongprayoon ◽  
...  
Keyword(s):  
Economic Burden ◽  
Nationwide Inpatient Sample ◽  
Granulomatosis With Polyangiitis ◽  
Kidney Injury ◽  
Total Hospital Cost ◽  
National Inpatient Sample ◽  
Total Hospital ◽  
All Cause Mortality ◽  
The Usa ◽  
Inpatient Database

Abstract Objective To characterize inpatient epidemiology and economic burden of granulomatosis with polyangiitis (GPA). Methods Patients with GPA were identified from the Nationwide Inpatient Sample (NIS), the largest inpatient database in the USA consisting of over 4000 non-federal acute care hospitals, using the ICD-9 CM code. A cohort of comparators without GPA was also constructed from the same database. Data on demographics, procedures, length of stay, mortality, morbidity and total hospitalization charges were extracted. All analysed data were extracted from the database for the years 2005–2014. Results The inpatient prevalence of GPA was 32.6 cases per 100 000 admissions. GPA itself (38.3%), pneumonia (13.7%) and sepsis (8.4%) were the most common reasons for admission. After adjusting for potential confounders, the all-cause mortality adjusted odds ratio (aOR) of patients with GPA was significantly higher than that of patients without GPA (aOR 1.20; 95% CI: 1.41, 1.61). This was also true for several morbidities, including acute kidney injury, multi-organ failure, shock and need for intensive care unit admission. Hospitalizations of patients with GPA were associated with higher cost as demonstrated by an adjusted additional mean of $5125 (95% CI: $4719, $5531) for total hospital cost and an adjusted additional mean of $16 841 (95% CI: $15 280, $18 403) for total hospitalization charges when compared with patients without GPA. Conclusion Inpatient prevalence of GPA was higher than what would be expected from prevalence in the general population. Hospitalizations of patients with GPA were associated with higher morbidity, mortality and cost.

Treatments and outcomes of encapsulating peritoneal sclerosis in patients undergoing peritoneal dialysis: 295 cases from a nationwide inpatient database in Japan

2020 ◽  
Vol 40 (6) ◽  
pp. 593-599
Author(s):  
Takaaki Konishi ◽  
Michimasa Fujiogi ◽  
Nobuaki Michihata ◽  
Kojiro Morita ◽  
Hiroki Matsui ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Emergency Admission ◽  
Corticosteroid Treatment ◽  
Normal Body Mass Index ◽  
Continuous Hemodiafiltration ◽  
Venous Catheterization ◽  
Number Of Patients ◽  
Significant Difference ◽  
Never Smokers ◽  
Inpatient Database

Background: The number of patients undergoing renal replacement therapy is increasing. We evaluated the practice patterns and outcomes of encapsulating peritoneal sclerosis (EPS) in patients undergoing peritoneal dialysis. Methods: Using a Japanese national inpatient database, we identified 295 patients with EPS who were hospitalized from July 2010 to March 2017. We categorized them into four groups: those who underwent surgery only ( n = 39), those who received corticosteroid treatment only ( n = 70), those who underwent both ( n = 30), and those who underwent neither ( n = 156). We investigated their characteristics, treatments, and outcomes. Results: More than half of patients were males and never-smokers and had a normal body mass index. Patients tended to undergo parenteral nutrition for 2 months. The proportions of emergency admission, intensive care unit (ICU) admission, central venous catheterization, catecholamine use, mechanical ventilation, and continuous hemodiafiltration were significantly different among the four groups (61%, 8.1%, 37.0%, 44.0%, 8.8%, and 5.8%, respectively). The both-treatment group had a significantly longer hospital stay (37.0 vs. 37.5 vs. 72.5 vs. 31.0 days, p < 0.001) and higher costs (US$16,554 vs. US$17,029 vs. US$33,757 vs. US$13,983, p < 0.001) than the other groups. In total, 52 patients (18%) died during hospitalization. There was no significant difference in inhospital complications and death, discharge status, 30-day readmission, or length of ICU stay among the four groups. Conclusions: Our findings provide useful information for clinicians and patients hospitalized for treatment of EPS.

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