scholarly journals Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1461
Author(s):  
Jorge Arias-de la Torre ◽  
Evangelia Anna María Zioga ◽  
Lizza Macorigh ◽  
Laura Muñoz ◽  
Oriol Estrada ◽  
...  

Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered—admission avoidance (n = 7214; 75.1%) and early assisted discharge (n = 2387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities.

2020 ◽  
Author(s):  
Jorge Arias de la Torre ◽  
Evangelia Anna María Zioga ◽  
Lizza Macorigh ◽  
Laura Muñoz ◽  
Oriol Estrada ◽  
...  

Abstract Background Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. Previous studies have described two basic types of HaH: hospital admission avoidance and early discharge The aims of this study were: To describe the characteristics of different types of hospital-at-home (HaH) contacts; to assess readmission, mortality, and mean length of stay for each HaH modality; and to examine which factors could be related to these results. Methods A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered: admission avoidance (n=7,214; 75.1%) and early discharge (n=2,387; 24.9%). The main outcome indicators were readmission, mortality, and mean length of stay (days). Contact characteristics were compared at bivariable level and indicators were calculated for each HaH modality. Multivariable General linear models were fitted to assess the association between explanatory factors and outcomes. Results Differences in contact characteristics between HaH modalities were observed at bivariable level. In the hospital avoidance modality there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early discharge one, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. Conclusions The results show that the HaH results in Catalonia are acceptable and similar to those observed in other contexts. The factors related to these results could help improve the effectiveness and efficiency of the different HaH modalities.


2019 ◽  
Author(s):  
Jorge Arias de la Torre ◽  
Evangelia Anna María Zioga ◽  
Lizza Macorigh ◽  
Laura Muñoz ◽  
Oriol Estrada ◽  
...  

Abstract Background Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. Previous studies have described two basic types of HaH: hospital admission avoidance and early discharge The aims of this study were: To describe the characteristics of different types of hospital-at-home (HaH) contacts; to assess readmission, mortality, and mean length of stay for each HaH modality; and to examine which factors could be related to these results. Methods A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered: admission avoidance (n=7,214; 75.1%) and early discharge (n=2,387; 24.9%). The main outcome indicators were readmission, mortality, and mean length of stay (days). Contact characteristics were compared at bivariable level and indicators were calculated for each HaH modality. Multivariable General linear models were fitted to assess the association between explanatory factors and outcomes. Results Differences in contact characteristics between HaH modalities were observed at bivariable level. In the hospital avoidance modality there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early discharge one, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. Conclusions The results show that the HaH results in Catalonia are acceptable and similar to those observed in other contexts. The factors related to these results could help improve the effectiveness and efficiency of the different HaH modalities.


2021 ◽  
Vol 9 ◽  
Author(s):  
Yi Feng Lai ◽  
Yee Wei Lim ◽  
Win Sen Kuan ◽  
Joel Goh ◽  
John Tshon Yit Soong ◽  
...  

Introduction: Hospital-at-Home (HaH) programmes are well-established in Australia, Europe, and the United States. However, there is limited experience in Asia, where the hospital is traditionally seen as a safe and trusted space for healing. This cross-sectional study aimed to explore attitudes and perceptions among patients and caregivers in Singapore toward this care model.Methods: A quantitative study design was adopted to collect data among patients and their caregivers from medical wards within two acute hospitals in Singapore. Using a series of closed-ended and open-ended questions, the investigator-administered survey aimed to explore barriers and facilitators determining patients' and caregivers' responses. The study questionnaire was pretested and validated. Data were summarised using descriptive statistics, and logistic regression was performed to determine key factors influencing patients' decisions to enrol in such programmes.Results: Survey responses were collected from 120 participants (101 patients, 19 caregivers; response rate: 76%), of which 87 respondents (72.5%) expressed willingness to try HaH if offered. Many respondents valued non-quantifiable programme benefits, including perceived gains in quality of life. Among them, reasons cited for acceptance included preference for the comfort of their home environment, presence of family members, and confidence toward remote monitoring modalities. Among respondents who were unwilling to accept HaH, a common reason indicated was stronger confidence toward hospital care.Discussion: Most patients surveyed were open to having acute care delivered in their home environment, and concerns expressed may largely be addressed by operational considerations. The findings provide useful insights toward the planning of HaH programmes in Singapore.


2012 ◽  
pp. 129-134
Author(s):  
Thi Lan Tran ◽  
Thi Huong Le ◽  
Xuan Ninh Nguyen

Objectives: Assess the nutritional status, worm infection status and some related factors among children aged 12-36 months of Dakrong district, Quang Tri province. Subject and method: A cross sectional study was carried out in 2010, in 680 children aged 12-36 months in 4 communes of Dakrong district, Quang Tri province. Results: The malnutrition rate was 55.0% for underweight, 66.5% for stunting and 16.2% for wasting. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), followed by Hookworm and Trichuris (6.5% and 6.2%, respectively). The prevalence of worm infection among children under two is very high (27.0%). The prevalence of worm infection was distributed quite equally between the malnutrition children group and normal children group. Recommendation: Early deworming forchildren from 12 months should be considered as important strategy against the malnutrition of children in Dakrong district, Quang Tri province


2020 ◽  
Vol 15 (2) ◽  
pp. 105-110
Author(s):  
Haile Kassahun ◽  
Dugessa Tesfaye

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029931 ◽  
Author(s):  
Akihiko Narisada ◽  
Kohta Suzuki

ObjectiveTo investigate the associations among procrastination (time inconsistency), work environment and obesity-related factors in Japanese male workers.DesignCross-sectional study.SettingData were collected at two work sites of Japanese electronics manufacturing company in 2015.Participants795 full-time male workers in a Japanese electric company, aged 35–64 years, who underwent health checkups in 2015.Main outcome measuresBody mass index (BMI), adult weight change, obesity (BMI ≥25 kg/m2), adult weight gain over 10 kg (AWG10) and metabolic syndrome (MetS). Multivariable linear and logistic regression analyses were performed to assess the associations of procrastination assessed by using a one-item questionnaire and white-collar and blue-collar work with obesity-related factors.ResultsWhite-collar workers with high procrastination levels showed positive associations with BMI (B: 0.75, 95% CI 0.06 to 1.44) and adult weight change (B: 1.77, 95% CI 0.26 to 3.29), and had increased odds of AWG10 (OR: 1.85, 95% CI 1.04 to 3.29) and MetS (OR: 2.29 95% CI 1.18 to 4.44) after adjustment for age, education, work-related factors and lifestyle factors. However, such positive associations were not observed among blue-collar workers.ConclusionsProcrastination and white-collar work might have a joint effect on weight gain during adulthood and consequential obesity.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah L. McKune ◽  
Daniel Acosta ◽  
Nick Diaz ◽  
Kaitlin Brittain ◽  
Diana Joyce- Beaulieu ◽  
...  

Abstract Background Given the emerging literature regarding the impacts of lockdown measures on mental health, this study aims to describe the psychosocial health of school-aged children and adolescents during the COVID-19 Safer-at-Home School mandates. Methods A cross-sectional study was conducted in April 2020 (n = 280) among K-12 students at a research school in North Central Florida. Bivariate analysis and logistic and multinomial logistic regression models were used to examine socio-demographic and knowledge, attitude, and practice (KAP) predictors of indicators of anxiety-related, depressive, and obsessive-compulsive disorder(OCD)-related symptoms. Outcomes (anxiety, OCD, and depressive related symptoms) were measured by indices generated based on reported symptoms associated with each psychosocial outcome. Results Loss of household income was associated with increased risk for all three index-based outcomes: depressive symptoms [aOR = 3.130, 95% CI = (1.41–6.97)], anxiety-related symptoms [aOR = 2.531, 95%CI = (1.154–5.551)], and OCD-related symptoms [aOR = 2.90, 95%CI = (1.32–6.36)]. Being female was associated with being at higher risk for depressive symptoms [aOR = 1.72, 95% CI = (1.02–2.93)], anxiety-related symptoms [aOR = 1.75, 95% CI = (1.04–2.97)], and OCD-related symptoms [aOR = 1.764, 95%CI = (1.027–3.028)]. Parental practices protective against COVID-19 were associated with children being at higher risk of depressive symptoms [aOR = 1.55, 95% CI = (1.04–2.31)]. Lower school level was associated with children being at higher risk of anxiety-related and OCD-related symptoms. Conclusions As the COVID-19 pandemic continues, schools should prioritize mental health interventions that target younger, female students, and children of families with income loss. Limiting the spread of COVID-19 through school closure may exacerbate negative psychosocial health outcomes in children, thus school administrators should move quickly to target those at greatest risk.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.


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