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Sample records for hospitalized persons united

  1. Nontuberculous Mycobacteria–associated Lung Disease in Hospitalized Persons, United States, 1998–2005

    PubMed Central

    Billinger, Megan E.; Olivier, Kenneth N.; Viboud, Cecile; Montes de Oca, Ruben; Steiner, Claudia; Holland, Steven M.

    2009-01-01

    The prevalence and trends of pulmonary nontuberculous mycobacteria (NTM)–associated hospitalizations in the United States were estimated using national hospital discharge data. Records were extracted for all persons with a pulmonary NTM International Classification of Diseases code (031.0) hospitalized in the 11 states with continuous data available from 1998 through 2005. Prevalence was calculated using US census data. Pulmonary NTM hospitalizations (031.0) increased significantly with age among both sexes: relative prevalence for persons 70–79 years of age compared with those 40–49 years of age was 15/100,000 for women (9.4 vs. 0.6) and 9/100,000 for men (7.6 vs. 0.83). Annual prevalence increased significantly among men and women in Florida (3.2%/year and 6.5%/year, respectively) and among women in New York (4.6%/year) with no significant changes in California. The prevalence of pulmonary NTM–associated hospitalizations is increasing in selected geographic areas of the United States. PMID:19861046

  2. Quality and Innovations for Caring Hospitalized Older Persons in the Unites States

    PubMed Central

    Yoo, Ji Won; Kim, Sun Jung; Geng, Yan; Shin, Hyun Phil; Nakagawa, Shunichi

    2014-01-01

    Older persons are occasionally acutely ill and their hospitalizations frequently end up with complications and adverse outcomes. Medicare from U.S. federal government’s payment resource for older persons is facing financial strain. Medicare highlights both cost-saving and high quality of care while older persons are hospitalized. Several health policy changes were initiated to achieve Medicare’s goals. In response to Medicare’s health policy changes, U.S. hospital environments have been changed and these resulted in hospital quality measurements’ improvement. American seniors are facing the challenges during and around their hospital care. Several innovative measures are suggested to overcome these challenges. PMID:24490116

  3. Increase in nonhepatic diagnoses among persons with hepatitis C hospitalized for any cause, United States, 2004-2011.

    PubMed

    Tong, X; Spradling, P R

    2015-11-01

    Although persons with hepatitis C virus (HCV) infection may experience nonhepatic illnesses, little is known about the frequency of and trends in such conditions in a population-based sample of HCV-infected persons. Using hospitalization data collected during 2004-2011 from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, we examined trends in comorbidities among all hospitalizations that included either a principal or secondary HCV diagnostic code (i.e., HCV was not necessarily the cause for hospitalization). We also compared comorbidities among all persons aged 45-64 years hospitalized with and without principal or secondary HCV diagnostic codes. The estimated number of hospitalizations among persons with HCV infection increased from 850,490 in 2004-2005 to 1,178,633 in 2010-2011; mean age at hospitalization was 50 years in 2004-2005 and 52.5 years in 2010-2011. There were significant increases in the prevalence of most medical and psychiatric comorbidities; the largest were for lipid disorders, chronic kidney disease and obesity. Among HCV-infected aged 45-64 persons hospitalized for any cause, the prevalence of alcohol /substance abuse, mental disorders, chronic kidney disease, pneumonia, hepatitis B virus infection and HIV infection were significantly higher than those aged 45-64 persons hospitalized without HCV infection (P < 0.001 for all). The prevalence of cryoglobulinaemia, vasculitis, nephrotic syndrome or membranoproliferative glomerulonephritis and porphyria cutanea tarda among hospitalizations with HCV infection was consistently low during the study period (i.e., <0.5%). The increase we observed in nonhepatic comorbidities associated with a high risk of HCV-related complications has important implications for the current HCV treatment recommendations in a greatly expanded treatment population. PMID:25894392

  4. Hospitality, Recreation, and Personal Service Occupations: Grade 8. Cluster V.

    ERIC Educational Resources Information Center

    Calhoun, Olivia H.

    A curriculum guide for grade 8, the document is devoted to the occupational cluster "Hospitality, Recreation, and Personal Service Occupations." It is divided into four units: recreational resources for education, employment, and professional opportunities; barbering and cosmetology; mortuary science; hotel-motel management. Each unit is…

  5. Leptospirosis-Associated Hospitalizations, United States, 1998–2009

    PubMed Central

    Callinan, Laura S.; Holman, Robert C.; Steiner, Claudia; Guerra, Marta A.

    2014-01-01

    A small percentage of persons with leptospirosis, a reemerging zoonosis, experience severe complications that require hospitalization. The number of leptospirosis cases in the United States is unknown. Thus, to estimate the hospitalization rate for this disease, we analyzed US hospital discharge records for 1998–2009 for the total US population by using the Nationwide Inpatient Sample. During that time, the average annual rate of leptospirosis-associated hospitalizations was 0.6 hospitalizations/1,000,000 population. Leptospirosis-associated hospitalization rates were higher for persons >20 years of age and for male patients. For leptospirosis-associated hospitalizations, the average age of patients at admission was lower, the average length of stay for patients was longer, and hospital charges were higher than those for nonleptospirosis infectious disease–associated hospitalizations. Educating clinicians on the signs and symptoms of leptospirosis may result in earlier diagnosis and treatment and, thereby, reduced disease severity and hospitalization costs. PMID:25076111

  6. Radiation decontamination unit for the community hospital.

    PubMed

    Waldron, R L; Danielson, R A; Shultz, H E; Eckert, D E; Hendricks, K O

    1981-05-01

    "Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit. PMID:6784538

  7. Personal health among midlife women hospital employees.

    PubMed

    Angard, N; Chez, R A; Young, C

    1998-12-01

    We hypothesized that women employees working in a hospital environment would be particularly attuned to aspects of personal health, well-being, and disease prevention. We performed an observational study at a local hospital, offering free assessments in its outpatient women's wellness screening program to women employees aged 39-60 years. Data from the first 60 women to enroll in the program are presented as a test of our hypothesis. Undiagnosed hypertension, abnormal lipid profiles, glucose intolerance, alcohol abuse, abnormal cervical cytology, breast masses, depression, or combinations of these were found in 49 of the 60 women. Twenty-one women were obese. Most women with abnormal findings did not follow specific personalized recommendations for remedial follow-up, including referral to a specialist. An important percentage of midlife women employees at this hospital exhibited unhealthful personal behaviors, had unrecognized disease, and did not use recommended health screening practices. The data emphasize the benefit for employees who participate in medical facility worksite health promotion programs. PMID:9929862

  8. Information for managers in hospitals: representing maternity unit statistics graphically.

    PubMed Central

    Szczepura, A; Mugford, M; Stilwell, J A

    1987-01-01

    Staff who organise and run maternity units contribute many statistics to their health authority but do not find it easy to obtain information about their unit from these statistics. Data that are collected routinely, however, can be used to provide each unit with a graphical profile of its activity and resources. The method described here was derived from the personality profiles used by psychologists and allows staff in one unit to assess the outcome, activity, and use of resources in their unit in relation to similar units, to explain some of the differences when these occur, or to highlight potential problems. Examples are taken from a study of maternity units in the West Midlands. It is concluded that the technique can indicate potential problems and usefully be adopted by those who monitor maternity care in districts or hospitals. PMID:3105784

  9. Hospital readmission from a transitional care unit.

    PubMed

    Anderson, Mary Ann; Tyler, Denice; Helms, Lelia B; Hanson, Kathleen S; Sparbel, Kathleen J H

    2005-01-01

    The purpose of this project was to characterize patients readmitted to the hospital during a stay in a transitional care unit (TCUT). Typically, readmitted patients were females, widowed, with 8 medical diagnoses, and taking 12 different medications. Readmission from the TCU occurred within 7 days as a result of a newly developed problem. Most patients did not return home after readmission from the TCU. Understanding high-risk patients' characteristics that lead to costly hospital readmission during a stay in the TCU can assist clinicians and healthcare providers to plan and implement timely and effective interventions, and help facility personnel in fiscal and resource management issues. PMID:15686074

  10. Personal characteristics and back injury among hospital nursing personnel.

    PubMed

    Owen, B D; Damron, C F

    1984-12-01

    Since back injury is the largest workman's compensation claim in most industries, the relationship between selected personal characteristics and back injury in hospital nursing personnel were studied. The sample included 64 female nursing personnel, half back injured and half not. Demographic: Workers were more likely to be back injured if they were older, worked longer on nursing units requiring frequent lifting, had family members with back problems, and had family members whose back problems began at an early age. Physical: The back injured had less muscle flexibility, less keen proprioception, and greater unequal leg length. Life style: Back injured were more vulnerable to frustration and stress overload (overstimulation), smoked more cigarettes, spent fewer hours exercising, and rated their physical condition lower. The variables with the greatest discriminatory power to predict back injury were a sense of overload, muscle flexibility, proprioception, family history of back problems, difference in leg length, years of risk in nursing practice, and smoking. PMID:6570060

  11. 31 CFR 500.330 - Person within the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person within the United States. 500... Definitions § 500.330 Person within the United States. (a) The term, person within the United States, includes: (1) Any person, wheresoever located, who is a resident of the United States; (2) Any person...

  12. 31 CFR 515.330 - Person within the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person within the United States. 515... Definitions § 515.330 Person within the United States. (a) The term person within the United States, includes: (1) Any person, wheresoever located, who is a resident of the United States; (2) Any person...

  13. 31 CFR 596.313 - United States person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person. 596.313 Section... General Definitions § 596.313 United States person. The term United States person means any United States... States, or any person in the United States....

  14. Aspects of Fear of Personal Death, Levels of Awareness, and Professional Affiliation among Dialysis Unit Staff Members.

    ERIC Educational Resources Information Center

    Ungar, Lea; And Others

    1990-01-01

    Examined expressions of fear of personal death among physicians, nurses, and social workers working in hospital dialysis units. Results indicated no differences in fear of personal death between 71 dialysis personnel and 68 other hospital personnel serving as controls. Physicians had lowest scores of fear of personal death followed by nurses and…

  15. 31 CFR 596.313 - United States person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person. 596.313 Section... General Definitions § 596.313 United States person. The term United States person means any United States citizen or national, permanent resident alien, juridical person organized under the laws of the...

  16. 31 CFR 560.314 - United States person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person. 560.314 Section... § 560.314 United States person. The term United States person means any United States citizen, permanent resident alien, entity organized under the laws of the United States (including foreign branches), or...

  17. 31 CFR 560.314 - United States person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person. 560.314 Section... § 560.314 United States person. The term United States person means any United States citizen, permanent resident alien, entity organized under the laws of the United States (including foreign branches), or...

  18. Unit Cost of Medical Services at Different Hospitals in India

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  19. 26 CFR 1.957-3 - United States person defined.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of sections...

  20. 31 CFR 103.39 - Person outside the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Person outside the United States. 103... Person outside the United States. For the purposes of this subpart, a remittance or transfer of funds, or... the United States, shall be deemed to be a remittance or transfer to a person outside the...

  1. 26 CFR 1.957-3 - United States person defined.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 10 2011-04-01 2011-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes...

  2. Hospital librarianship in the United States: at the crossroads

    PubMed Central

    Wolf, Diane G.; Chastain-Warheit, Christine C.; Easterby-Gannett, Sharon; Chayes, Marion C.; Long, Bradley A.

    2002-01-01

    This paper examines recent developments in hospital librarianship in the United States, including the current status of hospital-based clinical library services. Several examples of hospital library services are presented that demonstrate some characteristics of struggling and thriving services. The implications of the informationist concept are considered. The continuation of the hospital librarian's primary role in support of patient care is explored, as core competencies are reexamined for relevancy in the new millennium. PMID:11838458

  3. Kawasaki syndrome hospitalizations and associated costs in the United States.

    PubMed Central

    Belay, Ermias D.; Holman, Robert C.; Maddox, Ryan A.; Foster, David A.; Schonberger, Lawrence B.

    2003-01-01

    OBJECTIVES: To describe the epidemiologic characteristics of patients hospitalized with Kawasaki syndrome (KS) and estimate associated costs in the United States, using a large national hospital discharge dataset. METHODS: Hospitalization discharge records with KS for 1997 through 1999 for U.S. residents <18 years of age were selected from Solucient's hospital discharge records. These records are collected from most of the self-governing children's hospitals and approximately one-third of short-term, non-federal general hospitals in the United States. RESULTS: A total of 7,431 hospital discharges with a KS diagnosis were identified; 2,270 of the discharges were in 1997, 2,700 in 1998, and 2,461 in 1999. Boys comprised 60.0% of the discharges, and 76.4% of discharges were among children ages <5 years. For the 44 states and the District of Columbia with at least one hospital reporting KS, the average annual KS hospitalization rate was 10.2 per 100,000 children ages <5 years. The KS hospitalization rate for boys (12.0 per 100,000) was higher than that for girls (8.3 per 100,000) (risk ratio 1.45; 95% confidence interval 1.37, 1.52). Extrapolation to the U.S. population showed an estimated average annual KS hospitalization rate of 21.6. The median KS hospitalization cost for children <5 years of age during the study period was $6,169 US dollars. CONCLUSIONS: The KS hospitalization rate was consistent with that of previous U.S. studies, although the extrapolated rate may be an overestimation. The median hospitalization cost for KS was higher than that for respiratory syncytial virus-associated bronchiolitis and diarrheal diseases. Large hospitalization datasets can be used to monitor the occurrence of KS in the United States. PMID:12941859

  4. Length of stay and hospital readmission for persons with disabilities.

    PubMed Central

    Ottenbacher, K J; Smith, P M; Illig, S B; Fiedler, R C; Granger, C V

    2000-01-01

    OBJECTIVES: Length of stay (LOS) and hospital readmission for persons receiving medical rehabilitation were examined. METHODS: A total of 96,473 patient records (1994-1998) were analyzed. Mean age of patients was 68.97 years; 61% were female and 83% were non-Hispanic White. RESULTS: A decrease in LOS of 6.07 days (SD = 3.23) and increase in hospital readmission were found across all impairment groups (P < .001). Readmission increases ranged from 6.7% for amputations to 1.4% for orthopedic conditions. LOS was longer (2.1 days) for readmitted patients (P < .01). Age was not a significant predictor of rehospitalization. CONCLUSIONS: Understanding variables associated with rehospitalization is important as prospective payment systems are introduced for postacute care. PMID:11111267

  5. Mobility decline in patients hospitalized in an intensive care unit

    PubMed Central

    de Jesus, Fábio Santos; Paim, Daniel de Macedo; Brito, Juliana de Oliveira; Barros, Idiel de Araujo; Nogueira, Thiago Barbosa; Martinez, Bruno Prata; Pires, Thiago Queiroz

    2016-01-01

    Objective To evaluate the variation in mobility during hospitalization in an intensive care unit and its association with hospital mortality. Methods This prospective study was conducted in an intensive care unit. The inclusion criteria included patients admitted with an independence score of ≥ 4 for both bed-chair transfer and locomotion, with the score based on the Functional Independence Measure. Patients with cardiac arrest and/or those who died during hospitalization were excluded. To measure the loss of mobility, the value obtained at discharge was calculated and subtracted from the value obtained on admission, which was then divided by the admission score and recorded as a percentage. Results The comparison of these two variables indicated that the loss of mobility during hospitalization was 14.3% (p < 0.001). Loss of mobility was greater in patients hospitalized for more than 48 hours in the intensive care unit (p < 0.02) and in patients who used vasopressor drugs (p = 0.041). However, the comparison between subjects aged 60 years or older and those younger than 60 years indicated no significant differences in the loss of mobility (p = 0.332), reason for hospitalization (p = 0.265), SAPS 3 score (p = 0.224), use of mechanical ventilation (p = 0.117), or hospital mortality (p = 0.063). Conclusion There was loss of mobility during hospitalization in the intensive care unit. This loss was greater in patients who were hospitalized for more than 48 hours and in those who used vasopressors; however, the causal and prognostic factors associated with this decline need to be elucidated. PMID:27410406

  6. Influenza-Related Hospitalizations and Poverty Levels - United States, 2010-2012.

    PubMed

    Hadler, James L; Yousey-Hindes, Kimberly; Pérez, Alejandro; Anderson, Evan J; Bargsten, Marisa; Bohm, Susan R; Hill, Mary; Hogan, Brenna; Laidler, Matt; Lindegren, Mary Lou; Lung, Krista L; Mermel, Elizabeth; Miller, Lisa; Morin, Craig; Parker, Erin; Zansky, Shelley M; Chaves, Sandra S

    2016-02-12

    Annual influenza vaccine is recommended for all persons aged ≥6 months in the United States, with recognition that some persons are at risk for more severe disease (1). However, there might be previously unrecognized demographic groups that also experience higher rates of serious influenza-related disease that could benefit from enhanced vaccination efforts. Socioeconomic status (SES) measures that are area-based can be used to define demographic groups when individual SES data are not available (2). Previous surveillance data analyses in limited geographic areas indicated that influenza-related hospitalization incidence was higher for persons residing in census tracts that included a higher percentage of persons living below the federal poverty level (3-5). To determine whether this association occurs elsewhere, influenza hospitalization data collected in 14 FluSurv-NET sites covering 27 million persons during the 2010-11 and 2011-12 influenza seasons were analyzed. The age-adjusted incidence of influenza-related hospitalizations per 100,000 person-years in high poverty (≥20% of persons living below the federal poverty level) census tracts was 21.5 (95% confidence interval [CI]: 20.7-22.4), nearly twice the incidence in low poverty (<5% of persons living below the federal poverty level) census tracts (10.9, 95% CI: 10.3-11.4). This relationship was observed in each surveillance site, among children and adults, and across racial/ethnic groups. These findings suggest that persons living in poorer census tracts should be targeted for enhanced influenza vaccination outreach and clinicians serving these persons should be made aware of current recommendations for use of antiviral agents to treat influenza (6). PMID:26866729

  7. Personality disorders in a Swedish peacekeeping unit.

    PubMed

    Michel, Per-Olof; Lundin, Tom; Larsson, Gerry

    2005-01-01

    There is a lack of knowledge about the incidence of personality disorders and their consequences among peacekeepers. Moreover, most studies are follow-up studies in which, if at all, personality traits are screened for after the soldiers have left their service abroad. The aim of this paper was to study personality disorders in a longitudinal perspective. The method used was to screen the personnel in a Swedish mechanized battalion serving in Bosnia from March until October 1996 on four occasions: before deployment, immediately after deployment, 6 months after deployment and 1 year after deployment. Serving in the battalion were 724 individuals of whom 516 took part in the survey. The screening instrument used was the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The result shows that the rate of personality disorders were on the same level, or a little bit lower, than in the general population. Moreover, personality disorders were related to impaired general mental health and to reported traumatic experiences. Personality disorders also seemed to contribute to poor mental health 1 year after returning home from a mission abroad. The implications of these results for the future selection of peacekeepers are discussed. PMID:16195111

  8. Delirium in Prolonged Hospitalized Patients in the Intensive Care Unit

    PubMed Central

    Vahedian Azimi, Amir; Ebadi, Abbas; Ahmadi, Fazlollah; Saadat, Soheil

    2015-01-01

    Background: Prolonged hospitalization in the intensive care unit (ICU) can impose long-term psychological effects on patients. One of the most significant psychological effects from prolonged hospitalization is delirium. Objectives: The aim of this study was to assess the effect of prolonged hospitalization of patients and subsequent delirium in the intensive care unit. Patients and Methods: This conventional content analysis study was conducted in the General Intensive Care Unit of the Shariati Hospital of Tehran University of Medical Sciences, from the beginning of 2013 to 2014. All prolonged hospitalized patients and their families were eligible participants. From the 34 eligible patients and 63 family members, the final numbers of actual patients and family members were 9 and 16, respectively. Several semi-structured interviews were conducted face-to-face with patients and their families in a private room and data were gathered. Results: Two main themes from two different perspectives emerged, 'patients' perspectives' (experiences during ICU hospitalization) and 'family members' perspectives' (supportive-communicational experiences). The main results of this study focused on delirium, Patients' findings were described as pleasant and unpleasant, factual and delusional experiences. Conclusions: Family members are valuable components in the therapeutic process of delirium. Effective use of family members in the delirium caring process can be considered to be one of the key non-medical nursing components in the therapeutic process. PMID:26290854

  9. Hospital Mortality in the United States following Acute Kidney Injury

    PubMed Central

    Rezaee, Michael E.; Marshall, Emily J.; Matheny, Michael E.

    2016-01-01

    Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths increased almost twofold from 147,943 to 285,768 deaths. We discuss the importance of the 71% reduction in AKI-related mortality among hospitalized patients in the United States and draw on the discussion of whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI. PMID:27376083

  10. Temporal Trends in Hospitalization for Acute Decompensated Heart Failure in the United States, 1998-2011.

    PubMed

    Agarwal, Sunil K; Wruck, Lisa; Quibrera, Miguel; Matsushita, Kunihiro; Loehr, Laura R; Chang, Patricia P; Rosamond, Wayne D; Wright, Jacqueline; Heiss, Gerardo; Coresh, Josef

    2016-03-01

    Estimates of the numbers and rates of acute decompensated heart failure (ADHF) hospitalization are central to understanding health-care utilization and efforts to improve patient care. We comprehensively estimated the frequency, rate, and trends of ADHF hospitalization in the United States. Based on Atherosclerosis Risk in Communities (ARIC) Study surveillance adjudicating 12,450 eligible hospitalizations during 2005-2010, we developed prediction models for ADHF separately for 3 International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 428 discharge diagnosis groups: 428 primary, 428 nonprimary, or 428 absent. We applied the models to data from the National Inpatient Sample (11.5 million hospitalizations of persons aged ≥55 years with eligible ICD-9-CM codes), an all-payer, 20% probability sample of US community hospitals. The average estimated number of ADHF hospitalizations per year was 1.76 million (428 primary, 0.80 million; 428 nonprimary, 0.83 million; 428 absent, 0.13 million). During 1998-2004, the rate of ADHF hospitalization increased by 2.0%/year (95% confidence interval (CI): 1.8, 2.5) versus a 1.4%/year (95% CI: 0.8, 2.1) increase in code 428 primary hospitalizations (P < 0.001). In contrast, during 2005-2011, numbers of ADHF hospitalizations were stable (-0.5%/year; 95% CI: -1.4, 0.3), while the numbers of 428-primary hospitalizations decreased by -1.5%/year (95% CI: -2.2, -0.8) (P for contrast = 0.03). In conclusion, the estimated number of hospitalizations with ADHF is approximately 2 times higher than the number of hospitalizations with ICD-9-CM code 428 in the primary position. The trend increased more steeply prior to 2005 and was relatively flat after 2005. PMID:26895710

  11. Unit-based incident reporting and root cause analysis: variation at three hospital unit types

    PubMed Central

    Wagner, Cordula; Merten, Hanneke; Zwaan, Laura; Lubberding, Sanne; Timmermans, Danielle; Smits, Marleen

    2016-01-01

    Objectives To minimise adverse events in healthcare, various large-scale incident reporting and learning systems have been developed worldwide. Nevertheless, learning from patient safety incidents is going slowly. Local, unit-based reporting systems can help to get faster and more detailed insight into unit-specific safety issues. The aim of our study was to gain insight into types and causes of patient safety incidents in hospital units and to explore differences between unit types. Design Prospective observational study. Setting 10 emergency medicine units, 10 internal medicine units and 10 general surgery units in 20 hospitals in the Netherlands participated. Patient safety incidents were reported by healthcare providers. Reports were analysed with root cause analysis. The results were compared between the 3 unit types. Results A total of 2028 incidents were reported in an average reporting period of 8 weeks per unit. More than half had some consequences for patients, such as a prolonged hospital stay or longer waiting time, and a small number resulted in patient harm. Significant differences in incident types and causes were found between unit types. Emergency units reported more incidents related to collaboration, whereas surgical and internal medicine units reported more incidents related to medication use. The distribution of root causes of surgical and emergency medicine units showed more mutual similarities than those of internal medicine units. Conclusions Comparable incidents and causes have been found in all units, but there were also differences between units and unit types. Unit-based incident reporting gives specific information and therefore makes improvements easier. We conclude that unit-based incident reporting has an added value besides hospital-wide or national reporting systems that already exist in various countries. PMID:27329443

  12. Paying the Hospital: Foreign Lessons For the United States

    PubMed Central

    Glaser, William A.

    1983-01-01

    This special report synthesizes the findings of a Health Care Financing Administration grant which allowed the author to analyze hospital finance in six foreign countries and in the United States. The author identified the principal problems facing hospital owners, carriers, and governments in the United States, and he conducted lengthy field work abroad to learn how each country dealt with the same problems. One set of the author's conclusions makes more clear issues that are debated in the United States, such as the meaning of “cost-based reimbursement” and “prospective reimbursement”. Some of the author's findings show the difficulty of implementing policies often proposed in the United States, such as incentive reimbursement schemes. Other findings of the author show the conditions necessary for cost containment, such as strong representation of consumers and firm political will by government. PMID:10310003

  13. 31 CFR 510.311 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 510.311 Section 510.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS General Definitions § 510.311 United States...

  14. Upward trend in dengue incidence among hospitalized patients, United States.

    PubMed

    Streit, Judy A; Yang, Ming; Cavanaugh, Joseph E; Polgreen, Philip M

    2011-05-01

    International travel and a global expansion of dengue fever have the potential to increase the incidence of dengue in the United States. We conducted a retrospective cohort analysis of trends in dengue among hospitalized patients by using the National Inpatient Sample (2000-2007); the number of cases more than tripled (p<0.0001). PMID:21529411

  15. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    PubMed

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study. PMID:24894404

  16. Personal response systems in the United States.

    PubMed

    Montgomery, C

    1992-01-01

    In summation, although Personal Response Systems are relatively new in the marketplace they have made tremendous inroads over the past fifteen years. The next decade presents some difficult problems for this country in terms of its aging population and the delivery of quality, cost effective health care to all who need it. In light of these problems, the PRS industry can offer viable solutions-solutions for the U.S. health care system in helping to control and reduce the cost of health care delivery; solutions for industry in attempting to meet their employee health care needs; solutions for families who are coping with the strains of eldercare; and most important, solutions for many people who, regardless of age, could not live independently without a Personal Response System. PMID:10126442

  17. Unit-based interprofessional leadership models in six US hospitals.

    PubMed

    Kim, Christopher S; King, Emmanuel; Stein, Jason; Robinson, Edmondo; Salameh, Mohammad; O'Leary, Kevin J

    2014-08-01

    The landscape of hospital-based care has shifted to place greater emphasis on improving quality and delivering value. In response, hospitals and healthcare organizations must reassess their strategies to improve care delivery in their facilities and beyond. Although these institutional goals may be defined at the executive level, implementation takes place at local sites of care. To lead these efforts, hospitals need to appoint effective leaders at the frontlines. Hospitalists are well poised to take on the role of the local clinical care improvement leader based on their experiences as direct frontline caregivers and their integral roles in hospital-wide quality and safety initiatives. A unit-based leadership model consisting of a medical director paired with a nurse manager has been implemented in several hospitals to function as an effector arm in response to the changing landscape of inpatient care. We provide an overview of this new model of leadership and describe the experiences of 6 hospitals that have implemented it. PMID:24799385

  18. Sudden Death in Hospital after Discharge from Coronary Care Unit

    PubMed Central

    Thompson, Peter; Sloman, Graeme

    1971-01-01

    In a group of 339 patients with acute myocardial infarction treated in a coronary care unit, 273 left the unit while improving and were expected to leave hospital alive; 23 had a cardiac arrest or died suddenly while still in hospital—17 died immediately or after temporary resuscitation and six were resuscitated to leave hospital alive. Ventricular fibrillation was found in 13 of the 20 patients attended by the cardiac arrest team. The incidents were scattered from the 4th to the 24th day after the onset of infarction. Risk factors in these “late sudden death” patients were compared with the 250 patients who left the unit while improving and did not die or suffer cardiac arrest. The patients susceptible to late sudden death were characterized early in their hospital course by the findings of severe, predominantly anterior infarction, left ventricular failure, persistent sinus tachycardia, and frequent ventricular arrhythmias. It is suggested that such patients be chosen for prolonged observation in a second-stage coronary care unit. PMID:5113015

  19. Designing Environments for Handicapped Persons: The Evaluation of Play Unit.

    ERIC Educational Resources Information Center

    Hursh, Daniel E.; House, Diane J.

    1983-01-01

    Evaluation of Play Unit for the Severely Handicaped (PUSH) designed for the living room of a residential area used by 16 severely retarded multiply handicapped persons revealed that the impact of the unit was individualized and diverse, and that the responsiveness of the environemt's components appeared to be important. (CL)

  20. Sickle cell hospital unit: a disease-specific model.

    PubMed

    Adams-Graves, Patricia; Ostric, Elizabeth J; Martin, Mary; Richardson, Pat; Lewis, James B

    2008-01-01

    American urban hospitals often serve large populations of sickle cell disease (SCD) patients. Those hospitals that choose to implement an adult SCD-specific inpatient unit have the opportunity to acquire multiple operational benefits. Such units may ultimately reduce patient morbidity and mortality; improve timely access to quality medical care in a cost-effective manner; reduce overcrowding in the emergency department; and increase patient, family, physician, and payer satisfaction. SCD is a serious, painful, genetic blood disorder that affects a growing population of adults in the United States. A single mistake in the gene that codes for hemoglobin causes crescent-shaped red blood cells that are sticky, are stiff, and have a short life span. These cells cause blockages, tremendous pain brought on by lack of oxygen in the muscles, organ damage, stroke, and problems with infections. The cells' short life span often results in anemia. The unpredictable pain event-sickle cell disease with crisis-is the most common reason for presentation to the emergency department and for hospital admission. For many SCD patients, the emergency department process and the general, overly conservative approach to pain relief lead to a delay in treatment and prolong needless suffering. Regional Medical Center at Memphis (Tennessee) established an SCD unit and developed an inpatient care delivery model that decreases the burden of caring for SCD patients on its busy emergency department, improves SCD patients' satisfaction and access to timely quality care, and reduces the needless pain and suffering of SCD patients. This SCD model may be replicated in large urban hospitals with a daily SCD patient census of five or more. PMID:18856136

  1. Analyzing staffing trade-offs on acute care hospital units.

    PubMed

    Berkow, Steven; Vonderhaar, Kate; Stewart, Jennifer; Virkstis, Katherine; Terry, Anne

    2014-10-01

    Given today's resource-limited environment, nurse leaders must make judicious staffing decisions to deliver safe, cost-effective care. Investing in 1 element of staffing often requires scaling back in another. A national cross section of acute care hospital unit leaders was surveyed regarding staffing resources, including nurse workload, education, specialty certification, experience, and level of support staff. The authors report findings from the survey and discuss the trade-offs observed among units regarding nurse-to-patient ratios and the proportion of baccalaureate-prepared nurses. PMID:25208268

  2. 31 CFR 549.312 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 549.312 Section 549.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY LEBANON SANCTIONS REGULATIONS...

  3. 31 CFR 549.312 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 549.312 Section 549.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY LEBANON SANCTIONS REGULATIONS...

  4. 31 CFR 549.312 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 549.312 Section 549.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY LEBANON SANCTIONS REGULATIONS...

  5. 31 CFR 549.312 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 549.312 Section 549.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY LEBANON SANCTIONS REGULATIONS...

  6. 31 CFR 552.311 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 552.311 Section 552.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY YEMEN SANCTIONS REGULATIONS...

  7. 31 CFR 552.311 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 552.311 Section 552.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY YEMEN SANCTIONS REGULATIONS...

  8. 31 CFR 592.312 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 592.312 Section 592.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS...

  9. 31 CFR 592.312 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 592.312 Section 592.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS...

  10. 31 CFR 592.312 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 592.312 Section 592.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS...

  11. 31 CFR 592.312 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 592.312 Section 592.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS...

  12. 31 CFR 592.312 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 592.312 Section 592.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL...

  13. 31 CFR 536.316 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 536.316 Section 536.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS...

  14. 31 CFR 536.316 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 536.316 Section 536.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS...

  15. 31 CFR 536.316 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 536.316 Section 536.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING...

  16. 31 CFR 536.316 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 536.316 Section 536.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS...

  17. 31 CFR 536.316 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 536.316 Section 536.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS...

  18. 31 CFR 594.315 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 594.315 Section 594.315 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM...

  19. 31 CFR 541.312 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 541.312 Section 541.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ZIMBABWE SANCTIONS...

  20. 31 CFR 589.312 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 589.312 Section 589.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY UKRAINE RELATED SANCTIONS...

  1. 31 CFR 544.312 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 544.312 Section 544.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS...

  2. 31 CFR 544.312 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 544.312 Section 544.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION...

  3. 31 CFR 539.313 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 539.313 Section 539.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE...

  4. 31 CFR 539.313 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 539.313 Section 539.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE...

  5. 31 CFR 544.312 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 544.312 Section 544.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION...

  6. 31 CFR 544.312 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 544.312 Section 544.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION...

  7. 31 CFR 539.313 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 539.313 Section 539.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE...

  8. 31 CFR 539.313 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 539.313 Section 539.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE...

  9. 31 CFR 539.313 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 539.313 Section 539.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION...

  10. 31 CFR 544.312 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 544.312 Section 544.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION...

  11. 31 CFR 576.317 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 576.317 Section 576.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRAQ STABILIZATION AND INSURGENCY...

  12. 31 CFR 576.317 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 576.317 Section 576.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRAQ STABILIZATION AND INSURGENCY...

  13. 31 CFR 576.317 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 576.317 Section 576.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRAQ STABILIZATION AND INSURGENCY...

  14. 31 CFR 576.317 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 576.317 Section 576.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRAQ STABILIZATION AND INSURGENCY...

  15. 31 CFR 558.311 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 558.311 Section 558.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SOUTH SUDAN SANCTIONS REGULATIONS...

  16. 31 CFR 545.315 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 545.315 Section 545.315 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TALIBAN (AFGHANISTAN)...

  17. 31 CFR 510.311 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 510.311 Section 510.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS...

  18. 31 CFR 510.311 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 510.311 Section 510.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS...

  19. 31 CFR 541.312 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 541.312 Section 541.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ZIMBABWE SANCTIONS REGULATIONS...

  20. 31 CFR 541.312 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 541.312 Section 541.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ZIMBABWE SANCTIONS REGULATIONS...

  1. 31 CFR 541.312 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 541.312 Section 541.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ZIMBABWE SANCTIONS REGULATIONS...

  2. 31 CFR 541.312 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 541.312 Section 541.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ZIMBABWE SANCTIONS REGULATIONS...

  3. 31 CFR 593.313 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 593.313 Section 593.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  4. 31 CFR 562.311 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 562.311 Section 562.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS ABUSES...

  5. 31 CFR 562.311 - United States person; U.S. person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person; U.S. person. 562.311 Section 562.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS ABUSES SANCTIONS REGULATIONS General Definitions § 562.311...

  6. 31 CFR 562.311 - United States person; U.S. person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person; U.S. person. 562.311 Section 562.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS ABUSES SANCTIONS REGULATIONS General Definitions § 562.311...

  7. 31 CFR 562.311 - United States person; U.S. person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person; U.S. person. 562.311 Section 562.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS ABUSES...

  8. 31 CFR 510.311 - United States person; U.S. person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States person; U.S. person. 510.311 Section 510.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS...

  9. 31 CFR 548.312 - United States person; U.S. person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States person; U.S. person. 548.312 Section 548.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BELARUS SANCTIONS...

  10. Personality and personal projects: linking big five and PAC units of analysis.

    PubMed

    Little, B R; Lecci, L; Watkinson, B

    1992-06-01

    This article examines the relationships between classical trait units as represented by the five-factor model (e.g., Digman, 1990) and personal action construct (PAC) units as measured by Personal Projects Analysis (Little, 1983). One hundred and forty-seven students were administered the NEO Personality Inventory (Costa & McCrae, 1985) and two components of Personal Projects methodology during their first term in university. Neuroticism and Conscientiousness were related to problematic and positive project systems, respectively, with these effects generalizing across the academic and interpersonal project domains. Extraversion and Agreeableness were also associated with positive evaluations of personal projects, particularly in the interpersonal domain. Openness was distinctively linked with project initiation and value congruency. We suggest theoretical and applied implications of using PAC methods to expand and refine the classical trait research agenda. PMID:1635052

  11. Challenges in Hospital-Associated Infection Management: A Unit Perspective.

    PubMed

    Stacy, Kathleen M

    2015-01-01

    Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results. Each initiative presents its own unique set of challenges; however, common issues influence all initiatives. These common issues include organization and unit culture, current clinical practice guidelines being used to drive the initiatives, performance discrepancies on the part of nursing staff, availability of resources including equipment and supplies, monitoring of the data, and conflicting quality improvement priorities. PMID:26200734

  12. Decommissioning of a 60Co unit and estimation of personal doses.

    PubMed

    Lin, K H; Lin, J P; Liu, M T; Chu, T C

    2003-01-01

    Chang-hua Christian Hospital needs to uninstall the 60Co unit. The mode of this 60Co teletherapy unit is SHIMADZU RTGS-10. The original lead head was taken as the source container of this 60Co unit. The source head was dismantled and put into the prepared wooden box, after the source was sealed. This study describes the planning and dismantling of the retirement and transport of the 60Co unit, and personal doses measured during the procedure. This work estimates the doses of radiation received by exposed workers during the dismantling of the machine. The workers received doses of approximately 53 microSv. This study shows that the original lead head can be used as the source container of this 60Co unit. The 60Co machine was smoothly dismantled and transported by conscientious and careful workers, using planned and controlled radiation protection, following the ALARA (as low as reasonably achievable) rule. PMID:14653329

  13. A person-time analysis of hospital activity among cancer survivors in England

    PubMed Central

    Maddams, J; Utley, M; Møller, H

    2011-01-01

    Background: There are around 2 million cancer survivors in the UK. This study describes the inpatient and day case hospital activity among the population of cancer survivors in England. This is one measure of the burden of cancer on the individual and the health service. Methods: The national cancer registry data set for England (1990–2006) is linked to the NHS Hospital Episode Statistics (HES) database. Cohorts of survivors were defined as those people recorded in the cancer registry data with a diagnosis of breast, colorectal, lung or prostate cancer before 2007. The person-time of prevalence in 2006 for each cohort of survivors was calculated according to the cancer type, sex, age and time since diagnosis. The corresponding HES episodes of care in 2006 were used to calculate the person-time of admitted hospital care for each cohort of survivors. The average proportion of time spent in hospital by survivors in each cohort was calculated as the summed person-time of hospital activity divided by the summed person-time of prevalence. The analysis was conducted separately for cancer-related episodes and non-cancer-related episodes. Results: Lung cancer survivors had the highest intensity of cancer-related hospital activity. For all cancers, cancer-related hospital activity was highest in the first year following diagnosis. Breast and prostate cancer survivors had peaks of cancer-related hospital activity in the relatively young and relatively old age groups. The proportion of time spent in hospital for non-cancer-related care was much lower than that for cancer-related care and increased gradually with age but was generally constant regardless of time since diagnosis. Conclusion: The person-time approach used in this study is more revealing than a simple enumeration of cancer survivors and hospital admissions. Hospital activity among cancer survivors is highest soon after diagnosis. The effect of age on the amount of hospital activity is different for each type of

  14. The federal government's use of Title VI and Medicare to racially integrate hospitals in the United States, 1963 through 1967.

    PubMed Central

    Reynolds, P P

    1997-01-01

    Explicit discrimination against minorities existed in the 1960s in hospital patient admissions and physician and nurse staff appointments. With passage of the Civil Rights Act of 1964, along with Medicare legislation in 1965, civil rights advocates within the federal government had both a legislative mandate to guarantee equal access to programs funded by the federal government in Title VI and a federal program that affected every hospital in the country in Medicare. This study was conducted to determine the extent to which the Medicare hospital certification program was a major determinant in the racial integration of hospitals throughout the United States. In-depth interviews were conducted with individuals involved in hospital and health care policy in the 1950s and 1960s. Other primary resources include archival and personal manuscripts, government documents, newspapers, and periodicals. PMID:9366643

  15. Hospitalization for esophageal achalasia in the United States

    PubMed Central

    Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Lidor, Anne O

    2015-01-01

    AIM: To assess the outcome of different treatments in patients admitted for esophageal achalasia in the United States. METHODS: This is a retrospective analysis using the Nationwide Inpatient Sample over an 8-year period (2003-2010). Patients admitted with a primary diagnosis of achalasia were divided into 3 groups based on their treatment: (1) Group 1: patients who underwent Heller myotomy during their hospital stay; (2) Group 2: patients who underwent esophagectomy; and (3) Group 3: patients not undergoing surgical treatment. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), discharge destination and total hospital charges. RESULTS: Among 27141 patients admitted with achalasia, nearly half (48.5%) underwent Heller myotomy, 2.5% underwent esophagectomy and 49.0% had endoscopic or other treatment. Patients in group 1 were younger, healthier, and had the lowest mortality when compared with the other two groups. Group 2 had the highest LOS and hospital charges among all groups. Group 3 had the highest mortality (1.2%, P < 0.001) and the lowest home discharge rate (78.8%) when compared to the other groups. The most frequently performed procedures among group 3 were esophageal dilatation (25.9%) and injection (13.3%). Among patients who died in this group the most common associated morbidities included acute respiratory failure, sepsis and aspiration pneumonia. CONCLUSION: Surgery for achalasia carries exceedingly low mortality in the modern era; however, in complicated patients, even less invasive treatments are burdened by significant mortality and morbidity. PMID:26421106

  16. Non-Work-Related Use of Personal Mobile Phones by Hospital Registered Nurses

    PubMed Central

    2015-01-01

    Background Personal mobile phones and other personal communication devices (smartphones and tablet computers) provide users with an ever-increasing number and diversity of non-work-related activities while at work. In hospitals, where the vigilance of health care workers is essential for patient care, the potential distraction of these devices could be hazardous to patients. Objective The objective of this study was to determine the frequency of non-work-related use of personal mobile phones and other personal communication devices among hospital registered nurses. Methods In March 2014, a previously validated 30-question survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. There were 825 respondents who met the inclusion criteria. Results The use of a personal mobile phone or other personal communication device while working (excluding meal times and breaks) was reported by 78.1% (644/825) of respondents. Nurses reported regularly (sometimes, often, or always) sending personal emails and text messages (38.6%, 318/825), reading news (25.7%, 212/825), checking/posting on social networking sites (20.8%, 172/825), shopping (9.6%, 79/825), and playing games (6.5%, 54/825) while working. Conclusions This study found that hospital nurses frequently use their personal mobile phones or other personal communication devices for non-work-related activities at work. The primary activity reported was to send personal emails and text messages to family and friends. PMID:25586982

  17. Understanding Personal Learning Environment Perspectives of Thai International Tourism and Hospitality Higher Education Students

    ERIC Educational Resources Information Center

    Tanyong, Siriwan; Sharafuddin, Mohamed Ali

    2016-01-01

    This paper is part of a periodic research conducted in developing a personal learning environment for Thailand's higher education students with English as medium of instruction. The objective of the first phase in this research was to understand the personal learning environment perspectives of Thai International tourism and hospitality higher…

  18. 38 CFR 17.43 - Persons entitled to hospital or domiciliary care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions of 38 U.S.C. 1710, 1722, and 1729, and 38 CFR 17.44 and 17.45, for: (1) Persons in the Armed... VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.43 Persons entitled to...

  19. 38 CFR 17.43 - Persons entitled to hospital or domiciliary care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provisions of 38 U.S.C. 1710, 1722, and 1729, and 38 CFR 17.44 and 17.45, for: (1) Persons in the Armed... VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.43 Persons entitled to...

  20. 38 CFR 17.43 - Persons entitled to hospital or domiciliary care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provisions of 38 U.S.C. 1710, 1722, and 1729, and 38 CFR 17.44 and 17.45, for: (1) Persons in the Armed... VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.43 Persons entitled to...

  1. 38 CFR 17.43 - Persons entitled to hospital or domiciliary care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provisions of 38 U.S.C. 1710, 1722, and 1729, and 38 CFR 17.44 and 17.45, for: (1) Persons in the Armed... VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.43 Persons entitled to...

  2. 38 CFR 17.43 - Persons entitled to hospital or domiciliary care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provisions of 38 U.S.C. 1710, 1722, and 1729, and 38 CFR 17.44 and 17.45, for: (1) Persons in the Armed... VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.43 Persons entitled to...

  3. Histoplasmosis-Associated Hospitalizations in the United States, 2001-2012.

    PubMed

    Benedict, Kaitlin; Derado, Gordana; Mody, Rajal K

    2016-01-01

    We examined trends in histoplasmosis-associated hospitalizations in the United States using the 2001-2012 National (Nationwide) Inpatient Sample. An estimated 50 778 hospitalizations occurred, with significant increases in hospitalizations overall and in the proportion of hospitalizations associated with transplant, diabetes, and autoimmune conditions often treated with biologic therapies; therefore, histoplasmosis remains an important opportunistic infection. PMID:26894201

  4. Histoplasmosis-Associated Hospitalizations in the United States, 2001–2012

    PubMed Central

    Benedict, Kaitlin; Derado, Gordana; Mody, Rajal K.

    2016-01-01

    We examined trends in histoplasmosis-associated hospitalizations in the United States using the 2001–2012 National (Nationwide) Inpatient Sample. An estimated 50 778 hospitalizations occurred, with significant increases in hospitalizations overall and in the proportion of hospitalizations associated with transplant, diabetes, and autoimmune conditions often treated with biologic therapies; therefore, histoplasmosis remains an important opportunistic infection. PMID:26894201

  5. Ensemble-based methods for forecasting census in hospital units

    PubMed Central

    2013-01-01

    Background The ability to accurately forecast census counts in hospital departments has considerable implications for hospital resource allocation. In recent years several different methods have been proposed forecasting census counts, however many of these approaches do not use available patient-specific information. Methods In this paper we present an ensemble-based methodology for forecasting the census under a framework that simultaneously incorporates both (i) arrival trends over time and (ii) patient-specific baseline and time-varying information. The proposed model for predicting census has three components, namely: current census count, number of daily arrivals and number of daily departures. To model the number of daily arrivals, we use a seasonality adjusted Poisson Autoregressive (PAR) model where the parameter estimates are obtained via conditional maximum likelihood. The number of daily departures is predicted by modeling the probability of departure from the census using logistic regression models that are adjusted for the amount of time spent in the census and incorporate both patient-specific baseline and time varying patient-specific covariate information. We illustrate our approach using neonatal intensive care unit (NICU) data collected at Women & Infants Hospital, Providence RI, which consists of 1001 consecutive NICU admissions between April 1st 2008 and March 31st 2009. Results Our results demonstrate statistically significant improved prediction accuracy for 3, 5, and 7 day census forecasts and increased precision of our forecasting model compared to a forecasting approach that ignores patient-specific information. Conclusions Forecasting models that utilize patient-specific baseline and time-varying information make the most of data typically available and have the capacity to substantially improve census forecasts. PMID:23721123

  6. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  7. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  8. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  9. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  10. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  11. The significance of services in a psychiatric hospital for family members of persons with mental illness.

    PubMed

    Shor, Ron; Shalev, Anat

    2015-03-01

    Hospitalization of persons with mental illness may cause their family members to experience multiple stressors that stem from the hospitalization as well as from the duties of helping him or her. However, providing support services in psychiatric hospitals for family members has received only limited attention. To change this situation, mental health professionals in a psychiatric hospital in Israel developed an innovative family-centered practice model, the Family Members' Support and Consultation (FMSC) service center. We examined the significance to family members of the services they received from the FMSC service center in a study that included 20 caregivers. Ten participated in 2 focus groups of 5 participants each; 10 were interviewed personally. We implemented a thematic analysis to analyze the data. According to the participants, the staff of the FMSC service center provided support services that helped them cope with the stressors and difficulties they experienced within the context of the psychiatric hospital. The participants emphasized the significance of the immediacy and accessibility of support provided, as well as the positive effects of systemic interventions aimed at changing the relationships between family members and systems in the psychiatric hospital. Our findings show the importance of integrating a service that focuses on the needs of family members of persons with mental illness within a psychiatric hospital. PMID:25485823

  12. 78 FR 53478 - Proposed Information Collection; United States Park Police Personal History Statement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... National Park Service Proposed Information Collection; United States Park Police Personal History Statement... Police Personal History Statement) to collect detailed personal history information from applicants... information, including financial data and residence history. Selective Service information and military...

  13. Epidemiology of Abusive Abdominal Trauma Hospitalizations in United States Children

    ERIC Educational Resources Information Center

    Lane, Wendy Gwirtzman; Dubowitz, Howard; Langenberg, Patricia; Dischinger, Patricia

    2012-01-01

    Objectives: (1) To estimate the incidence of abusive abdominal trauma (AAT) hospitalizations among US children age 0-9 years. (2) To identify demographic characteristics of children at highest risk for AAT. Design: Secondary data analysis of a cross-sectional, national hospitalization database. Setting: Hospitalization data from the 2003 and 2006…

  14. Hospitalization for Congestive Heart Failure: United States, 2000-2010

    MedlinePlus

    ... care, health care utilization, National Hospital Discharge Survey Did the number and age distribution of patients hospitalized ... those aged 65–74 and 75–84 decreased. Did the rate of hospitalization for CHF change from ...

  15. 42 CFR 412.25 - Excluded hospital units: Common requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From the Prospective Payment Systems for Inpatient Operating Costs and... the governing body or chief executive officer of the hospital in which it is located, and it...

  16. 22 CFR 72.26 - Vesting of personal estate in United States.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Vesting of personal estate in United States. 72... PROPERTY AND ESTATES DEATHS AND ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.26 Vesting of personal estate in United States. (a) If no claimant with a legal right to...

  17. 42 CFR 412.130 - Retroactive adjustments for incorrectly excluded hospitals and units.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the inpatient population the hospital planned to treat during that cost reporting period, if the inpatient population actually treated in the hospital during that cost reporting period did not meet the... under § 412.29(c) regarding the inpatient population the hospital planned to treat in that unit...

  18. Hospital Utilization among Persons with an Intellectual Disability, Ontario, Canada, 1995-2001

    ERIC Educational Resources Information Center

    Balogh, Robert S.; Hunter, Duncan; Ouellette-Kuntz, Helene

    2005-01-01

    Background: It has been suggested that persons with an intellectual disability consume a disproportionate amount of hospital services. Policy changes in Ontario in the 1970s and 1980s made it necessary for community health services to accommodate this population that formerly received most of its medical care in the institutions where they lived.…

  19. Identifying Risk Factors for the Prediction of Hospital Readmission among Older Persons with Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Middleton, Renee Annette

    Older persons (55 years and older) with cardiovascular disease are at increased risk for hospital readmission when compared to other subgroups of our population. This issue presents an economic problem, a concern for the quality and type of care provided, and an urgent need to implement innovative strategies designed to reduce the rising cost of…

  20. Working Models of Attachment in Psychiatrically Hospitalized Adolescents: Relation to Psychopathology and Personality.

    ERIC Educational Resources Information Center

    Rosenstein, Diana S.; Horowitz, Harvey A.

    This study examined the role of attachment in adolescent psychopathology among psychiatrically hospitalized adolescents. Subjects consisted of 60 adolescents and 27 of their mothers. Measures included the Adult Attachment Interview classification for both the adolescents and their mothers, and a battery of diagnostic and personality assessment of…

  1. Emergency department utilization, hospital admissions, and physician visits among elderly African American persons.

    PubMed

    Bazargan, M; Bazargan, S; Baker, R S

    1998-02-01

    This study uses a theoretical model of health services utilization to examine (a) emergency department utilization, (b) hospital admissions, and (c) office-based physician visits among a sample of 998 low-income elderly African American persons. Poisson Regression analysis was used to estimate the parameters specified in the Andersen behavioral model. Some of the more interesting results include the following: (a) a greater frequency of emergency room visits among respondents with a lower level of accessibility to physician services, (b) a lack of a significant relationship between some chronic illnesses such as diabetes and heart problems and the frequency of office-based physician visits, (c) a greater number of hospital admissions among insured persons, and (d) a significant impact of the health locus of control indexes on all three types of health care utilization. The results of this study challenge the assumption that hospital and emergency use are the results of nondiscretionary behavior. PMID:9499651

  2. Prehospital and hospital delays after stroke onset--United States, 2005-2006.

    PubMed

    2007-05-18

    Each year approximately 700,000 persons in the United States have a new or recurrent stroke; of these persons, 15%-30% become permanently disabled, and 20% require institutionalization during the first 3 months after the stroke. The severity of stroke-related disability can be reduced if timely and appropriate treatment is received. Patients with ischemic stroke may be eligible for treatment with intravenous thrombolytic (i.e., tissue plasminogen activator [t-PA]) therapy within 3 hours of symptom onset. Receipt of this treatment usually requires patients to recognize stroke symptoms and receive prompt transport to a hospital emergency department (ED), where timely evaluation and brain imaging (i.e., computed tomography or magnetic resonance imaging) can take place. For patients eligible for t-PA, evidence suggests that the earlier patients are treated after the onset of symptoms the greater the likelihood of a more favorable outcome. In 2001, Congress established the Paul Coverdell National Acute Stroke Registry to measure and track the quality of care provided to acute stroke patients. To assess prehospital delays from onset of stroke symptoms to ED arrival and hospital delays from ED arrival to receipt of brain imaging, CDC analyzed data from the four states participating in the national stroke registry. The results of that analysis indicated that fewer than half (48.0%) of stroke patients for whom onset data were available arrived at the ED within 2 hours of symptom onset, and prehospital delays were shorter for persons transported to the ED by ambulance (i.e., emergency medical services) than for persons who did not receive ambulance transport. The interval between ED arrival and brain imaging also was significantly reduced for those arriving by ambulance. More extensive public education is needed regarding early recognition of stroke and the urgency of telephoning 9-1-1 to receive ambulance transport. Shortening prehospital and hospital delays will increase

  3. A goal-oriented limited-duration approach for borderline personality disorder during brief inpatient hospitalizations.

    PubMed

    Siefert, Caleb J

    2012-12-01

    As part of their overall care, patients with borderline personality disorder may require inpatient hospitalization for containment and stabilization in the context of severe distress, increased risk for self-harm, or after self-harming acts. Though data suggests that such patients are frequently hospitalized, the benefits of brief hospitalizations can sometimes be questionable. In some cases, the hospitalization environment may increase patient distress. Additionally, frequent serial hospitalizations can disrupt or sidetrack longer-term outpatient treatments. The present paper presents a Goal-Oriented Limited-Duration Borderline Personality Disorder Inpatient Treatment approach. The approach integrates elements from many other expert-based approaches for working in brief hospital settings and centers on the creation of a preadmission treatment agreement with a planned discharge date. This agreement involves clear goals for treatment and specifies how staff will be involved. Establishing a discharge date early in treatment allows staff to immediately begin working with feelings of rejection or abandonment. At discharge, recommendations are made and criteria for future admissions are set forth. This paper provides a description of the approach, information to consider in determining appropriateness, discussion of methods for clarifying goals, review of the discharge planning approach, and several examples of clinician-patient exchanges. This paper concludes with a case example in which the approach was used and discussions of future directions and potential benefits and limitations of the approach. PMID:22181025

  4. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... after October 1, 1997— (i) Separate governing body. The hospital has a governing body that is separate from the governing body of the hospital occupying space in the same building or on the same campus....

  5. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... after October 1, 1997— (i) Separate governing body. The hospital has a governing body that is separate from the governing body of the hospital occupying space in the same building or on the same campus....

  6. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    PubMed Central

    Armstrong, Susan J.; Rispel, Laetitia C.; Penn-Kekana, Loveday

    2015-01-01

    Background Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high

  7. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... authorized by 38 U.S.C. 1703 and 38 CFR 17.52; or (2) If the veteran needs non-immediate hospitalization..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing...

  8. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... authorized by 38 U.S.C. 1703 and 38 CFR 17.52; or (2) If the veteran needs non-immediate hospitalization..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing...

  9. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... authorized by 38 U.S.C. 1703 and 38 CFR 17.52; or (2) If the veteran needs non-immediate hospitalization..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing...

  10. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... authorized by 38 U.S.C. 1703 and 38 CFR 17.52; or (2) If the veteran needs non-immediate hospitalization..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing...

  11. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... authorized by 38 U.S.C. 1703 and 38 CFR 17.52; or (2) If the veteran needs non-immediate hospitalization..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing...

  12. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

    PubMed Central

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning. PMID:27433491

  13. 22 CFR 72.26 - Vesting of personal estate in United States.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Vesting of personal estate in United States. 72.26 Section 72.26 Foreign Relations DEPARTMENT OF STATE PROTECTION AND WELFARE OF AMERICANS, THEIR PROPERTY AND ESTATES DEATHS AND ESTATES Personal Estates of Deceased United States Citizens and Nationals § 72.26 Vesting of personal estate in...

  14. 31 CFR 535.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 535.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  15. 31 CFR 515.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 515.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a)......

  16. 31 CFR 515.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 515.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  17. 31 CFR 535.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 535.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  18. 31 CFR 500.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 500.329 Person subject to the jurisdiction of the United States. The term, person subject to the jurisdiction of the United States, includes: (a)......

  19. 31 CFR 535.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 535.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  20. 31 CFR 515.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 515.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  1. 31 CFR 515.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 515.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  2. 31 CFR 535.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 535.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  3. 31 CFR 535.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 535.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a)......

  4. 31 CFR 515.329 - Person subject to the jurisdiction of the United States.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Person subject to the jurisdiction of... CONTROL REGULATIONS General Definitions § 515.329 Person subject to the jurisdiction of the United States. The term person subject to the jurisdiction of the United States includes: (a) Any......

  5. Patterns of Inequality. Unit 3, The Philosophy of Equality and Inequality. Unit 4, Personal Inequality as an Ideological Concept.

    ERIC Educational Resources Information Center

    Hookham, Maurice; Holloway, Clive

    Open University course units are presented on the philosophy of equality and inequality (Unit 3) and on personal inequality as an ideological concept (Unit 4). The substance of Unit 3 consists of extracts from the writings of eight philosophers. The role of the philosopher in forming legitimatizing ideologies is also illustrated. The eight…

  6. Influence of indoor air quality and personal factors on the sick building syndrome (SBS) in Swedish geriatric hospitals.

    PubMed Central

    Nordström, K; Norbäck, D; Akselsson, R

    1995-01-01

    OBJECTIVES--Sick building syndrome (SBS) involves symptoms such as irritation to the eyes, skin, and upper airways, headache, and fatigue. The relations between such symptoms and both personal and environmental factors were studied in 225 female hospital workers, working in eight hospital units in the south of Sweden. METHODS--Symptoms of SBS and personal factors were measured by means of a standardised self administered questionnaire. The technical investigation comprised a building survey and measurements of room temperature, supply air temperature, air humidity, and exhaust air flow. RESULTS--The prevalence of symptoms differed from one unit to another. The mean value of weekly complaints of fatigue was 30%, of eye irritation 23%, and of dry facial skin 34%. Eye irritation was related to work stress, self reported exposure to static electricity, and was also more common in buildings with a high ventilation flow and a high noise level (55 dB(A)) from the ventilation system. Nasal symptoms were related to asthma and hay fever only. Throat symptoms were more common in smokers, subjects with asthma or hay fever, new buildings, and in buildings with a high ventilation flow. Facial skin irritation was related to a lack of control of the work conditions, and was more common in new buildings, and buildings with a high ventilation flow and ventilation noise. General symptoms, such as headache and fatigue, were related to current smoking, asthma or hay fever, work dissatisfaction, and static electricity. CONCLUSION--As the prevalence of symptoms was high, there is a need to improve the indoor environment as well as the psychosocial environment in hospitals. These improvements could include a reduction of ventilation noise, minimised smoking, and improvements in the psychosocial climate. Further research is needed to identify indoor climatic factors that cause the increased prevalence of symptoms of SBS in new buildings. PMID:7735389

  7. [The weighted health care unit: a new tool for hospital budgeting].

    PubMed

    Bestard Perelló, J J; Sevilla Pérez, F; Corella Monzón, I; Elola Somoza, J

    1993-01-01

    Hospital budgets must be based on estimated workload in order to fairly distribute available financial resources. A tool to measure hospital production is need to achieve this aim. We present in this article the results of a study on hospital cost which was carried out to design a new unit for measuring intermediate hospital products: the Weighted Health Care Unit (Unidad Ponderada Asistencial: UPA). Thereafter we use multiple regression to find out structure, services and activity variables which explain the variations in expenses per UPA among 64 hospitals of INSALUD. Significant variables include: doctors per hospital bed, hospital staff (sanitary personnel except doctors plus administrative assistants) per bed, hospital size (less than 200 beds), ICU beds percentage, oncology service, UPAs per bed average length of stay. These variables, along with interactions between them, explain 91.4% of the variance of expenses per UPA. The UPA and statistical modeling allow a better understanding of hospital expenses and can be very useful in coordinating budgets to hospital activity taking into account the different characteristics of each hospital. PMID:8169037

  8. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization.

    PubMed

    Domingos, Thiago da Silva; Braga, Eliana Mara

    2015-01-01

    OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State) was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001) of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization. PMID:26107706

  9. Testing family-centered, function-focused care in hospitalized persons with dementia

    PubMed Central

    Boltz, Marie; Chippendale, Tracy; Resnick, Barbara; Galvin, James E

    2015-01-01

    Summary Aim Hospital-acquired disability causes decreased quality of life for patients with dementia and family caregivers, and increased societal costs. Materials & methods A comparative, repeated measures study tested the feasibility and preliminary efficacy of the family-centered, function-focused care intervention (Fam-FFC) in dyads of hospitalized, medical patients with dementia and family caregivers (FCGs). Results The intervention group demonstrated better activities of daily living and walking performance, and less severity/duration of delirium and hospital readmissions, but no significant differences in gait/balance. FCGs showed increased preparedness for caregiving and less anxiety but no significant differences in depression, strain and mutuality. Conclusion Fam-FFC presents a possible pathway to meeting the Triple Aim of improved patient care, improved patient health and reduced costs for persons with dementia. PMID:26107319

  10. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002-2011(1).

    PubMed

    Wuerth, Brandon A; Bonnewell, John P; Wiemken, Timothy L; Arnold, Forest W

    2016-09-01

    Because the epidemiology of pneumonia is changing, we performed an updated, population-based analysis of hospitalization and case-fatality rates for pneumonia patients in the United States. From 2002 to 2011, hospitalization rates decreased significantly for pneumonia caused by pneumococcus and Haemophilus influenzae but increased significantly for Pseudomonas spp., Staphylococcus aureus, and influenza virus. PMID:27532154

  11. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–20111

    PubMed Central

    Wuerth, Brandon A.; Bonnewell, John P.; Wiemken, Timothy L.

    2016-01-01

    Because the epidemiology of pneumonia is changing, we performed an updated, population-based analysis of hospitalization and case-fatality rates for pneumonia patients in the United States. From 2002 to 2011, hospitalization rates decreased significantly for pneumonia caused by pneumococcus and Haemophilus influenzae but increased significantly for Pseudomonas spp., Staphylococcus aureus, and influenza virus. PMID:27532154

  12. U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  13. Trends in Out-of-Hospital Births in the United States, 1990-2012

    MedlinePlus

    ... occurring out-of-hospital, by race and Hispanic origin of mother: United States, 1990–2012 NOTE: Non- ... in 1990; these states did not report Hispanic origin on their birth certificates for these years. SOURCE: ...

  14. Hospital restructuring stressors, support, and nursing staff perceptions of unit functioning.

    PubMed

    Burke, Ronald J

    2005-01-01

    Hospital restructuring and downsizing have taken place in most developed countries during the past 10 years. A small but growing body of research findings has identified aspects of these changes that serve as sources of stress for nursing staff during these transitions as well as organizational initiatives that facilitate those transitions. This study reports results from a longitudinal study of hospital restructuring and downsizing on nursing staff perceptions of hospital functioning. Data were collected in November 1996 and again in November 1999 from hospital-based nursing staff using questionnaires. The findings showed moderate but statistically significant relationships between restructuring stressors and organizational support in 1996 and perceptions of hospital functioning in 1999. Nursing staff reporting higher levels of restructuring stressors and lower hospital support in 1996 indicated more negative perceptions of unit and hospital functioning in 1999. PMID:15825816

  15. Rural Residents Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010

    MedlinePlus

    ... Health Care Statistics. References Health Resources and Services Administration, Department of Health and Human Services. Area Resource File (ARF). 2012. Moscovice I, Stensland J. Rural hospitals: Trends, challenges, and a future research and policy analysis agenda. J Rural Health ...

  16. The Vocational Personality of School Psychologists in the United States

    ERIC Educational Resources Information Center

    Toomey, Kristine D.; Levinson, Edward M.; Morrison, Takea J.

    2008-01-01

    This study represents the first empirical test of the vocational personality of US school psychologists. Specifically, we investigated the personality of school psychologists using Holland's (1997) well-researched theory of vocational personalities and work environments. The sample consisted of 241 randomly selected members of the National…

  17. Healthcare resource utilization and epidemiology of pediatric burn-associated hospitalizations, United States, 2000.

    PubMed

    Shields, Brenda J; Comstock, R Dawn; Fernandez, Soledad A; Xiang, Huiyun; Smith, Gary A

    2007-01-01

    The objective of this study was to describe the epidemiology and financial burden of burn-associated hospitalizations for children younger than 18 years in the United States. Retrospective data analysis of pediatric burn-associated hospitalizations was done using the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2000. An estimated 10,000 children younger than 18 years were hospitalized for burn-associated injuries in the United States in 2000. These children spent an estimated 66,200 days in the hospital with associated hospital charges equal to USD 211,772,700. Total charges and length of stay for pediatric burn-associated hospitalizations in the United States during 2000 were associated with degree of burn, percentage of total body surface area burned, child's age, region of the United States, hospital location, and hospital type. Children 2 years old or younger were more likely to be nonwhite, be hospitalized for burns, and burn their hands/wrists, compared with children 3 to 17 years of age. Male children in both age groups were more likely to be hospitalized for burns than female children. Children 2 years old or younger were more likely to be burned by hot liquids/vapors and contact with hot substances/objects, while children 3 to 17 years were more likely to be burned by fire/flames. This study is the first national study on healthcare resource utilization for pediatric burn-associated hospitalizations to utilize the KID database. Burns are a major source of pediatric morbidity and are associated with significant national healthcare resource utilization annually. Future burn prevention efforts should emphasize implementing passive injury prevention strategies, especially for young children who are nonwhite and live in low-income communities. PMID:17925649

  18. Preliminary results of 2009 pandemic influenza surveillance in the United States using the Aggregate Hospitalization and Death Reporting Activity

    PubMed Central

    Jhung, Michael A.; Davidson, Heidi; McIntyre, Anne; Gregg, William J.; Dasgupta, Sharoda; D’Mello, Tiffany; White, Victoria; Fowlkes, Ashley; Brammer, Lynnette; Finelli, Lyn

    2011-01-01

    Please cite this paper as: Jhung et al. (2011) Preliminary results of 2009 pandemic influenza surveillance in the United States using the Aggregate Hospitalization and Death Reporting Activity. Influenza and Other Respiratory Viruses 5(5), 321–327. Background  To augment established influenza surveillance systems in the United States, the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists implemented the Aggregate Hospitalization and Death Reporting Activity (AHDRA) in August 2009. The AHDRA was designed to meet increased demands for timely and detailed information describing illness severity during the 2009 H1N1 influenza A (pH1N1) pandemic response. Objectives  We describe the implementation of AHDRA and provide preliminary results from this new surveillance activity. Methods  All 50 US states were asked to report influenza‐associated hospitalizations and deaths to AHDRA each week using either a laboratory‐confirmed or syndromic surveillance definition. Aggregate counts were used to calculate age‐specific weekly and cumulative rates per 100 000, and laboratory‐confirmed reports were used to estimate the age distribution of pH1N1 influenza‐associated hospitalizations and deaths. Results  From August 30, 2009, through April 6, 2010, AHDRA identified 41 689 laboratory‐confirmed influenza‐associated hospitalizations and 2096 laboratory‐confirmed influenza‐associated deaths. Aggregate Hospitalization and Death Reporting Activity rates peaked earlier than hospitalization and death rates seen in previous influenza seasons with other surveillance systems, and the age distribution of cases revealed a tendency for hospitalizations and deaths to occur in persons <65 years for age. Conclusions  Aggregate Hospitalization and Death Reporting Activity laboratory‐confirmed reports provided important information during the 2009 pandemic response. Aggregate Hospitalization and Death Reporting

  19. Development and Validation of a Web-Based Survey on the Use of Personal Communication Devices by Hospital Registered Nurses: Pilot Study

    PubMed Central

    LeVasseur, Sandra A; Li, Dongmei

    2013-01-01

    Background The use of personal communication devices (such as basic cell phones, enhanced cell phones or smartphones, and tablet computers) in hospital units has risen dramatically in recent years. The use of these devices for personal and professional activities can be beneficial, but also has the potential to negatively affect patient care, as clinicians may become distracted by these devices. Objective No validated questionnaire examining the impact of the use of these devices on patient care exists; thus, we aim to develop and validate an online questionnaire for surveying the views of registered nurses with experience of working in hospitals regarding the impact of the use of personal communication devices on hospital units. Methods A 50-item, four-domain questionnaire on the views of registered nursing staff regarding the impact of personal communication devices on hospital units was developed based on a literature review and interviews with such nurses. A repeated measures pilot study was conducted to examine the psychometrics of a survey questionnaire and the feasibility of conducting a larger study. Psychometric testing of the questionnaire included examining internal consistency reliability and test-retest reliability in a sample of 50 registered nurses. Results The response rate for the repeated measures was 30%. Cronbach coefficient alpha was used to examine the internal consistency and reliability, and in three of the four question groups (utilization, impact, and opinions), the correlation was observed to be very high. This suggests that the questions were measuring a single underlying theme. The Cronbach alpha value for the questions in the performance group, describing the use of personal communication devices while working, was lower than those for the other question groups. These values may be an indication that the assumptions underlying the Cronbach alpha calculation may have been violated for this group of questions. A Spearman rho correlation

  20. Firearm-related hospitalizations and in-hospital mortality in the United States, 2000-2010.

    PubMed

    Kalesan, Bindu; French, Clare; Fagan, Jeffrey A; Fowler, Dennis L; Galea, Sandro

    2014-02-01

    Most firearm-related injuries are nonfatal and require hospitalization. Using data on 3,257,720 hospitalizations from the National Hospital Discharge Survey (2000-2010), we determined overall and cause-, gender-, and race-specific trends in firearm-related hospitalization (FRH) and determinants of in-hospital firearm mortality. Types of FRH evaluated, according to International Classification of Diseases, Ninth Revision, Clinical Modification, E-diagnostic codes, were accident (codes E922.0-E922.3, E922.8, and E922.9), assault (codes E965.0-E965.4), attempted suicide (codes E955.0-E955.4), legal intervention (code E970), undetermined intent (codes E985.0-E985.3), and war (code E991). A moderate reduction in FRH rates was observed from 2000 to 2011: from 62 FRHs per 100,000 hospitalizations to 57 per 100,000 (P-trend = 0.0016). The majority of FRHs were due to assault (P-trend = 0.19) or accident (P-trend = 0.32) and showed no significant reduction in rates over time, whereas rates for 14% of all FRHs-those due to attempted suicide (P-trend = 0.002) and undetermined intent (P-trend = 0.0029)-declined moderately. Moderate declines were observed among both blacks (from 213.1 FRHs per 100,000 hospitalizations to 164.4 per 100,000; P-trend = 0.049) and whites (from 38.4 FRHs per 100,000 hospitalizations to 32.2 per 100,000; P-trend = 0.031). The decline was significant only among men (effect size = 0.9, P-trend = 0.004). In conclusion, the reduction in FRH was driven by a reduction in self-inflicted and undetermined injuries. FRH rates were 6-fold greater among blacks than among whites and 14-fold greater in men than in women throughout the period. PMID:24148708

  1. The behavioral medicine unit: a community hospital model for inpatient treatment of adolescent depression.

    PubMed

    Greydanus, D E; Porter, J; Rypma, C B; Heuer, T; Granberg, A; Ruch, R

    1986-12-01

    This article describes one community hospital's response to the overwhelming needs of adolescents in central Iowa. It is based on the premise that many youths who have severe depression do not effectively respond to various outpatient counseling measures, and are in need of some type of inpatient treatment. Most such programs are locked psychiatric units run by child or adolescent psychiatrists. In our case, those wards already in existence are filled to capacity and cannot respond to outside needs. Placing these youth on traditional medical adolescent wards does not work, since medical staff are usually not geared to deal with the many, ever-changing mental health needs of these patients. Thus, we developed an unlocked adolescent inpatient unit with a pediatrician experienced in adolescent medicine as medical director; moreover, the program extensively utilizes psychologists, nurse-counselors, social worker-family therapists, recreation therapists, and other specialists. This program is a way for physicians trained in adolescent medicine and other appropriate persons to contribute to the complex health needs of youth; it is preferable to do this rather than send all depressed teenagers away by referrals, as seems to happen in some cases. It is also an important way for physicians and other specialists to demonstrate their expertise--both the Society for Adolescent Medicine and American Academy of Pediatrics have advocated such a demonstration--and to give physicians important training in the medical and mental health care needs of youth. Finally, the Spectrum Unit program provides a meaningful way for the primary care physician to be involved in the inpatient treatment of depressed adolescent patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3602650

  2. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Facilitation by a United States person. 538.407 Section 538.407 Money and Finance: Treasury Regulations Relating to Money and Finance... action by a U.S. person that assists or supports trading activity with Sudan by any person....

  3. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Facilitation by a United States person. 538.407 Section 538.407 Money and Finance: Treasury Regulations Relating to Money and Finance... action by a U.S. person that assists or supports trading activity with Sudan by any person....

  4. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Facilitation by a United States person. 538.407 Section 538.407 Money and Finance: Treasury Regulations Relating to Money and Finance... action by a U.S. person that assists or supports trading activity with Sudan by any person....

  5. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Facilitation by a United States person. 538.407 Section 538.407 Money and Finance: Treasury Regulations Relating to Money and Finance... action by a U.S. person that assists or supports trading activity with Sudan by any person....

  6. Organizational Effects on Patient Satisfaction in Hospital Medical-Surgical Units

    PubMed Central

    Bacon, Cynthia Thornton; Mark, Barbara

    2010-01-01

    Objective The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients’ satisfaction with nursing care in hospitals. Background Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. Methods The data source for this study was the Outcomes Research in Nursing Administration Project, a multi-site organizational study to investigate relationships among nurse staffing, organizational context and structure and patient outcomes. The sample for this study was 2720 patients and 3718 RNs in 286 medical-surgical units in 146 hospitals. Results Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status and better symptom management were also associated with higher levels of patient satisfaction. Conclusions Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses’ work engagement and effective symptom management, are important influences on patient satisfaction. PMID:19423987

  7. 8 CFR 319.2 - Person whose United States citizen spouse is employed abroad.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Person whose United States citizen spouse is employed abroad. 319.2 Section 319.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.2 Person whose United States citizen spouse is employed abroad. (a) Eligibility. To be...

  8. 8 CFR 319.2 - Person whose United States citizen spouse is employed abroad.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Person whose United States citizen spouse is employed abroad. 319.2 Section 319.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.2 Person whose United States citizen spouse is employed abroad. (a) Eligibility. To be...

  9. Chinese International Students' Personal and Sociocultural Stressors in the United States

    ERIC Educational Resources Information Center

    Yan, Kun; Berliner, David C.

    2013-01-01

    To date, no empirical research has focused solely upon understanding the personal and sociocultural stressors of Chinese international students in the United States. This qualitative inquiry examined what the most stressful aspects of their personal and social lives in the United States are, how they characterize their stress, and what conditions…

  10. 26 CFR 301.7505-1 - Sale of personal property acquired by the United States.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... to make deposits to secure the performance of their agreements. Any such deposit, but not more than... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Sale of personal property acquired by the... Actions by the United States § 301.7505-1 Sale of personal property acquired by the United States....

  11. Nursing care quality: comparison of unit-hired, hospital float pool, and agency nurses.

    PubMed

    Strzalka, A; Havens, D S

    1996-07-01

    As fiscal constraints and hospital downsizing become driving forces in the health care arena, nurse administrators are challenged to satisfy fluctuating staffing needs while ensuring high-quality care. Hospital in-house nurses and agency nurses are two solutions often used to supplement unit staffing. The article reports a study that examined the quality of care administered on one unit by unit-hired, float pool, and agency nurses through a comparison of the groups' documentation on nine clinical quality indicators. Findings suggested significant differences among the three groups on these indicators. Implications for nurse administrators are discussed. PMID:8783546

  12. Adverse Outcomes After Hospitalization and Delirium in Persons With Alzheimer Disease

    PubMed Central

    Fong, Tamara G.; Jones, Richard N.; Marcantonio, Edward R.; Tommet, Douglas; Gross, Alden L.; Habtemariam, Daniel; Schmitt, Eva; Yap, Liang; Inouye, Sharon K.

    2012-01-01

    Background Hospitalization, frequently complicated by delirium, can be a life-changing event for patients with Alzheimer disease (AD). Objective To determine risks for institutionalization, cognitive decline, or death associated with hospitalization and delirium in patients with AD. Design Prospective cohort enrolled between 1991 and 2006 into the Massachusetts Alzheimer’s Disease Research Center (MADRC) patient registry. Setting Community-based. Participants 771 persons aged 65 years or older with a clinical diagnosis of AD. Measurements Hospitalization, delirium, death, and institutionalization were identified through administrative databases. Cognitive decline was defined as a decrease of 4 or more points on the Blessed Information-Memory-Concentration test score. Multivariate analysis was used to calculate adjusted relative risks (RRs). Results Of 771 participants with AD, 367 (48%) were hospitalized and 194 (25%) developed delirium. Hospitalized patients who did not have delirium had an increased risk for death (adjusted RR, 4.7 [95% CI, 1.9 to 11.6]) and institutionalization (adjusted RR, 6.9 [CI, 4.0 to 11.7]). With delirium, risk for death (adjusted RR, 5.4 [CI, 2.3 to 12.5]) and institutionalization (adjusted RR, 9.3 [CI, 5.5 to 15.7]) increased further. With hospitalization and delirium, the adjusted RR for cognitive decline for patients with AD was 1.6 (CI, 1.2 to 2.3). Among hospitalized patients with AD, 21% of the incidences of cognitive decline, 15% of institutionalization, and 6% of deaths were associated with delirium. Limitations Cognitive outcome was missing in 291 patients. Sensitivity analysis was performed to test the effect of missing data, and a composite outcome was used to decrease the effect of missing data. Conclusion Approximately 1 in 8 hospitalized patients with AD who develop delirium will have at least 1 adverse outcome, including death, institutionalization, or cognitive decline, associated with delirium. Delirium prevention may

  13. Factors associated with variations in hospital expenditures for acute heart failure in the United States

    PubMed Central

    Ziaeian, Boback; Sharma, Puza P.; Yu, Tzy-Chyi; Johnson, Katherine Waltman; Fonarow, Gregg C.

    2015-01-01

    Background Relatively little contemporary data are available that describe differences in acute heart failure (AHF) hospitalization expenditures as a function of patient and hospital characteristics, especially from a population-based investigation. This study aimed to evaluate factors associated with variations in hospital expenditures for AHF in the United States. Methods A cross-sectional analysis using discharge data from the 2011 Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, was conducted. Discharges with primary International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis codes for AHF in adults were included. Costs were estimated by converting Nationwide Inpatient Sample charge data using the Healthcare Cost and Utilization Project Cost-to-Charge Ratio File. Discharges with highest (≥80th percentile) versus lowest (≤20th percentile) costs were compared for patient characteristics, hospital characteristics, utilization of procedures, and outcomes. Results Of the estimated 1 million AHF hospital discharges, the mean cost estimates were $10,775 per episode. Younger age, higher percentage of obesity, atrial fibrillation, pulmonary disease, fluid/electrolyte disturbances, renal insufficiency, and greater number of cardiac/noncardiac procedures were observed in stays with highest versus lowest costs. Highest-cost discharges were more likely to be observed in urban and teaching hospitals. Highest-cost AHF discharges also had 5 times longer length of stay, were 9 times more costly, and had higher in-hospital mortality (5.6% vs 3.5%) compared with discharges with lowest costs (all P < .001). Conclusions Acute heart failure hospitalizations are costly. Expenditures vary markedly among AHF hospitalizations in the United States, with substantial differences in patient and hospital characteristics, procedures, and in-hospital outcomes among discharges with highest compared with lowest costs. PMID:25641538

  14. Demographics and Personality Factors Associated with Burnout among Nurses in a Singapore Tertiary Hospital

    PubMed Central

    Dhaliwal, Satvinder S.; Ayre, Tracy Carol; Uthaman, Thendral; Fong, Kuan Yok; Tien, Choo Eng; Zhou, Huaqiong; Della, Phillip

    2016-01-01

    Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off score of <33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout. PMID:27478835

  15. Demographics and Personality Factors Associated with Burnout among Nurses in a Singapore Tertiary Hospital.

    PubMed

    Ang, Shin Yuh; Dhaliwal, Satvinder S; Ayre, Tracy Carol; Uthaman, Thendral; Fong, Kuan Yok; Tien, Choo Eng; Zhou, Huaqiong; Della, Phillip

    2016-01-01

    Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off score of <33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout. PMID:27478835

  16. Predictors of patient satisfaction with inpatient hospital pain management across the United States: A national study.

    PubMed

    McFarland, Daniel C; Shen, Megan Johnson; Holcombe, Randall F

    2016-07-01

    Satisfactory pain management of hospitalized patients remains a national unmet need for the United States. Although prior research indicates that inpatient pain management may be improving nationally, not all populations of patients rate pain management as equally satisfactory. County-level predictors, such as demographics and population density, and hospital-level predictors (eg, hospital-bed number), are understudied determinants of pain management patient satisfaction. We created a multivariate regression model of pain management patient satisfaction scores as indicated by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results based on county and hospital level predictors. Number of hospital beds (β = -0.16), percent foreign-born (β = -0.16), and population density (β = -0.08) most strongly predicted unfavorable ratings, whereas African American (β = 0.23), white (β= 0.23), and younger population (β = 0.08) most strongly predicted favorable ratings. Greater attention should be placed on pain management in larger hospitals that serve foreign-born patients in population-dense areas. Journal of Hospital Medicine 2016;11:498-501. © 2016 Society of Hospital Medicine. PMID:26970075

  17. United States Department of Justice findings letters in psychiatric hospital CRIPA cases: an aid or a distraction?

    PubMed

    Geller, Jeffrey; Lee, Leilani

    2013-01-01

    The Civil Rights of Institutionalized Persons Act (CRIPA) of 1980 allows the United States Department of Justice (DOJ) to investigate and file lawsuits against certain institutions, including state and county psychiatric hospitals, where individuals within may face unconstitutional conditions. Subsequent to an investigation and before negotiations or litigation, the state is provided a Findings Letter generated by the DOJ that generally contains recommended remedial measures. It has never been determined to what extent a Findings Letter provides a state with a recommendation specific to the institution for corrective action before the state enters into negotiations with the DOJ. Three study groups were derived from a sample of 15 Findings Letters written to states concerning their psychiatric hospitals between 2003 and 2009. The individual recommended remedial measures, labeled texts of interest (TOI), were identified, and the degree of overlap among the Findings Letters was determined. To a surprising degree, TOIs overlapped to various extents, from exact copies of text to paraphrased versions, in Findings Letters written between 2003 and 2009 to different states and for multiple state hospitals in the same state. The recommended remedial measures provided in the DOJ's Findings Letters are not specific to each state hospital's deficiencies. The Findings Letters offer limited guidance to the state on how to remedy the deficiencies before negotiating with the DOJ. This lack of specificity causes inefficient and delayed remediation of unconstitutional conditions and other deficiencies in care and treatment in psychiatric hospitals. While the current process most often leads to improvements in state hospitals, it is a costly, inefficient remedy, despite the possibility of alternative remedial processes of less expensive and equal or greater effectiveness. PMID:23771930

  18. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    PubMed Central

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  19. Trends in pediatric pulmonary hypertension–related hospitalizations in the United States from 2000–2009

    PubMed Central

    Crystal, Matthew A.; Morales, David L. S.; Gerald, Ken; Hanna, Brian D.; Mallory, George B.; Rossano, Joseph W.

    2015-01-01

    Abstract There are few data on the epidemiology of pulmonary hypertension (PH)–related hospitalizations in children in the United States. Our aim was to determine hospital mortality, length of hospitalization, and hospital charges pertaining to PH-related hospitalizations and also the effects of codiagnoses and comorbidities. A retrospective review of the Kids’ Inpatient Database during the years 2000, 2003, 2006, and 2009 was analyzed for patients ≤20 years of age with a diagnosis of PH by ICD-9 (International Classification of Diseases, Ninth Revision) codes, along with associated diagnoses and comorbidities. Descriptive statistics, including Rao-Scott χ2, ANOVA, and logistic regression models, were utilized on weighted values with survey analysis procedures. The number of PH-related hospital admissions is rising, from an estimated 7,331 (95% confidence interval [CI]: 5,556–9,106) in 2000 to 10,792 (95% CI: 8,568–13,016) in 2009. While infant age and congenital heart disease were most commonly associated with PH-related hospitalizations, they were not associated with mortality. Overall mortality for PH-related hospitalizations was greater than that for hospitalizations not associated with PH, 5.7% versus 0.4% (odds ratio: 16.22 [95% CI: 14.78%–17.8%], P < 0.001), but mortality is decreasing over time. Sepsis, respiratory failure, acute renal failure, hepatic insufficiency, arrhythmias, and the use of extracorporeal membrane oxygenation are associated with mortality. The number of PH-related hospitalizations is increasing in the United States. The demographics of PH in this study are evolving. Despite the increasing prevalence, mortality is improving. PMID:26064460

  20. [Tasks performed by nurses at inpatient units in a training hospital].

    PubMed

    Costa, Rita de Almeida; Shimizu, Helena Eri

    2005-01-01

    The purpose of this study was to identify and analyze tasks performed by nurses at inpatient units in a large general hospital in Brasilia, Federal District, which also functions as a training hospital. A quantitative, exploratory, descriptive study was carried out and involved a total of 612 hours of direct observation of the activities performed by 18 nurses at the General Medicine, Surgical, Pediatric and Maternity units. The tasks observed were classified as: administration, nursing care delivery, education and related to information system. Nurses dedicate a large part of their time to administrative tasks, followed by tasks related to nursing care delivery and information system, performing almost no educative tasks. PMID:16308621

  1. Sexual and reproductive health of persons aged 10-24 years - United States, 2002-2007.

    PubMed

    Gavin, Lorrie; MacKay, Andrea P; Brown, Kathryn; Harrier, Sara; Ventura, Stephanie J; Kann, Laura; Rangel, Maria; Berman, Stuart; Dittus, Patricia; Liddon, Nicole; Markowitz, Lauri; Sternberg, Maya; Weinstock, Hillard; David-Ferdon, Corinne; Ryan, George

    2009-07-17

    This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior and health outcomes; 2) disparities by sex, age, race/ethnicity, and geographic residence; and 3) trends over time. The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes. In 2004, approximately 745,000 pregnancies occurred among U.S. females aged <20 years. In 2006, approximately 22,000 adolescents and young adults aged 10-24 years in 33 states were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and approximately 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis. One-quarter of females aged 15-19 years and 45% of those aged 20-24 years had evidence of infection with human papillomavirus during 2003-2004, and approximately 105,000 females aged 10--24 years visited a hospital emergency department (ED) for a nonfatal sexual assault injury during 2004-2006. Although risks tend to increase with age, persons in the youngest age group (youths aged 10--14 years) also are affected. For example, among persons aged 10-14 years, 16,000 females became pregnant in 2004, nearly 18,000 males and females were reported to have sexually transmitted diseases (STDs) in 2006, and 27,500 females visited a hospital ED because of a nonfatal sexual assault injury during 2004

  2. Network security vulnerabilities and personal privacy issues in Healthcare Information Systems: a case study in a private hospital in Turkey.

    PubMed

    Namoğlu, Nihan; Ulgen, Yekta

    2013-01-01

    Healthcare industry has become widely dependent on information technology and internet as it moves from paper to electronic records. Healthcare Information System has to provide a high quality service to patients and a productive knowledge share between healthcare staff by means of patient data. With the internet being commonly used across hospitals, healthcare industry got its own share from cyber threats like other industries in the world. The challenge is allowing knowledge transfer to hospital staff while still ensuring compliance with security mandates. Working in collaboration with a private hospital in Turkey; this study aims to reveal the essential elements of a 21st century business continuity plan for hospitals while presenting the security vulnerabilities in the current hospital information systems and personal privacy auditing standards proposed by regulations and laws. We will survey the accreditation criteria in Turkey and counterparts in US and EU. We will also interview with medical staff in the hospital to understand the needs for personal privacy and the technical staff to perceive the technical requirements in terms of network security configuration and deployment. As hospitals are adopting electronic transactions, it should be considered a must to protect these electronic health records in terms of personal privacy aspects. PMID:23823398

  3. Hospitalization frequency and charges for neurocysticercosis, United States, 2003-2012.

    PubMed

    O'Neal, Seth E; Flecker, Robert H

    2015-06-01

    Neurocysticercosis, brain infection with Taenia solium larval cysts, causes substantial neurologic illness around the world. To assess the effect of neurocysticercosis in the United States, we reviewed hospitalization discharge data in the Nationwide Inpatient Sample for 2003-2012 and found an estimated 18,584 hospitalizations for neurocysticercosis and associated hospital charges totaling >US $908 million. The risk for hospitalization was highest among Hispanics (2.5/100,000 population), a rate 35 times higher than that for the non-Hispanic white population. Nearly three-quarters of all hospitalized patients with neurocysticercosis were Hispanic. Male sex and age 20-44 years also incurred increased risk. In addition, hospitalizations and associated charges related to cysticercosis far exceeded those for malaria and were greater than for those for all other neglected tropical diseases combined. Neurocysticercosis is an increasing public health concern in the United States, especially among Hispanics, and costs the US health care system a substantial amount of money. PMID:25988221

  4. Hospitalization Frequency and Charges for Neurocysticercosis, United States, 2003–2012

    PubMed Central

    Flecker, Robert H.

    2015-01-01

    Neurocysticercosis, brain infection with Taenia solium larval cysts, causes substantial neurologic illness around the world. To assess the effect of neurocysticercosis in the United States, we reviewed hospitalization discharge data in the Nationwide Inpatient Sample for 2003–2012 and found an estimated 18,584 hospitalizations for neurocysticercosis and associated hospital charges totaling >US $908 million. The risk for hospitalization was highest among Hispanics (2.5/100,000 population), a rate 35 times higher than that for the non-Hispanic white population. Nearly three-quarters of all hospitalized patients with neurocysticercosis were Hispanic. Male sex and age 20–44 years also incurred increased risk. In addition, hospitalizations and associated charges related to cysticercosis far exceeded those for malaria and were greater than for those for all other neglected tropical diseases combined. Neurocysticercosis is an increasing public health concern in the United States, especially among Hispanics, and costs the US health care system a substantial amount of money. PMID:25988221

  5. The relationship between hospital unit culture and nurses' quality of work life.

    PubMed

    Gifford, Blair D; Zammuto, Raymond F; Goodman, Eric A

    2002-01-01

    Turnover rates for hospital nurses have been increasing in recent years, which is partially a result of increasing pressure on nurses from higher productivity expectations in a managed care environment. Improving nurse retention is a difficult challenge to managers since the bureaucratic cultural norm of hospitals, with its hierarchical structures, rules, and regulations, and heavy emphasis on measurement of outcomes and costs, may not be the culture most conducive to enhancing nurses' job satisfaction and commitment. Accordingly, this study investigates the relationships between unit organizational culture and several important job-related variables for nurse retention in the labor and delivery units of seven hospitals. Data analysis shows that unit organizational culture does affect nurses' quality of work life factors and that human relations cultural values are positively related to organizational commitment, job involvement, empowerment, and job satisfaction, and negatively related to intent to turnover. These findings suggest that although increasing recruitment of nurses and improved compensation and benefits strategies may offset hospital nurse shortages in the short term, improving quality of work life may be a more practical and long-term approach to improving hospital nurse retention. PMID:11836962

  6. Legal Outcomes of Sexually Abused Children Evaluated at the Philippine General Hospital Child Protection Unit

    ERIC Educational Resources Information Center

    Sugue-Castillo, Mariella

    2009-01-01

    Objectives: To describe the legal outcomes and factors associated with case reaching court and conviction for sexual abuse of children seen at the Philippine General Hospital Child Protection Unit (PGH-CPU) from 1997 to 2000. Methods: Mixed transdisciplinary research design combined longitudinal cohort with qualitative methods. Data were obtained…

  7. Factors Affecting Code Status in a University Hospital Intensive Care Unit

    ERIC Educational Resources Information Center

    Van Scoy, Lauren Jodi; Sherman, Michael

    2013-01-01

    The authors collected data on diagnosis, hospital course, and end-of-life preparedness in patients who died in the intensive care unit (ICU) with "full code" status (defined as receiving cardiopulmonary resuscitation), compared with those who didn't. Differences were analyzed using binary and stepwise logistic regression. They found…

  8. Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001-2010.

    PubMed

    Schmeltz, Michael T; Petkova, Elisaveta P; Gamble, Janet L

    2016-01-01

    Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat. PMID:27618079

  9. Clinical assessment of the oral cavity of patients hospitalized in an intensive care unit of an emergency hospital

    PubMed Central

    da Cruz, Maristela Kapitski; de Morais, Teresa Márcia Nascimento; Trevisani, Deny Munari

    2014-01-01

    Objective To describe the oral health status of patients hospitalized in an intensive care unit. Methods Clinical assessment of the oral cavity was performed in 35 patients at two time-points (up to 48 hours after admission and 72 hours after the first assessment) and recorded in data collection forms. The following data were collected: plaque index, condition of the mucosa, presence or absence of dental prosthesis, number of teeth present, and tongue coating index. Results The prevalence of nosocomial infection was 22% (eight patients), with 50% respiratory tract infections. All patients exhibited oral biofilm, and 20 (57%) showed biofilm visible to the naked eye; tongue coating was present on more than two thirds of the tongue in 24 patients (69%) and was thick in most cases. A significant increase in plaque index (p=0.007) occurred after 72 hours, although the tongue coating index was p<0.001 regarding the area and p=0.5 regarding the thickness. Conclusion The plaque and tongue coating indices increased with the length of hospital stay at the intensive care unit. PMID:25607267

  10. Heat, Heat Waves, and Hospital Admissions among the Elderly in the United States, 1992–2006

    PubMed Central

    Zanobetti, Antonella; Schwartz, Joel D.; Wellenius, Gregory A.; O’Neill, Marie S.

    2014-01-01

    Background: Heat-wave frequency, intensity, and duration are increasing with global climate change. The association between heat and mortality in the elderly is well documented, but less is known regarding associations with hospital admissions. Objectives: Our goal was to determine associations between moderate and extreme heat, heat waves, and hospital admissions for nonaccidental causes among Medicare beneficiaries ≥ 65 years of age in 114 cities across five U.S. climate zones. Methods: We used Medicare inpatient billing records and city-specific data on temperature, humidity, and ozone from 1992 through 2006 in a time-stratified case-crossover design to estimate the association between hospitalization and moderate [90th percentile of apparent temperature (AT)] and extreme (99th percentile of AT) heat and heat waves (AT above the 95th percentile over 2–8 days). In sensitivity analyses, we additionally considered confounding by ozone and holidays, different temperature metrics, and alternate models of the exposure–response relationship. Results: Associations between moderate heat and hospital admissions were minimal, but extreme heat was associated with a 3% (95% CI: 2%, 4%) increase in all-cause hospital admissions over the subsequent 8 days. In cause-specific analyses, extreme heat was associated with increased hospitalizations for renal (15%; 95% CI: 9%, 21%) and respiratory (4%; 95% CI: 2%, 7%) diseases, but not for cardiovascular diseases. An added heat-wave effect was observed for renal and respiratory admissions. Conclusion: Extreme heat is associated with increased hospital admissions, particularly for renal causes, among the elderly in the United States. Citation: Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O’Neill MS. 2014. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992–2006. Environ Health Perspect 122:1187–1192; http://dx.doi.org/10.1289/ehp.1206132 PMID:24905551

  11. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  12. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  13. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  14. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  15. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  16. Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs

    PubMed Central

    Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D.K.; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

    2016-01-01

    Background & objectives: Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. Methods: This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. Results: The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were 2,04,787 (US$ 3,413) and 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was 1,48,200 (95% CI 55,716 to 2,40,685, P<0.01). Interpretation & conclusions: This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care. PMID:27377508

  17. The evolution of an acute care hospital unit to a DRG-exempt rehabilitation unit. A preliminary communication.

    PubMed

    Parfenchuck, T A; Parziale, J R; Liberman, J R; Butcher, R P; Ahern, D K

    1990-02-01

    The Health Care Financing Administration's decision to adopt a prospective based payment system has caused many institutions to implement new policies and practices. A recent area of interest for many hospitals has been the creation of diagnosis-related group (DRG) exempt units to maximize reimbursement practices. We analyzed changes which occurred when an eight bed acute care stroke unit (SU) was converted to a DRG exempt eight bed rehabilitation unit (RU). The time period involved was 1 1/2 months before and 1 1/2 months after the transition occurred. Analysis of data from the pre- and posttransition periods revealed that: (1) length of stay increased significantly from 11.7 to 15.3 days (P less than 0.001); (2) functional independence measure (FIM) score improvement was significantly greater (P less than 0.05) for RU patients (0.84/day) than for SU patients (0.39/day); (3) disposition to home v other facilities increased significantly from 50 to 81% (P less than 0.05); (4) the overall occupancy increased from 94 to 100% and all beds were filled with rehabilitation patients; (5) the proportion of patients with Medicare as their primary insurer was comparable before (64%) and after (67%) unit conversion; (6) gross income from rehabilitation patients increased by 43%. Indirect savings via reduction of acute hospital length of stay for Medicare patients increased total income from operation of this unit. We conclude that patients on the RU stayed longer, had greater daily improvements in functional status, and were more likely to be discharged to home. This appears to be due to a more efficient use of rehabilitation beds and a concomitant overall improvement in reimbursement to the hospital.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2105736

  18. Housing as an intervention on hospital use: access among chronically homeless persons with disabilities.

    PubMed

    Parker, David

    2010-12-01

    A study examining demographics and hospital utilization for chronically homeless persons with disabilities was conducted at pre-housing enrollment and at 6 months post-housing. Of the 20 participants, 70% (n = 14) were Black American and 30% (n = 6) were White; 100% (n = 20) were non-Hispanic; 90% (n = 18) were men; 40% (n = 8) were veterans; Median years since last permanent housing and total homelessness were 7 and 10.5 respectively. The following increases were observed: employment (0 to 1); income (20%, n = 4 to 35%, n = 7); primary care (25%, n = 5 to 95%, n = 19); and mental health service use (25%, n = 5 to 60%, n = 12). Known disabilities included HIV (15%, n = 3); hepatitis C (45%, n = 9); mental illness (60%, n = 12) and substance abuse (80%, n = 16) with 45% (n = 9) dually diagnosed. Over the course of the study, Emergency department visits and inpatient hospitalization use decreased. While these differences were not statistically significant (p = 0.14 and p = 0.31, respectively), they translate to an estimated $250,208 savings. PMID:21125341

  19. Acinetobacter infections prevalence and frequency of the antibiotics resistance: comparative study of intensive care units versus other hospital units

    PubMed Central

    Uwingabiye, Jean; Frikh, Mohammed; Lemnouer, Abdelhay; Bssaibis, Fatna; Belefquih, Bouchra; Maleb, Adil; Dahraoui, Souhail; Belyamani, Lahcen; Bait, Abdelouahed; Haimeur, Charki; Louzi, Lhoussain; Ibrahimi, Azeddine; Elouennass, Mostafa

    2016-01-01

    Introduction This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Results During the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n = 6352) and 9.6% of Gram negative rods (n = 4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p <0.05) except for colistin, tetracycline and rifampicin. Conclusion This paper shows that solving the problem of prevalence and high rate of multidrug resistant Acinetobacter infection which represents a therapeutic impasse, requires the control of the hospital environment and optimizing hands hygiene and antibiotics use in the hospital. PMID:27347280

  20. Evaluation of intoxicated patients hospitalized in a newly-opened level two pediatric intensive care unit

    PubMed Central

    Güngörer, Vildan; Yisldırım, Nurdan Kökten

    2016-01-01

    Aim: The study aimed to retrospectively examine the demographic and etiological characteristics, prognosis and length of stay in intensive care unit of intoxicated patients hospitalized in Level two Pediatric Intensive Care Unit in Maternity and Child Health Hospital of Samsun. Material and Methods: The study retrospectively examined the records of patients hospitalized between 14th March 2014 and 14th March 2015 in Level two Pediatric Intensive Care Unit in Maternity and Child Health Hospital of Samsun with respect to age, gender, cause of poisoning, time of emergency department admission, length of hospitalization and prognosis. Results: Of 82 patients admitted to the Intensive Care Unit, 29 (35.3%) were male and 53 (64.6%) were female. The mean age of the male and female patients was 7.89±6.3 years and 11.2±5.7 years, respectively and the mean age of the study group was 10.04±6.1. Twenthy one (39,6%) of the female patients were at the age group of 0–14 years and 32 (60.4%) were at the age group of 14–18 years. Twenthy (68.9%) of the male patients were at the age group of 0–14 years and nine (31.1%) were at the age group of 14–18 years. The cause of poisoning was drug intoxication (antidepressants, antibiotics, painkillers and other drugs) in 64 patients (78%) and the remaining 18 patients (22%) were admitted to hospital for other causes (rat poison, mushroom, carbonmonoxide, scorpion stings, bonzai and pesticides). Thirthy eight (46.3%) of all the patients used such substances for suicidal purpose. Thirthy three (62.2%) of these were female and 32 were at the age group of 14–18 years. Fourty (48.7%) of the patients who ingested medication ingested one drug, while 24 (29.2%) ingested multiple drugs. Antidepressants were found to be the most commonly used drugs (31.2%). The mean hospital admission time was 3.41±2 hours and the mean time of intensive care unit stay was 2.89±1.04 days. No mortality was recorded. Thirthy patients (36.5%) were referred

  1. Establishing a Personal Health Record System in an Academic Hospital: One Year's Experience

    PubMed Central

    Ro, Hyun Jung; Jung, Se Young; Hwang, Hee; Yoo, Sooyoung; Baek, Hyunyoung; Lee, Kiheon; Bae, Woo Kyung; Han, Jong-Soo; Kim, Sarah; Park, Hwayeon

    2015-01-01

    Background Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. Methods Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. Results The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. Conclusion For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR. PMID:26019761

  2. The Creation of a Biocontainment Unit at a Tertiary Care Hospital. The Johns Hopkins Medicine Experience.

    PubMed

    Garibaldi, Brian T; Kelen, Gabor D; Brower, Roy G; Bova, Gregory; Ernst, Neysa; Reimers, Mallory; Langlotz, Ronald; Gimburg, Anatoly; Iati, Michael; Smith, Christopher; MacConnell, Sally; James, Hailey; Lewin, John J; Trexler, Polly; Black, Meredith A; Lynch, Chelsea; Clarke, William; Marzinke, Mark A; Sokoll, Lori J; Carroll, Karen C; Parish, Nicole M; Dionne, Kim; Biddison, Elizabeth L D; Gwon, Howard S; Sauer, Lauren; Hill, Peter; Newton, Scott M; Garrett, Margaret R; Miller, Redonda G; Perl, Trish M; Maragakis, Lisa L

    2016-05-01

    In response to the 2014-2015 Ebola virus disease outbreak in West Africa, Johns Hopkins Medicine created a biocontainment unit to care for patients infected with Ebola virus and other high-consequence pathogens. The unit team examined published literature and guidelines, visited two existing U.S. biocontainment units, and contacted national and international experts to inform the design of the physical structure and patient care activities of the unit. The resulting four-bed unit allows for unidirectional flow of providers and materials and has ample space for donning and doffing personal protective equipment. The air-handling system allows treatment of diseases spread by contact, droplet, or airborne routes of transmission. An onsite laboratory and an autoclave waste management system minimize the transport of infectious materials out of the unit. The unit is staffed by self-selected nurses, providers, and support staff with pediatric and adult capabilities. A telecommunications system allows other providers and family members to interact with patients and staff remotely. A full-time nurse educator is responsible for staff training, including quarterly exercises and competency assessment in the donning and doffing of personal protective equipment. The creation of the Johns Hopkins Biocontainment Unit required the highest level of multidisciplinary collaboration. When not used for clinical care and training, the unit will be a site for research and innovation in highly infectious diseases. The lessons learned from the design process can inform a new research agenda focused on the care of patients in a biocontainment environment. PMID:27057583

  3. Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

    ERIC Educational Resources Information Center

    Viney, Linda L.; And Others

    1994-01-01

    Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

  4. Hospital Use by Children in the United States and Canada. Comparative International Vital and Health Statistics Reports.

    ERIC Educational Resources Information Center

    Kozak, Lola Jean; McCarthy, Eileen

    1984-01-01

    This document presents a statistical study of hospital use by children in the United States and Canada designed to determine why the hospital discharge rate of children in the United States is lower than many other Western industrialized nations, although the discharge rate for the general U.S. population is higher. Several reasons for the lower…

  5. 8 CFR 319.1 - Persons living in marital union with United States citizen spouse.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... States citizen spouse. 319.1 Section 319.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.1 Persons living in marital union with United States citizen spouse. (a) Eligibility. To be eligible for naturalization under section 319(a) of the Act, the spouse of a United States citizen...

  6. 8 CFR 319.1 - Persons living in marital union with United States citizen spouse.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... States citizen spouse. 319.1 Section 319.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.1 Persons living in marital union with United States citizen spouse. (a) Eligibility. To be eligible for naturalization under section 319(a) of the Act, the spouse of a United States citizen...

  7. Personal Economic and Financial Security. Unit 7: A Core Curriculum of Related Instruction for Apprentices.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.

    The personal economic and financial security unit is presented to assist apprentices to acquire a general knowledge of how to maintain economic security and stability. The unit consists of six modules: (1) Fair Labor Standards Act: minimum wages and maximum hours, (2) unemployment insurance: payments for the unemployed worker, (3) workmen's…

  8. 8 CFR 319.1 - Persons living in marital union with United States citizen spouse.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... States citizen spouse. 319.1 Section 319.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.1 Persons living in marital union with United States citizen spouse. (a) Eligibility. To be eligible for naturalization under section 319(a) of the Act, the spouse of a United States citizen...

  9. 8 CFR 319.1 - Persons living in marital union with United States citizen spouse.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... States citizen spouse. 319.1 Section 319.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.1 Persons living in marital union with United States citizen spouse. (a) Eligibility. To be eligible for naturalization under section 319(a) of the Act, the spouse of a United States citizen...

  10. 8 CFR 319.1 - Persons living in marital union with United States citizen spouse.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... States citizen spouse. 319.1 Section 319.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY... § 319.1 Persons living in marital union with United States citizen spouse. (a) Eligibility. To be eligible for naturalization under section 319(a) of the Act, the spouse of a United States citizen...

  11. A Time Study of Physicians’ Work in a German University Eye Hospital to Estimate Unit Costs

    PubMed Central

    Wolff, Jan; McCrone, Paul; Patel, Anita; Auber, Gerd; Reinhard, Thomas

    2015-01-01

    Background Technical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians’ work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output. Methods A self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit. Results Forty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations. Conclusion The presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff. PMID:25803022

  12. Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil

    PubMed Central

    Diogo, Luciano Passamani; Bahlis, Laura Fuchs; Wajner, André; Waldemar, Fernando Starosta

    2015-01-01

    Objective To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units. Methods This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student’s t test, Mann-Whitney test, and logistic regression. Results Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021). Conclusion Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals. PMID:26465244

  13. [Microflora formation in the newborn in maternity hospitals and neonatal abnormality units].

    PubMed

    Shilova, V P; Rozanova, S M; Kyrf, M V; Beĭkin, Ia B; Kuznetsova, L S; Turintseva, E G; Usova, O P; Chernykh, N G; Iagafarova, I S

    2007-10-01

    The basic sources of pyoseptic infection pathogens are infected and colonized neonatal infants in maternity hospitals. Microbiological monitoring revealed the specific features of biocenosis formation in the newborn in the "Mother and Baby" units, resuscitative departments (RD), intensive care units, and neonatal abnormality departments (NAD). Irrespective of the conditions of hospital stay, methicillin-resistant S. epidermis (MRSE) and Enterococcus faecium were prevalent in the neonatal microbial landscape. Colonization with the normal flora in the newborn actively treated with antibiotics is difficult in RD, at the same time there is a significant infection with the mycotic flora. Broad-spectrum beta-lactamase producing Klebsiela pneumonia strains have received wide acceptance in NAD. PMID:18154133

  14. The Scottish Women's Hospitals for Foreign Service--the Girton and Newnham Unit, 1915-1918.

    PubMed

    Morrison, E; Parry, C

    2014-01-01

    The Scottish Women's Hospitals for Foreign Service were established shortly after the outbreak of the First World War. Opportunities were limited for medical women prior to the war and during it they were unable to obtain a commission in the Royal Army Medical Corps, hence the formation of these voluntary all-women units. The Girton and Newnham Unit, under the leadership of Dr L McIlroy, served with distinction in France, Serbia and Greece, demonstrating clinical competence in the management of the emergency medical and surgical problems associated with warfare, areas usually off-limits to women doctors. They were severely tested but showed endurance and resilience in the running of their hospital in the most difficult of conditions. PMID:25516907

  15. Comparison of Unit-Level Patient Turnover Measures in Acute Care Hospital Settings.

    PubMed

    Park, Shin Hye; Dunton, Nancy; Blegen, Mary A

    2016-06-01

    High patient turnover is a critical factor increasing nursing workload. Despite the growing number of studies on patient turnover, no consensus about how to measure turnover has been achieved. This study was designed to assess the correlation among patient turnover measures commonly used in recent studies and to examine the degree of agreement among the measures for classifying units with different levels of patient turnover. Using unit-level data collected for this study from 292 units in 88 hospitals participating in the National Database of Nursing Quality Indicators®, we compared four patient turnover measures: the inverse of length of stay (1/LOS), admissions, discharges, and transfers per daily census (ADTC), ADTC with short-stay adjustment, and the number of ADTs and short-stay patients divided by the total number of treated patients, or Unit Activity Index (UAI). We assessed the measures' agreement on turnover quartile classifications, using percent agreement and Cohen's kappa statistic (weighted and unweighted). Pearson correlation coefficients also were calculated. ADTC with or without adjustment for short-stay patients had high correlations and substantial agreement with the measure of 1/LOS (κ = .62 to .91; r = .90 to .95). The UAI measure required data less commonly collected by participating hospital units and showed only moderate correlations and fair agreement with the other measures (κ = .23 to .39; r = .41 to .45). The UAI may not be comparable and interchangeable with other patient turnover measures when data are obtained from multiple units and hospitals. © 2016 Wiley Periodicals, Inc. PMID:26998744

  16. Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011

    PubMed Central

    Mhyre, Jill M.; Tsen, Lawrence C.; Einav, Sharon; Kuklina, Elena V.; Leffert, Lisa R.; Bateman, Brian T.

    2015-01-01

    Background The objective of this analysis was to evaluate the frequency, distribution of potential etiologies, and survival rates of maternal cardiopulmonary arrest during the hospitalization for delivery in the United States. Methods By using data from the Nationwide Inpatient Sample during the years 1998 through 2011, the authors obtained weighted estimates of the number of U.S. hospitalizations for delivery complicated by maternal cardiac arrest. Clinical and demographic risk factors, potential etiologies, and outcomes were identified and compared in women with and without cardiac arrest. The authors tested for temporal trends in the occurrence and survival associated with maternal arrest. Results Cardiac arrest complicated 1 in 12,000 or 8.5 per 100,000 hospitalizations for delivery (99% CI, 7.7 to 9.3 per 100,000). The most common potential etiologies of arrest included hemorrhage, heart failure, amniotic fluid embolism, and sepsis. Among patients with cardiac arrest, 58.9% of patients (99% CI, 54.8 to 63.0%) survived to hospital discharge. Conclusions Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis. Survival depends on the underlying etiology of arrest. PMID:24694844

  17. [Potential uses of AP-DRG to describe the health care profile in hospital units].

    PubMed

    Noronha, Marina Ferreira de; Portela, Margareth Crisóstomo; Lebrão, Maria Lúcia

    2004-01-01

    The All Patient Diagnosis Related Groups (AP-DRG) provide a classification system for general hospital inpatients, aggregating hospitalizations based on resource use and clinical criteria. The different versions of the AP-DRG have been applied to inpatient care management and reimbursement. This paper aimed to describe the classification and explore the potential for generating information on inpatient care management based on data from the Ribeirão Preto region (Sao Paulo State, Brazil) in 1997, including public, private, and charity hospitals. We compared average length of stay related to DRGs in the Ribeirão Preto region and the United States. Using the relative cost weights of the AP-DRGs constructed for New York State, we verified the profile of inpatient care provided by 30 hospitals in the Ribeirão Preto region, and reimbursement for hospital care provided to patients referred from other municipalities and covered by the Unified National Health System (SUS). Our findings indicate the applicability of the classification to inform the decision-making process on inpatient care regionalization and organization in levels of complexity, as well as for improvement of inpatient care monitoring and reimbursement. PMID:15608938

  18. Implementation of a Personal Fitness Unit Using the Personalized System of Instruction Model

    ERIC Educational Resources Information Center

    Prewitt, Steven; Hannon, James C.; Colquitt, Gavin; Brusseau, Timothy A.; Newton, Maria; Shaw, Janet

    2015-01-01

    Levels of physical activity and health-related fitness (HRF) are decreasing among adolescents in the United States. Several interventions have been implemented to reverse this downtrend. Traditionally, physical educators incorporate a direct instruction (DI) strategy, with teaching potentially leading students to disengage during class. An…

  19. 22 CFR 51.43 - Persons born outside the United States applying for a passport for the first time.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Persons born outside the United States applying... NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.43 Persons born outside the United States applying for a passport for the first time. (a) General. A person born outside...

  20. 22 CFR 51.43 - Persons born outside the United States applying for a passport for the first time.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Persons born outside the United States applying... NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.43 Persons born outside the United States applying for a passport for the first time. (a) General. A person born outside...

  1. 22 CFR 51.43 - Persons born outside the United States applying for a passport for the first time.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Persons born outside the United States applying... NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.43 Persons born outside the United States applying for a passport for the first time. (a) General. A person born outside...

  2. 22 CFR 51.43 - Persons born outside the United States applying for a passport for the first time.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Persons born outside the United States applying... NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.43 Persons born outside the United States applying for a passport for the first time. (a) General. A person born outside...

  3. Controlling hospital readmission of elderly persons living at home: a risk factor analysis.

    PubMed

    Kellogg, F R; Brickner, P W; Conley, L; Conroy, M

    1991-01-01

    A large proportion of hospital stays stem from rapid readmission of elderly patients. These patients represent high cost users of inpatient care. Intervention in the hospital admission-readmission cycle may serve the interests of patients and payors alike. Data collected through comprehensive geriatric assessment can be useful in identifying those patients at high risk of readmission and who might benefit from more intensive in-hospital or post hospital attention. However, risk factors for readmission are largely unknown. We conducted a prospective study of elderly patients admitted to a metropolitan teaching hospital medical service and assessed by a geriatric team, to increase our knowledge of the factors associated with hospital readmissions. The most powerful predictor of hospital readmission within 6 months proved to be prior hospitalization. Attempts to reduce rehospitalizations in elderly patients must focus on those with prior recent hospitalizations. PMID:10115077

  4. Hilton's Rest and Pain, Guy's Hospital personalities and Guy's South African rugby connection.

    PubMed

    Dubovsky, H

    1997-07-01

    Guy's Hospital occupies a unique position in medical history. John Hilton (1805-1879), as anatomist, physiologist, morbid anatomist and surgeon in his classic Rest and Pain, published in 1863 (reissued in 1950), formulated principles for the diagnostic significance of pain and the value of rest in healing. An array of personalities graced Guy's Medical School in that era. The triumvirate of Richard Bright (1789-1858). Thomas Addison (1793-1860) and Thomas Hodgkin (1798-1866) contemporaneously discovered the diseases that bear their names. Sir Astley Cooper, a leading surgeon of his day (1768-1841), performed the first amputation of the hip joint before the era of anaesthesia. John Keats (1795-1821) qualified as a surgeon at Guy's but, realising his unsuitability of temperament, became a leading English poet. This change of direction caused him anguish and suffering, mainly because of the rejection of his poetry; tuberculosis led to his death in Rome, where he is buried. Guy's Medical School also allowed South Africans to enter as rugby players before the 1920s, when they were required to qualify overseas. PMID:9259729

  5. Access, quality, and costs of care at physician owned hospitals in the United States: observational study

    PubMed Central

    Orav, E John; Jena, Anupam B; Dudzinski, David M; Le, Sidney T; Jha, Ashish K

    2015-01-01

    Objective To compare physician owned hospitals (POHs) with non-POHs on metrics around patient populations, quality of care, costs, and payments. Design Observational study. Setting Acute care hospitals in 95 hospital referral regions in the United States, 2010. Participants 2186 US acute care hospitals (219 POHs and 1967 non-POHs). Main outcome measures Proportions of patients using Medicaid and those from ethnic and racial minority groups; hospital performance on patient experience metrics, care processes, risk adjusted 30 day mortality, and readmission rates; costs of care; care payments; and Medicare market share. Results The 219 POHs were more often small (<100 beds), for profit, and in urban areas. 120 of these POHs were general (non-specialty) hospitals. Compared with patients from non-POHs, those from POHs were younger (77.4 v 78.4 years, P<0.001), less likely to be admitted through an emergency department (23.2% v. 29.0%, P<0.001), equally likely to be black (5.1% v 5.5%, P=0.85) or to use Medicaid (14.9% v 15.4%, P=0.75), and had similar numbers of chronic diseases and predicted mortality scores. POHs and non-POHs performed similarly on patient experience scores, processes of care, risk adjusted 30 day mortality, 30 day readmission rates, costs, and payments for acute myocardial infarction, congestive heart failure, and pneumonia. Conclusion Although POHs may treat slightly healthier patients, they do not seem to systematically select more profitable or less disadvantaged patients or to provide lower value care. PMID:26333819

  6. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    PubMed

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications. PMID:18430292

  7. Leadership-organizational culture relationship in nursing units of acute care hospitals.

    PubMed

    Casida, Jesus; Pinto-Zipp, Genevieve

    2008-01-01

    The phenomena of leadership and organizational culture (OC) has been defined as the driving forces in the success or failure of an organization. Today, nurse managers must demonstrate leadership behaviors or styles that are appropriate for the constantly changing, complex, and turbulent health care delivery system. In this study, researchers explored the relationship between nurse managers' leadership styles and OC of nursing units within an acute care hospital that had achieved excellent organizational performance as demonstrated by a consistent increase in patient satisfaction ratings. The data from this study support that transformational and transactional contingent reward leaderships as nurse manager leadership styles that are associated with nursing unit OC that have the ability to balance the dynamics of flexibility and stability within their nursing units and are essential for maintaining organizational effectiveness. It is essential for first-line nursing leaders to acquire knowledge and skills on organizational cultural competence. PMID:18389837

  8. Improving referrals to the Liaison service at the Royal United Hospital in Bath

    PubMed Central

    Gomes-Pinto, Alister; Kuzminskyte, Ruta; Wooding, Katie; Asplin, Katherine; Ewins, Liz

    2015-01-01

    Psychiatry liaison services provide the interface between mental and physical health in the acute medical hospital, however there can be logistical and operational difficulties to overcome. This quality improvement project aimed to improve the timeliness of referrals to a liaison service from an acute hospital through simple interventions of a newsletter, email to staff, and a pilot including attending post-take ward rounds on the Medical Assessment Unit (MAU) of the hospital. This resulted in a faster referral process to liaison as well as improved staff satisfaction with the liaison service, both of which will have a positive benefit on the clinical management of patients and the patients experience in hospital. There was a significant improvement in overall staff satisfaction with the referral pathway, appropriateness of referrals and working hours of the Mental Health Liaison Team - increasing from 14% at baseline to 100% at the end of the study. Referral outcomes also showed a considerable improvement, with the percentage of junior doctors successfully able to locate the referral form increasing from 60% at baseline to 100%. PMID:26734414

  9. Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine.

    PubMed

    Al Laham, N A; Elmanama, A A; Tayh, G A

    2013-06-30

    The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1-90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

  10. Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011.

    PubMed

    Rentsch, Christopher; Tate, Janet P; Akgün, Kathleen M; Crystal, Stephen; Wang, Karen H; Ryan Greysen, S; Wang, Emily A; Bryant, Kendall J; Fiellin, David A; Justice, Amy C; Rimland, David

    2016-03-01

    Individuals with HIV infection are living substantially longer on antiretroviral therapy, but hospitalization rates continue to be relatively high. We do not know how overall or diagnosis-specific hospitalization rates compare between HIV-infected and uninfected individuals or what conditions may drive hospitalization trends. Hospitalization rates among United States Veterans were calculated and stratified by HIV serostatus and principal diagnosis disease category. Because alcohol-related diagnoses (ARD) appeared to have a disproportional effect, we further stratified our calculations by ARD history. A multivariable Cox proportional hazards model was fitted to assess the relative risk of hospitalization controlling for demographic and other comorbidity variables. From 1997 to 2011, 46,428 HIV-infected and 93,997 uninfected patients were followed for 1,497,536 person-years. Overall hospitalization rates decreased among HIV-infected and uninfected patients. However, cardiovascular and renal insufficiency admissions increased for all groups while gastrointestinal and liver, endocrine, neurologic, and non-AIDS cancer admissions increased among those with an alcohol-related diagnosis. After multivariable adjustment, HIV-infected individuals with an ARD had the highest risk of hospitalization (hazard ratio 3.24, 95 % CI 3.00, 3.49) compared to those free of HIV infection and without an ARD. Still, HIV alone also conferred increased risk (HR 2.08, 95 % CI 2.04, 2.13). While decreasing overall, risk of all-cause hospitalization remains higher among HIV-infected than uninfected individuals and is strongly influenced by the presence of an ARD. PMID:25711299

  11. Determining Family Needs on an Oncology Hospital Unit Using Interview, Art, and Survey.

    PubMed

    Catlin, Anita; Ford, Marilee; Maloney, Carrie

    2016-04-01

    A movement worldwide, and specifically new to our hospital, is the implementation of Patient- and Family-Centered Care. We were unsure, however, what the needs were of our patients' families. This triangulated study, on a 28-bed oncology unit, studied family members at the bedside. We asked family members what their needs were in a three-step process (open-ended interview, use of the Draw a Bridge art therapy technique, and the Family Inventory of Needs survey). Nineteen interviews revealed needs for physical comfort, emotional support, cultural sensitivity, recognition of help provided by family members and improved pain management. Art therapy revealed the stress of caregiving and helped to uncover unmet needs for interviewers to explore. The FIN identified that care at home after discharge was a major worry. Knowledge of family members' needs while a loved one is in the hospital allows for planning and provision of modalities to assist them in their caregiving. PMID:25862492

  12. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Facilitation by a United States person. 538.407 Section 538.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SUDANESE SANCTIONS REGULATIONS Interpretations § 538.407 Facilitation by...

  13. Task-Contingent Conscientiousness as a Unit of Personality at Work

    ERIC Educational Resources Information Center

    Minbashian, Amirali; Wood, Robert E.; Beckmann, Nadin

    2010-01-01

    The present study examined the viability of incorporating task-contingent units into the study of personality at work, using conscientiousness as an illustrative example. We used experience-sampling data from 123 managers to show that (a) momentary conscientiousness at work is contingent on the difficulty and urgency demands of the tasks people…

  14. 31 CFR 585.506 - Payments of obligations to persons within the United States authorized.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Policy § 585.506 Payments of obligations to persons within the United States authorized. (a) The transfer... Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY... the Blocked Assets Division, Office of Foreign Assets Control, U.S. Treasury Department,...

  15. 27 CFR 70.182 - Disposition of personal property acquired by the United States.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... secure the performance of their agreements. Any such deposit, but not more than $200, shall be retained... § 70.182 Disposition of personal property acquired by the United States. (a) Sale—(1) In general. Any... accordance with instructions issued by the appropriate TTB officer. (2) Time, place, manner and terms of...

  16. 30 CFR 74.5 - Tests of coal mine dust personal sampler units.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... under these regulations complies with the applicable permissibility provisions of 30 CFR 18.68. ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tests of coal mine dust personal sampler units. 74.5 Section 74.5 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

  17. 30 CFR 74.5 - Tests of coal mine dust personal sampler units.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... under these regulations complies with the applicable permissibility provisions of 30 CFR 18.68. ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tests of coal mine dust personal sampler units. 74.5 Section 74.5 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

  18. 30 CFR 74.5 - Tests of coal mine dust personal sampler units.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... under these regulations complies with the applicable permissibility provisions of 30 CFR 18.68. ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tests of coal mine dust personal sampler units. 74.5 Section 74.5 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

  19. 30 CFR 74.5 - Tests of coal mine dust personal sampler units.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... under these regulations complies with the applicable permissibility provisions of 30 CFR 18.68. ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tests of coal mine dust personal sampler units. 74.5 Section 74.5 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

  20. Implementation of Personal Response Units in Very Large Lecture Classes: Student Perceptions

    ERIC Educational Resources Information Center

    Barnett, John

    2006-01-01

    This article reports on a large scale implementation of personal response units in three introductory science courses at the University of Western Ontario in Canada. An online survey of students was conducted to gather their perceptions on the uses of the devices, triangulated by participant observation of the classes and email interviews with the…

  1. What Does a Hospital Survey on Patient Safety Reveal About Patient Safety Culture of Surgical Units Compared With That of Other Units?

    PubMed

    Shu, Qin; Cai, Miao; Tao, Hong-Bing; Cheng, Zhao-Hui; Chen, Jing; Hu, Yin-Huan; Li, Gang

    2015-07-01

    The objective of this study was to examine the strengths and weaknesses of surgical units as compared with other units, and to provide an opportunity to improve patient safety culture in surgical settings by suggesting targeted actions using Hospital Survey on Patient Safety Culture (HSOPSC) investigation.A Hospital Survey on Patient Safety questionnaire was conducted to physicians and nurses in a tertiary hospital in Shandong China. 12 patient safety culture dimensions and 2 outcome variables were measured.A total of 23.5% of respondents came from surgical units, and 76.5% worked in other units. The "overall perceptions of safety" (48.1% vs 40.4%, P < 0.001) and "frequency of events reported" (63.7% vs 60.7%, P = 0.001) of surgical units were higher than those of other units. However, the communication openness (38.7% vs 42.5%, P < 0.001) of surgical units was lower than in other units. Medical workers in surgical units reported more events than those in other units, and more respondents in the surgical units assess "patient safety grade" to be good/excellent. Three dimensions were considered as strengths, whereas 5 other dimensions were considered to be weaknesses in surgical units. Six dimensions have potential to aid in improving events reporting and patient safety grade. Appropriate working times will also contribute to ensuring patient safety. Medical staff with longer years of experience reported more events.Surgical units outperform the nonsurgical ones in overall perception of safety and the number of events reported but underperform in the openness of communication. Four strategies, namely deepening the understanding about patient safety of supervisors, narrowing the communication gap within and across clinical units, recruiting more workers, and employing the event reporting system and building a nonpunitive culture, are recommended to improve patient safety in surgical units in the context of 1 hospital. PMID:26166083

  2. Professional Culture and Personality Traits of Hospital Pharmacists across Canada: A Fundamental First Step in Developing Effective Knowledge Translation Strategies

    PubMed Central

    Rosenthal, Meagen; Hall, Kevin W; Bussières, Jean-François; Tsuyuki, Ross T

    2015-01-01

    Background: Evidence for the value of pharmacists’ interventions in the care of patients is strong and continues to grow, but the rate at which these new practice opportunities are being integrated into daily practice has not kept pace. The knowledge translation literature suggests that before effective change strategies can be implemented, a better understanding of the current environment must be obtained. Two important factors within the practice environment are the professional culture and personality traits of group members. Objective: To gain insight, at a national level, into the culture of hospital pharmacy, using the Organizational Culture Profile, and into hospital pharmacists’ personality traits, using the Big Five Inventory. Methods: A cross-sectional survey of hospital pharmacists from across Canada was conducted intermittently over the period August 2012 to September 2013. The online survey contained questions about demographic characteristics and practice setting, as well as questions from the Organizational Culture Profile and Big Five Inventory. The survey link was distributed directly to hospital pharmacists or made available through provincial monthly newsletters. All data were analyzed descriptively and inferentially. Results: In total, 401 surveys were returned. Descriptive analyses from the Organizational Culture Profile revealed that most respondents perceived value in the factors of supportiveness, competitiveness, and stability. Descriptive analyses from the Big Five Inventory revealed that respondents may have been more likely to exhibit behaviours in line with the trait of conscientiousness. Several significant subgroup differences were noted in relation to levels of education, regions of practice within Canada, years in practice, and proportion of time spent conducting clinical duties. Conclusions: The results from this survey provide preliminary insight into the professional culture and personality traits of Canadian hospital

  3. Trends in Prevalence of Diabetes Among Delivery Hospitalizations, United States, 1993–2009

    PubMed Central

    Bardenheier, Barbara; Elixhauser, Anne; Geiss, Linda S.; Gregg, Edward

    2015-01-01

    To describe recent trends in prevalence of pre-existing diabetes mellitus (PDM) (i.e., type 1 or type 2 diabetes) and gestational diabetes mellitus (GDM) among delivery hospitalizations in the United States. Data on delivery hospitalizations from 1993 through 2009 were obtained from the Health Care Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Diagnosis-Related Group codes were used to identify deliveries and diagnosis codes on presence of diabetes. Rates of hospitalizations with diabetes were calculated per 100 deliveries by type of diabetes, hospital geographic region, patient’s age, degree of urbanicity of patient’s residence, categorized median household income for patient’s ZIP Code, expected primary payer, and type of delivery. From 1993 to 2009, age-standardized prevalence of diabetes per 100 deliveries increased from 0.62 to 0.90 for PDM (trend p < 0.001) and from 3.09 to 5.57 for GDM (trend p < 0.001). In 2009, correlates of PDM at delivery included older age [40–44 vs. 15–24: odds ratio 6.45 (95 % CI 5.27–7.88)], Medicaid/Medicare versus private payment sources [1.77 (95 % CI 1.59–1.98)], patient’s ZIP Code with a median household income in bottom quartile versus other quartiles [1.54 (95 % CI 1.41, 1.69)], and C-section versus vaginal delivery [3.36 (95 % CI 3.10–3.64)]. Correlates of GDM at delivery were similar. Among U.S. delivery hospitalizations, the prevalence of diabetes is increasing. In 2009, the prevalence of diabetes was higher among women in older age groups, living in ZIP codes with lower household incomes, or with public insurance. PMID:24996952

  4. Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993-2009.

    PubMed

    Correa, Adolfo; Bardenheier, Barbara; Elixhauser, Anne; Geiss, Linda S; Gregg, Edward

    2015-03-01

    To describe recent trends in prevalence of pre-existing diabetes mellitus (PDM) (i.e., type 1 or type 2 diabetes) and gestational diabetes mellitus (GDM) among delivery hospitalizations in the United States. Data on delivery hospitalizations from 1993 through 2009 were obtained from the Health Care Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Diagnosis-Related Group codes were used to identify deliveries and diagnosis codes on presence of diabetes. Rates of hospitalizations with diabetes were calculated per 100 deliveries by type of diabetes, hospital geographic region, patient's age, degree of urbanicity of patient's residence, categorized median household income for patient's ZIP Code, expected primary payer, and type of delivery. From 1993 to 2009, age-standardized prevalence of diabetes per 100 deliveries increased from 0.62 to 0.90 for PDM (trend p < 0.001) and from 3.09 to 5.57 for GDM (trend p < 0.001). In 2009, correlates of PDM at delivery included older age [40-44 vs. 15-24: odds ratio 6.45 (95 % CI 5.27-7.88)], Medicaid/Medicare versus private payment sources [1.77 (95 % CI 1.59-1.98)], patient's ZIP Code with a median household income in bottom quartile versus other quartiles [1.54 (95 % CI 1.41, 1.69)], and C-section versus vaginal delivery [3.36 (95 % CI 3.10-3.64)]. Correlates of GDM at delivery were similar. Among U.S. delivery hospitalizations, the prevalence of diabetes is increasing. In 2009, the prevalence of diabetes was higher among women in older age groups, living in ZIP codes with lower household incomes, or with public insurance. PMID:24996952

  5. Rising United States Hospital Admissions for Acute Bacterial Skin and Skin Structure Infections: Recent Trends and Economic Impact

    PubMed Central

    Kaye, Keith S.; Patel, Dipen A.; Stephens, Jennifer M.; Khachatryan, Alexandra; Patel, Ayush; Johnson, Kenneth

    2015-01-01

    Background The number of ambulatory patients seeking treatment for skin and skin structure infections (SSSI) are increasing. The objective of this study is to determine recent trends in hospital admissions and healthcare resource utilization and identify covariates associated with hospital costs and mortality for hospitalized adult patients with a primary SSSI diagnosis in the United States. Methods We performed a retrospective cross-sectional analysis (years 2005–2011) of data from the US Healthcare Cost and Utilization Project National Inpatient Sample. Recent trends, patient characteristics, and healthcare resource utilization for patients hospitalized with a primary SSSI diagnosis were evaluated. Descriptive and bivariate analyses were conducted to assess patient and hospital characteristics. Results A total of 1.8% of hospital admissions for the years 2005 through 2011 were for adult patients with a SSSI primary diagnosis. SSSI-related hospital admissions significantly changed during the study period (P < .001 for trend) ranging from 1.6% (in 2005) to 2.0% (in 2011). Mean hospital length of stay (LOS) decreased from 5.4 days in the year 2005 to 5.0 days in the year 2011 (overall change, P < .001) with no change in hospital costs. Patients with postoperative wound infections had the longest hospital stays (adjusted mean, 5.81 days; 95% confidence interval (CI), 5.80–5.83) and highest total costs (adjusted mean, $9388; 95% CI, $9366-$9410). Year of hospital admission was strongly associated with mortality; infection type, all patient refined diagnosis related group severity of illness level, and LOS were strongly associated with hospital costs. Conclusions Hospital admissions for adult patients in the United States with a SSSI primary diagnosis continue to increase. Decreasing hospital inpatient LOS and mortality rate may be due to improved early treatment. Future research should focus on identifying alternative treatment processes for patients with SSSI

  6. Prolonged stays in hospital acute geriatric care units: identification and analysis of causes.

    PubMed

    Parent, Vivien; Ludwig-Béal, Stéphanie; Sordet-Guépet, Hélène; Popitéan, Laura; Camus, Agnès; Da Silva, Sofia; Lubrano, Anne; Laissus, Frederick; Vaillard, Laurence; Manckoundia, Patrick

    2016-06-01

    In France, the population of very old frail patients, who require appropriate high-quality care, is increasing. Given the current economic climate, the mean duration of hospitalization (MDH) needs to be optimized. This prospective study analyzed the causes of prolonged hospitalization in an acute geriatric care unit. Over 6 months, all patients admitted to the target acute geriatric care unit were included and distributed into two groups according to a threshold stay of 14 days: long MDH group (LMDHG) and short MDH group (SMDHG). These two groups were compared. 757 patients were included. The LMDHG comprised 442 with a mean age of 86.7 years, of whom 67.65% were women and the SMDHG comprised 315 with a mean age of 86.6 years, of whom 63.2% were women. The two groups were statistically similar for age, sex, living conditions at home (alone or not, help), medical history and number of drugs. Patients in the LMDHG were more dependent (p=0.005), and were more likely to be hospitalized for social reasons (p=0.024) and to have come from their homes (p=0.011) than those in the SMDHG. The reasons for the prolonged stay, more frequent in the LMDHG than the SMDHG (p<0.05), were principally: waiting for imaging examinations, medical complications, and waiting for discharge solutions, assistance from social workers and/or specialist consultations. In order to reduce the MDH in acute geriatric care unit, it is necessary to consider the particularities of the patients who are admitted, their medico-socio-psychological management, access to technical facilities/consultations and post-discharge accommodation. PMID:27277146

  7. Paranoid symptoms in patients on a general hospital psychiatric unit. Implications for diagnosis and treatment.

    PubMed

    Freedman, R; Schwab, P J

    1978-03-01

    Paranoid symptoms were found in 40% of patients admitted to a university general hospital psychiatric unit during a ten-month period. Fifty-eight percent of this group had frank paranoid delusions, while the rest had ideas of reference or generalized suspiciousness. Only one half of those who had paranoid delusions had paranoid schizophrenia. A significant number had affective disorders or organic brain disorder. Ideas of reference and suspiciousness were found in many patients who were not psychotic. The therapeutic implications of these findings are reported in three patients who were inadequately treated for affective disorders because the presence of paranoid symptomatology had led to an incorrect diagnosis of schizophrenia. PMID:727891

  8. Multidisciplinary team malfunctioning on a state hospital unit: a case study.

    PubMed

    Gomez, E A; Ruiz, P; Langrod, J

    1980-01-01

    The use of multidisciplinary teams in the care of psychiatric patients can be countertherapeutic unless attention is paid to the dynamics of team functioning. The authors present a case study of team malfunctioning on an inpatient unit in a state hospital that resulted from staff's role confusion and insecurity. Patient care was relegated to second place as major interpersonal conflicts among the staff were played out along ethnic and cultural lines. Resolution of the conflicts required identifying their source, clarifying staff roles, and initiating a special inservice training program focused primarily on the needs of paraprofessional staff. PMID:7353821

  9. Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial)

    PubMed Central

    Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Harwood, Rowan H.; Goldberg, Sarah E.; Bradshaw, Lucy E.; Gladman, John R. F.; Elliott, Rachel A.

    2015-01-01

    Background One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU) was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months. Objective To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care. Methods Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY) gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309). Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%). Results The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4)). The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008). The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded. Conclusions The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation

  10. Blood culture isolates from children admitted to Medical Unit III, Yangon Children's Hospital, 1998.

    PubMed

    Shwe, Than Nu; Nyein, Mar Mar; Yi, Wut; Mon, Aung

    2002-12-01

    A one year study (August 1998-July 1999) of bacteremia in febrile children was carried out in the Medical Unit (III), Yangon Children's Hospital (YCH), Myanmar, to determine: (1) the bacteria responsible for fever of five days or more in children; (2) the antibiotic sensitivity pattern of these bacteria. Children aged one month to 12 years who had fever for five days or more and who did not receive antibiotics within the first 48 hours irrespective of the diagnosis were included in this study. A total of 120 patients fulfilled the criteria. Bacteria could be isolated from 65 cases (54.2%). The commonest organism isolated was Salmonella typhi (43.1%). Others included Escherichia coli (12.3%), Staphylococcus aureus (7.7%), Pseudomonas aeruginosa (7.7%); Streptococcus, Shigella, Diplococcus, Klebsiella and Acinetobacter were also isolated. The Salmonella typhi were resistant to conventional antibiotics (ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole); however, they were sensitive to amikacin, netilmicin, nalidixic acid, and cephalothin. A cluster of enteric fever cases from Mingalartaungnyunt township was noticed and was reported to the Directorate of Health. Changes in the incidence and etiology of bacteremia in hospitals are well documented. Sentinel surveys of bacteremia in major hospitals should be carried out in order to detect the changing patterns of bacteremia and antibiotic sensitivity; such surveys will be of great help in establishing local antibiotic policies. PMID:12757224