Les hospitalisations des bébés nés extrêmement prématurément durent de très longues semaines. Le bébé et ses parents traversent alors différentes phases. L’intensité des affects et des angoisses ...parentales varie au cours de ces mois, en fonction de l’état de leur bébé et de la possibilité que les parents ont d’évoquer, de partager les tout premiers éprouvés qui ont eu lieu autour de l’accouchement et des premiers jours de vie.
Objectives: Clinical characteristics, follow-up and treatment outcomes of patients with isolated traumatic sternal fracture were presented and our clinical experiences on these patients were shared. ...Methods: Between January 2010 and December 2017, a total of 87 patients with isolated traumatic sternal fracture who were admitted to the emergency department and were hospitalized, were included in this observational cohort study. Medical data of these patients were collected from hospital records and then were retrospectively reviewed. Results: There were 65 (74.7%) male and 22 (25.3%) female patients. Mean age was 42.4 ± 13.7 years (range: 17-83). The most common etiological reason was traffic accident in vehicle. Sternal fractures were localized at corpus in 64 (73.6%) patients and at manubrium in 23 (26.4%) patients. The most common concomitant pathology was rib fracture with a ratio of 23% (20 patients). Mean length of hospital stay of patients was 3.1 ± 0.8 days. During the hospitalization period, no evidence of cardiac injury was observed in any patient. Conclusions: In view of rising healthcare costs and increasing demand for acute hospital and intensive care beds, it is crucial to determine hospitalization criteria for cases with traumatic sternal fracture. We believe that the hospitalization is not necessary in isolated traumatic sternal fractures where there is no other major injury.
Objectives
To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of ...medication‐related hospitalization in older adults.
Design
Quasi‐experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed‐effects analysis that modeled the intervention as a time‐dependent variable.
Setting
Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014. All five other such hospitals served as a contemporaneous comparison group.
Participants
Adult inpatients who met criteria for being at risk for medication problems (N = 2,083), 62% of whom were aged 65 or older.
Intervention
A state‐wide system of medication management services provided by specially trained hospital and community pharmacists serving high‐risk individuals from hospitalization through transition to home and for up to 1 year after discharge.
Measurements
Medication‐related hospitalization rate per 1,000 admissions of individuals aged 65 and older, adjusted for case mix; estimate of costs of hospitalizations and actual costs of pharmacist services.
Results
The predicted, case mix–adjusted medication‐related hospitalization rate of individuals aged 65 and older was 36.5% lower in the Pharm2Pharm hospitals after implementation than in the nonintervention hospitals (P = .01). The estimated annualized cost of avoided admissions was $6.6 million. The annual cost of the pharmacist services for all Pharm2Pharm participants was $1.8 million.
Conclusion
The Pharm2Pharm model was associated with an estimated 36% reduction in the medication‐related hospitalization rate for older adults and a 2.6:1 return on investment, highlighting the value of pharmacists as drug therapy experts in geriatric care.
Child partial hospitalization programs (CPHPs) provide specialized, intensive, interdisciplinary day treatment for children with significant social, emotional, and behavioral needs that warrant a ...higher level of care than outpatient therapy, but a less intensive care setting than admission to an inpatient unit. In many cases, partial hospitalization programs function as a step down from inpatient care to provide a gradual transition back into the home and school environments, where children's mental health challenges may have initially manifested, or as a means of averting a more restrictive form of care.
Existing hospitalization ratios for COVID-19 typically use case counts in the denominator, which problematically underestimates total infections because asymptomatic and mildly infected persons ...rarely get tested. As a result, surge models that rely on case counts to forecast hospital demand may be inaccurately influencing policy and decision-maker action.
Based on SARS-CoV-2 prevalence data derived from a statewide random sample (as opposed to relying on reported case counts), we determine the infection-hospitalization ratio (IHR), defined as the percentage of infected individuals who are hospitalized, for various demographic groups in Indiana. Furthermore, for comparison, we show the extent to which case-based hospitalization ratios, compared with the IHR, overestimate the probability of hospitalization by demographic group.
Secondary analysis of statewide prevalence data from Indiana, COVID-19 hospitalization data extracted from a statewide health information exchange, and all reported COVID-19 cases to the state health department.
State of Indiana as of April 30, 2020.
Demographic-stratified IHRs and case-hospitalization ratios.
The overall IHR was 2.1% and varied more by age than by race or sex. Infection-hospitalization ratio estimates ranged from 0.4% for those younger than 40 years to 9.2% for those older than 60 years. Hospitalization rates based on case counts overestimated the IHR by a factor of 10, but this overestimation differed by demographic groups, especially age.
In this first study of the IHR based on population prevalence, our results can improve forecasting models of hospital demand-especially in preparation for the upcoming winter period when an increase in SARS CoV-2 infections is expected.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The associated morbidity and mortality make AF a major public health burden. Hospitalizations account for the majority of the ...economic cost burden associated with AF. The main objective of this study is to examine the trends of AF-related hospitalizations in the United States and to compare patient characteristics, outcomes, and comorbid diagnoses.
With the use of the Nationwide Inpatient Sample from 2000 through 2010, we identified AF-related hospitalizations using International Classification of Diseases, 9th Revision, Clinical Modification code 427.31 as the principal discharge diagnosis. Overall AF hospitalizations increased by 23% from 2000 to 2010, particularly in patients ≥65 years of age. The most frequent coexisting conditions were hypertension (60.0%), diabetes mellitus (21.5%), and chronic pulmonary disease (20.0%). Overall in-hospital mortality was 1%. The mortality rate was highest in the group of patients ≥80 years of age (1.9%) and in the group of patients with concomitant heart failure (8.2%). In-hospital mortality rate decreased significantly from 1.2% in 2000 to 0.9% in 2010 (29.2% decrease; P<0.001). Although there was no significant change in mean length of stay, mean cost of AF hospitalization increased significantly from $6410 in 2001 to $8439 in 2010 (24.0% increase; P<0.001).
Hospitalization rates for AF have increased exponentially among US adults from 2000 to 2010. The proportion of comorbid chronic diseases has also increased significantly. The last decade has witnessed an overall decline in hospital mortality; however, the hospitalization cost has significantly increased.
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