Comparison of the clientele of an anonymous HIV test centre and persons tested in the general population.

This study compares the clientele of a Swiss anonymous test centre with the general population tested. Information was obtained through similar questionnaires submitted to two samples of HIV-tested people aged from 17 to 45 years: the first administered in the context of a general population telephone survey (n = 245) and the second completed during face-to-face interviews of the clientele of an anonymous test centre (n = 250). The test centre sample has higher proportions of younger and single people. Attenders for anonymous testing were more likely to have acquired a new regular partner during the year preceding the interview (48.0% versus 14.4%). These differences remain when controlling for age and gender. Decision to test comes mostly from the respondent's own initiative, but suggestion from a doctor is more frequent in the general population (23.8% versus 0.8%), whereas suggestion from partner or friends is more frequent in the anonymous centre (44.4% versus 3.0%). The anonymous test centre clientele is not different from the general population tested except for the relational situation and origin of decision for testing. The test centre has become a place where the general population finds a response to a situation-specific need for HIV testing.

Utilidad del complejo protrombínico en el control de la hemostasia en el trasplante cardiaco. experincia en el hospital la fe en el año 2009.

Molts dels pacients que van a ser sotmesos a trasplantament cardíac porten tractament amb anticoagulants orals, que cal revertir preoperatòriament. En aquest estudi es pretén valorar l'eficàcia del complex protrombínic en la reversió de l’anticoagulació oral, realitzant un estudi descriptiu, observacional i retrospectiu dels pacients trasplantats en 2009 en l'Hospital U. La Fe. Resultats: El tractament amb Complex Protrombínic va ser efectiu per a la reversió de l'efecte dels anticoagulants orals, ja que va disminuir el INR (P=0.006) després de la seua administració, amb l'avantatge de tenir un efecte ràpid i un escàs volum.

Características y factores pronósticos de los pacientes ingresados por síndrome coronario agudo sin elevación del ST en un hospital de tercer nivel

Registre per a estudiar l'impacte clínic de l'SCASEST a un hospital de tercer nivell. En un any van ingressar 310 pacients (54% Cardiologia, 46% Semicrítics/Unitat d'Estada Curta). La mortalitat hospitalaria va ser de l'1%; a 6 mesos va haver un 4,6% de morts i un 16% de reingressos. Edat, filtrat glomerular i FE van ser predictors de mortalitat; una troponina positiva i l'ingres a Cardiologia es van associar amb un menor risc de reingrés. Ingressar a Cardiologia es va associar a ser tributari de coronariografia i revascularització quirúrgica. El tipus de Servei pot tenir un impacte adicional en la història de l'SCASEST.

Financial impact of introducing the Swiss-DRG reimbursement system on potentially avoidable readmissions at a university hospital.

QUESTION UNDER STUDY: Thirty-day readmissions can be classified as potentially avoidable (PARs) or not avoidable (NARs) by following a specific algorithm (SQLape®). We wanted to assess the financial impact of the Swiss-DRG system, which regroups some readmissions occurring within 18 days after discharge within the initial hospital stay, on PARs at our hospital. METHODS: First, PARs were identified from all hospitalisations recorded in 2011 at our university hospital. Second, 2012 Swiss-DRG readmission rules were applied, regrouped readmissions (RR) were identified, and their financial impact computed. Third, RRs were classified as potentially avoidable (PARRs), not avoidable (NARRs), and others causes (OCRRs). Characteristics of PARR patients and stays were retrieved, and the financial impact of PARRS was computed. RESULTS: A total of 36,777 hospitalisations were recorded in 2011, of which 3,140 were considered as readmissions (8.5%): 1,470 PARs (46.8%) and 1,733 NARs (53.2%). The 2012 Swiss-DRG rules would have resulted in 910 RRs (2.5% of hospitalisations, 29% of readmissions): 395 PARRs (43% of RR), 181 NARRs (20%), and 334 OCRRs (37%). Loss in reimbursement would have amounted to CHF 3.157 million (0.6% of total reimbursement). As many as 95% of the 395 PARR patients lived at home. In total, 28% of PARRs occurred within 3 days after discharge, and 58% lasted less than 5 days; 79% of the patients were discharged home again. Loss in reimbursement would amount to CHF 1.771 million. CONCLUSION: PARs represent a sizeable number of 30-day readmissions, as do PARRs of 18-day RRs in the 2012 Swiss DRG system. They should be the focus of attention, as the PARRs represent an avoidable loss in reimbursement.

Alteraciones en la glucemia después del parto en mujeres controladas por Diabetes Gestacional en la consulta de Endocrinología del Hospital Arnau de Vilanova de Valencia

El present estudi és de tipus observacional, descriptiu i analític, retrospectiu i longitudinal. Pretén analitzar-ne en dones del departament de Salut 6 de la Comunitat Valenciana diagnosticades de diabetis gestacional, la alteració en la tolerancia a la glucosa en una mitjana d'1,5 anys després del part. La mostra presa va ser de 128 pacients. El 22, 66% va mostrar alteració glucèmica postpart; les dones amb antecedents familiars de diabetis eren més jóvens (32,06 front a 34,93, amb p=0,04).Ninguna dona tractada amb dieta va desenvolupar diabetis; de les tractades amb insulina ho va fer el 8,16% (p=0,02) i tenien major glucèmia basal (p=0,048).

Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count <= 200 cell/mm³ was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age > or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis.

The Lourdes Hospital Inquiry: An Inquiry into peripartum hysterectomy at Our Lady of Lourdes Hospital, Drogheda

Report Of Judge Maureen Harding Clark S.C., This non-statutory private Inquiry was established by a decision of the Government on the 6th of April 2004. Read the Report

Lourdes Hospital Redress Scheme 2007

Lourdes Hospital Redress Scheme 2007 This Scheme arises from the findings and recommendations contained in the Report of The Lourdes Hospital Inquiry, January 2006, published by the Department of Health and Children on 28 February 2006. The object of this scheme is to provide compensation for patients of Dr. Michael Neary who underwent unnecessary obstetric hysterectomy and bilateral oophorectomy. Click here to download PDF 154kb

Report on the Independent Review of Symptomatic Breast Care Services at Barringtons Hospital, Limerick

Report on the Independent Review of Symptomatic Breast Care Services at Barringtons Hospital, Limerick This independent review was established by Barringtons Hospital and the Department of Health and Children following concerns which had been raised about the standard of symptomatic breast care including cancer services at the Hospital. The terms of reference for the review are included at Appendix 1. An independent review team was established under the chairmanship of Dr Henrietta Campbell. The membership is listed at Appendix 2. Click here to download PDF 152kb

National Implementation Group (NIG) - European Working Time Directive & Non Consultant Hospital Doctors - Final Report December 2008

National Implementation Group (NIG) - European Working Time Directive & Non Consultant Hospital Doctors - Final Report December 2008  

La ética del cuidar y la atención de enfermería

El present treball analitza l'ètica de la cura i l'atenció d'infermeria. Es descriuen els seus antecedents i la influència del feminisme en les cures d'infermeria. Així mateix, s'analitza mitjançant unes entrevistes en profunditat, la dimensió ètica de les cures segons els models de Watson i Roach a un centre hospitalari del nostre pais.

Missed Opportunities: Evolution of Patients Leaving without Being Seen or against Medical Advice during a Six-Year Period in a Swiss Tertiary Hospital Emergency Department.

Aim. The study aimed at describing the evolution over a 6-year period of patients leaving the emergency department (ED) before being seen ("left without being seen" or LWBS) or against medical advice ("left against medical advice" or LAMA) and at describing their characteristics. Methods. A retrospective database analysis of all adult patients who are admitted to the ED, between 2005 and 2010, and who left before being evaluated or against medical advice, in a tertiary university hospital. Results. During the study period, among the 307,716 patients who were registered in the ED, 1,157 LWBS (0.4%) and 1,853 LAMA (0.9%) patients were identified. These proportions remained stable over the period. The patients had an average age of 38.5 ± 15.9 years for LWBS and 41.9 ± 17.4 years for LAMA. The median time spent in the ED before leaving was 102.4 minutes for the LWBS patients and 226 minutes for LAMA patients. The most frequent reason for LAMA was related to the excessive length of stay. Conclusion. The rates of LWBS and LAMA patients were low and remained stable. The patients shared similar characteristics and reasons for leaving were largely related to the length of stay or waiting time.

National Paediatric Hospital Independent Review

National Paediatric Hospital Independent Review Click here to download Overview of the Report PDF 403KB Click here to download National Paediatric Hospital Independent Review: Financial Analysis PDF 4.95MB Click here to download National Paediatric Hospital Independent Review: Financial Analysis Vol II: Appendices PDF 16.12MB Click here to download National Paediatric Hospital Independent Review: Clinical Analysis PDF 415KB Click here to download FAQs PDF 10KB

The Establishment of Hospital Groups as a transition to Independent Hospital Trusts

This is the Report on the Establishment of Hospital Groups as a Transition to Independent Hospital Trusts, as approved by Government on 14 May 2013. Click here to download The Establishment of Hospital Groups as a transition to Independent Hospital Trusts PDF 5.59MB Click here to download Securing the Future of Smaller Hospitals: A Framework for Development PDF 401KB Click here to download Frequently Asked Questions PDF 1.19MB