Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Inpatients”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2005

Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology.

OBJECTIVE: The changing healthcare environment world-wide is leading to extensive use of per case payment systems based on diagnosis-related groups (DRG). The aim of this study was to examine the impact of application of different DRG systems used in the German healthcare system. METHODS: We retrospectively analysed 2334 clinical data sets of inpatients discharged from an academic dermatological inpatient unit in 2003. Data were regarded as providing high coding quality in compliance with the diagnosis and procedure classifications as well as coding standards. The application of the Australian AR-DRG version 4.1, the German G-DRG version 1.0, and the German G-DRG version 2004 was considered in detail. To evaluate more specific aspects, data were broken down into 11 groups based on the principle diagnosis. MAIN OUTCOME MEASURE: DRG cost weights and case mix index were used to compare coverage of inpatient dermatological services. Economic impacts were illustrated by case mix volumes and calculation of DRG payments. RESULTS: Case mix index results and the pending prospective revenues vary tremendously from the application of one or another of the DRG systems. The G-DRG version 2004 provides increased levels of case mix index that encourages, in particular, medical dermatology. CONCLUSIONS: The AR-DRG version 4.1 and the first German DRG version 1.0 appear to be less suitable to adequately cover inpatient dermatology. The G-DRG version 2004 has been greatly improved, probably due to proceeding calculation standards and DRG adjustments. The future of inpatient dermatology is subject to appropriate depiction of well-established treatment standards.

Case Management↗
PubMed1997

Racial differences in the utilization of inpatient rehabilitation services among elderly stroke patients.

BACKGROUND AND PURPOSE: We undertook this study to ascertain whether elderly black and white patients who are hospitalized for stroke utilize inpatient physical and occupational therapy (PT/OT) services differently, adjusting for characteristics associated with use of these services. METHODS: We retrospectively reviewed medical records regarding the care received by a nationally representative sample of 2497 black and white Medicare patients, aged 65 years of older, who were hospitalized at any of 297 acute-care hospitals located in 30 communities within five states. RESULTS: Compared with whites, black stroke patients were younger and more likely to have Medicaid coverage, have an ischemic stroke, and have a motor deficit noted at the time of admission. There was no difference in either sex or level of consciousness on admission. Overall, a larger proportion of black stroke patients used inpatient PT/OT at some point during the hospitalization (66.3% versus 55.8%; P < .01). However, after adjustment for characteristics associated with use of PT/OT, there was no racial difference in either the likelihood of inpatient PT/OT use (adjusted relative risk, 1.06; 95% confidence limits, 0.89 to 1.27; P = .42) or time to initial contact (median: blacks, 6.6 days; whites, 7.4 days; P = .42). Adjusted analyses also indicated a similarity between the racial groups in the number of inpatient PT/OT days overall or as a proportion of the hospital stay. CONCLUSIONS: Elderly black and white stroke patients who have Medicare coverage have similar patterns of use of inpatient PT/OT services.

Black or African American↗
PubMed2002

Inpatient resource utilisation in younger (2-5 yrs) and older (6-14 yrs) asthmatic children in Finland.

Asthma is the most common chronic disorder among Finnish children, however, the economic burden of paediatric asthma in Finland has not yet been comprehensively evaluated. The objective of this study was to compare inpatient resource utilisation between younger (2-5 yrs) and older children (6-14 yrs) with asthma in Finland. A national database of inpatient resource utilisation was applied to determine use of hospital services among children with asthma in 1999. Regional estimates of charges were combined with hospitalisation episodes to determine total inpatient cost. The results indicate that younger asthmatic children consume 3-times more inpatient resources per capita. Incidence of first admissions because of asthma was 3-times higher in younger children. Hospitalisation and rehospitalisation rates were also 3- and 4-times higher, respectively. The total annual inpatient cost of asthma in children aged 2-5 and 6-14 yrs was Euro 1.98 million with each group accounting for Euro 1.12 million and Euro 0.86 million, respectively. Regional and age-related differences in hospitalisation rates and costs were likely related to variable clinical practice on the primary level, difficulties with diagnosis and compliance among younger children.

Adolescent↗
PubMed2004

Pharmacy cost evaluation of risperidone, olanzapine, and quetiapine for the treatment of schizophrenia in acute care inpatient settings.

OBJECTIVE: This study examines total pharmacy cost and usage patterns of schizophrenic patients in acute mental health inpatient settings for three atypical antipsychotics -- risperidone, olanzapine, and quetiapine. Despite the readily available unit cost information for drugs, actual pharmacy costs may deviate significantly from 'labeled costs'. Recent research findings indicate the need for more robust evaluation of such pharmacy costs. RESEARCH DESIGN AND METHODS: This study used data from non-randomized inpatient retrospective charts from three acute care inpatient mental health facilities. The final pooled sample included 327 patients, of which 120 received risperidone, 153 received olanzapine, and 54 received quetiapine. Medication cost was defined as the average wholesale price (AWP) as listed in the 2001 'Red Book'. Propensity scoring methodology and multinomial regression were employed to reduce treatment selection bias. RESULTS: The observed mean daily antipsychotic drug doses were 4.45 mg (SD 2.44) for risperidone, 14.04 mg (SD 5.55) for olanzapine, and 350.33 mg (SD 228.24) for quetiapine. The corresponding mean daily drug costs were $7.66(SD $4.20) for risperidone, $8.11 (SD $5.29) for quetiapine and, $12.10 (SD $4.79) for olanzepine. Numbers adjusted for treatment selection bias show that the average daily total pharmacy cost of risperidone was $4.35 lower than olanzapine (p < 0.001) and $1.41 lower than quetiapine (p = 0.38). The adjusted average daily pharmacy cost of olanzapine was $4.02 higher than quetiapine (p < 0.001). After statistical adjustment there were no significant differences between study drugs in terms of length of stay or patient functioning. CONCLUSION: This study provides the first US comparison of medication utilization patterns and pharmacy costs for olanzapine, risperidone, and quetiapine administered in acute mental health care inpatient settings. While this study did not estimate the full economic value of the three antipsychotics in these inpatient settings, it demonstrated that the mean daily costs for risperidone were lower than the mean daily costs for olanzapine (p < 0.001) and quetiapine although the later difference was not statistically significant (p = 0.38).

Adult↗
PubMed2006

Nutritional care of medical inpatients: a health technology assessment.

BACKGROUND: The inspiration for the present assessment of the nutritional care of medical patients is puzzlement about the divide that exists between the theoretical knowledge about the importance of the diet for ill persons, and the common failure to incorporate nutritional aspects in the treatment and care of the patients. The purpose is to clarify existing problems in the nutritional care of Danish medical inpatients, to elucidate how the nutritional care for these inpatients can be improved, and to analyse the costs of this improvement. METHODS: Qualitative and quantitative methods are deployed to outline how nutritional care of medical inpatients is performed at three Danish hospitals. The practices observed are compared with official recommendations for nutritional care of inpatients. Factors extraneous and counterproductive to optimal nutritional care are identified from the perspectives of patients and professional staff. A review of the literature illustrates the potential for optimal nutritional care. A health economic analysis is performed to elucidate the savings potential of improved nutritional care. RESULTS: The prospects for improvements in nutritional care are ameliorated if hospital management clearly identifies nutritional care as a priority area, and enjoys access to management tools for quality assurance. The prospects are also improved if a committed professional at the ward has the necessary time resources to perform nutritional care in practice, and if the care staff can requisition patient meals rich in nutrients 24 hours a day. At the kitchen production level prospects benefit from a facilitator contact between care and kitchen staff, and if the kitchen staff controls the whole food path from the kitchen to the patient. At the patient level, prospects are improved if patients receive information about the choice of food and drink, and have a better nutrition dialogue with the care staff. Better nutritional care of medical patients in Denmark is estimated to hold a cost savings potential reaching approximately USD 22 million. CONCLUSION: Every hospital and every bed ward has its strengths and weaknesses, but none of the participating bed wards fully satisfy nutritional care success criteria. All organisational levels have a significant potential for improvements of nutritional care of medical inpatients.

Aged↗
PubMed2006

A methodology to estimate the potential to move inpatient to one day surgery.

BACKGROUND: The proportion of surgery performed as a day case varies greatly between countries. Low rates suggest a large growth potential in many countries. Measuring the potential development of one day surgery should be grounded on a comprehensive list of eligible procedures, based on a priori criteria, independent of local practices. We propose an algorithmic method, using only routinely available hospital data to identify surgical hospitalizations that could have been performed as one day treatment. METHODS: Moving inpatient surgery to one day surgery was considered feasible if at least one surgical intervention was eligible for one day surgery and if none of the following criteria were present: intervention or affection requiring an inpatient stay, patient transferred or died, and length of stay greater than four days. The eligibility of a procedure to be treated as a day case was mainly established on three a priori criteria: surgical access (endoscopic or not), the invasiveness of the procedure and the size of the operated organ. Few overrides of these criteria occurred when procedures were associated with risk of immediate complications, slow physiological recovery or pain treatment requiring hospital infrastructure. The algorithm was applied to a random sample of one million inpatient US stays and more than 600 thousand Swiss inpatient stays, in the year 2002. RESULTS: The validity of our method was demonstrated by the few discrepancies between the a priori criteria based list of eligible procedures, and a state list used for reimbursement purposes, the low proportion of hospitalizations eligible for one day care found in the US sample (4.9 versus 19.4% in the Swiss sample), and the distribution of the elective procedures found eligible in Swiss hospitals, well supported by the literature. There were large variations of the proportion of candidates for one day surgery among elective surgical hospitalizations between Swiss hospitals (3 to 45.3%). CONCLUSION: The proposed approach allows the monitoring of the proportion of inpatient stay candidates for one day surgery. It could be used for infrastructure planning, resources negotiation and the surveillance of appropriate resource utilization.

Algorithms↗
PubMed2001

Inpatient costs, length of stay, and mortality for cerebrovascular events in community hospitals.

BACKGROUND: Accurate estimates of inpatient cost, length of stay (LOS), and mortality are necessary for the development of economic models to estimate the cost-effectiveness of stroke-related treatments. Estimates based on data from academic institutions may not be generalizable to community hospitals. In this study, the authors estimated inpatient costs, LOS, and in-hospital mortality for patients with subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), ischemic cerebral infarction (ICI), and TIA who were treated in community hospitals. METHODS: The authors selected patients using International Classification of Diseases-9-Clinical Modification primary diagnosis codes from the HBSI EXPLORE database. They analyzed patient-level data and inpatient costs, derived from detailed utilization data, for all patients admitted to 137 community hospitals in 1998. Multivariate statistical techniques were used to examine patient-, hospital-, and outcome-related factors associated with inpatient costs. RESULTS: Patients with SAH incurred the highest average cost ($23,777, n = 1,124), followed by patients with ICH ($10,241, n = 3,139), ICI ($5,837, n = 18,740), and TIA ($3,350, n = 7,861). Patient subgroups ranked in the same order for average LOS at 11.5 days for SAH, 7.5 days for ICH, 5.9 days for ICI, and 3.4 days for TIA. Almost one third of patients with SAH (29.0%) and ICH (33.1%) died during hospitalization, whereas 7.0% with ICI and 0.2% with TIA died. For each event, as patient age increased, average costs consistently decreased. Also, average costs were higher among patients treated in community teaching hospitals compared to community nonteaching hospitals for each cerebrovascular event (10 to 29%). CONCLUSIONS: Inpatient costs, LOS, and mortality for patients with cerebrovascular disease are dependent on patient and hospital characteristics.

Aged↗
PubMed2004

[Fifty years of psychosomatic inpatient treatment].

This article is a review of the historical development of psychosomatic inpatient treatment form its first roots to present. The major focus of the article is a description of the present situation of psychosomatic hospitals in Germany, the kind of inpatient treatment in psychosomatic medicine, current concepts, data on lengths of stay, comorbidity, and the spectrum of diagnoses concerning psychosomatic inpatients. Furthermore, data on effectiveness of inpatient treatment and a description of a typical patient sample in psychosomatic inpatient treatment are outlined.

History, 19th Century↗
PubMed2000

The frequency of smoking and problem drinking among general hospital inpatients in Brazil - using the AUDIT and Fagerström questionnaires.

CONTEXT: Although the CAGE questionnaire is one of the most widely used alcohol screening instruments, it has been criticized for not identifying people who are drinking heavily or who have alcohol related problems but do not as yet show symptoms of alcohol dependence. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire was developed by WHO as a screening instrument specifically designed to identify problem drinkers, as well as those who were already dependent on alcohol. OBJECTIVE: The aim of this study was to use the AUDIT and Fagerström questionnaires in a general hospital inpatient population to measure the frequency of problem drinking and nicotine dependence, and to see if levels varied between medical speciality. DESIGN: Retrospective cross-sectional study. SETTING: Federally funded public teaching hospital. SAMPLE: 275 inpatients from both genders. MAIN MEASUREMENTS: Socio-demographic data, AUDIT (Alcohol Use Disorders Identification Test) and Fagerström Test for Nicotine Dependence. RESULTS: We interviewed 275 inpatients, 49% of whom were men and 51% women. Thirty-four patients were identified as "cases" by the Audit questionnaire; 22% of the male patients and 3% of the females. Just over 21% of inpatients were current smokers. The gastroenterology (26%) and general medicine (16%) inpatient units had the largest number of individual cases. CONCLUSIONS: Only by knowing the prevalence of alcohol abuse/dependence and nicotine dependence in a general hospital can we evaluate the need for a specialized liaison service to identify and treat these patients.

Adolescent↗
PubMed1996

Relative risk and economic consequences of inpatient care among patients with renal failure.

During the final phases of chronic renal disease, inpatient care comprises an enormous share of morbidity and direct medical costs. Using an attributable risk methodology, this study calculated inpatient resource utilization and associated costs for chronic renal failure (CRF) and ESRD. A national hospital survey was used to identify the 348,962 hospitalizations for patients with renal failure in 1991. Among persons under the age of 65, pre-ESRD CRF patients had the same number of hospitalizations (nearly 75,000) as ESRD patients. Age-adjusted relative risk calculations indicate that patients with renal failure experience greater inpatient morbidity compared with other populations with chronic, progressive diseases. For example, compared with persons with diabetes, ischemic heart disease, hypertension, and emphysema, renal patients were at significantly higher risk of hospitalization for congestive heart failure, pneumonia, sepsis, electrolyte disorders, and gastrointestinal hemorrhage. Overall, renal failure patients were ten times more likely to be hospitalized (relative risk, 10.0; 95% confidence interval, 10.00 to 10.04) and, on average, were hospitalized nearly 1 day longer (P < 0.01) compared with the non-renal failure population in 1991. As a result, the economic consequences of inpatient care for the treatment of renal failure were enormous. In 1991, 222,827 hospitalizations, 1.5 million days of inpatient care, and $2.2 billion were attributable to renal failure. Further studies that examine other components of direct medical costs (e.g., long-term care, outpatient care, and pharmaceuticals) as well as indirect costs associated with the treatment and care of renal failure patients are warranted.

Adolescent↗
PubMed2000

Comparison of the inpatients admitted during the recent 5 years (January 1994-December 1998) with those admitted during the previous 5 years (January 1989-December 1993): a clinico-statistical study.

As society ages, the composition of the diseases that occur within it changes accordingly. With that in mind, we examined the characteristics and trends in the recent inpatients and compared these recent inpatients with those of a previous report to identify the changes that accompany the aging of society. Subjects were 1,534 cases (men 56.9%, female 43.1%, average age 47.1 years) who were hospitalized at Kurume University Hospital for treatment during the 5-year period from January 1st, 1994 through December 31st, 1998. The ratio of inpatients over 65 years old was about 1.8 times higher than in the previous study, showing a clear trend toward an increased overall age of inpatients. As for the types of disease observed, the most common malignancies were epithelial tumor, followed by other benign tumors, as well as 76 cases which included diseases resembling tumor (epulis and exostosis etc.). A majority of the patients (55.6%) were directed to the Hospital by their dentist, a finding similar to that of the previous report. As for geographical distribution, 93.3% of the inpatients lived within 40 km of the center of Kurume City where our oral surgery is located, an increase of about 10% from the last report. In other words, our results showed a reduction in the sphere of treatment distribution.

Disease↗
PubMed2000

The impact of an inpatient physician program on quality, utilization, and satisfaction.

OBJECTIVE: To evaluate an inpatient physician system initiated in June 1996 for all patients of a health maintenance organization admitted to the general medicine service of an urban teaching hospital. In the new program, attending physician duties were transferred from the patient's own general internist to another internist serving on a hospital-based rotation. STUDY DESIGN: Cohort with historical controls. PARTICIPANTS AND METHODS: We compared the following measures before and after the new inpatient physician program began: (1) hospital length of stay and total charges, (2) outcomes related to quality of care, (3) primary care physician satisfaction, and (4) housestaff satisfaction. Differences before and after initiation of the inpatient physician program were evaluated using multivariate analyses to adjust for patient differences and secular trends. RESULTS: There were 2265 patients discharged from the general medical service in the year following implementation of the inpatient physician program. Postintervention average length of stay decreased from 3.5 to 3.0 days (P < .001). In multivariate analyses, average length of stay was reduced by 0.3 days (P = .008), and total hospital charges were reduced an average of $426 per admission (P = .001). In-hospital mortality rates, percentage of patients discharged home directly, and 30-day readmission rates did not change significantly in the postintervention period. Satisfaction among primary care physicians was high, with 90% of those answering a survey responding that they would recommend a similar program to other primary care groups. Medical housestaff satisfaction with their educational experience also increased. CONCLUSIONS: Implementation of an inpatient physician program at this institution significantly decreased resource utilization while maintaining or improving quality of care. Satisfaction with the program was high among primary care internists and housestaff.

Adult↗
PubMed2003

A prospective analysis of inpatient consultations to a gastroenterology service.

The provision of a formal consultation service for inpatients between subspecialists is little studied. We prospectively surveyed the pattern of inpatient consultations from hospital-based generalists and surgeons to the gastroenterology (GI) service for inpatients in a large urban teaching hospital over a 5 month period. There are two GI consultants/attendings and five GI registrars/fellows on the service. A formal consultation is made by the requesting team to the GI service using the hospital computer network. All referrals over a 5 month period were prospectively analysed. 242 consecutive inpatient referrals were sent to the GI service over 5 months. Average age was 56 years, 48.8% males. 32 consultants/attendings from other disciplines sent referrals. Most patients were seen within one working day. Urgent referrals were seen without delay. The commonest reasons for referral were abdominal pain (15.8%), percutaneous endoscopic gastrostomy (PEG) tube insertion (13.6%), diarrhoea (12.8%), abnormal liver blood tests (10%), nausea and vomiting (8.2%), anaemia (6.2%), and melaena (4.9%). Iatrogenic diseases accounted for 6.2% of consultations. Ongoing patient care was assumed by the GI team in 9.5% of referrals. 15.3% required a second consultation visit before discharge. 22.7% of referrals were followed in the GI outpatients' clinic after discharge. 51.2% underwent an endoscopic procedure. 13.6% of referrals were for PEG tube insertion. A quarter of these were considered unsuitable for immediate PEG tube insertion. Subspecialty consultation provides an expert opinion, encourages discussion and learning, and improves patient care. In our experience, the provision of specialist advice and reassurance often speeded up a patient's work-up and expedited discharge. However, evaluating referral patients and subsequently providing ongoing inpatient and outpatient care and provision of endoscopy for these referrals contributes significantly to the workload of the GI service.

Adolescent↗
PubMed2005

[Study on the frequency of antibiotics use per day among inpatients in 151 hospitals in 2003].

OBJECTIVE: To investigate the antibiotics use in inpatients with hospitals under different scales. METHODS: On the day of August 7, 2003, antibiotics use among inpatients were investigated, medical order to each inpatient was checked and forms were filled. RESULTS: Data showed that 54.86% of the 89,539 inpatients from 151 hospitals were using antibiotics, out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis, and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy, only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases, intensive care unit, and pediatrics had the higher use of antibiotics. CONCLUSION: Inpatients in 151 hospitals had high prevalence of antibiotics use, especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.

Anti-Bacterial Agents↗
PubMed2006

[A survey of diabetes mellitus among inpatients in Guangdong province].

OBJECTIVES: To investigate the prevalence of diabetes and impaired glucose regulation (IGR) among the inpatients and their clinical features. METHODS: A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day of 2004. The fasting plasma glucose (FPG) levels of first screen when the patients were hospitalized were recorded. Those with the FPG levels from 5.6 to 6.9 mmol/l. who had not been previously diagnosed as with diabetes (P-DM) underwent oral glucose tolerance test (OGTT). The patients were classified into 5 groups according to the OGTT results: normal glucose tolerance (NGT), DM, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and IGT accompanied with IFG, the last 3 groups being called by a joint name of impaired glucose regulation (IGR). Those with FPG >or= 7.0 mmol/L who had not been diagnosed as with DM previously were diagnosed as newly-diagnosed DM (New-DM). RESULTS: Of the 8753 inpatients investigated 8.3% were with P-DM, 6.8% were diagnosed as with New-DM, and 4.9% were with IGR. OGTT was carried out in 433 inpatients. 27.9% of which were classified as with New-DM, and 49.9% with IGR. In the New-DM patients, 41.8% were accompanied with hypertension, 43.2% with proteinuria, and 67.6% with dyslipidemia. CONCLUSION: The prevalence rates of diabetes and IGR were 15.1% and 4.9% respectively among the inpatients investigated. The rate of diabetes was 27.9% among the patients underwent OGTT. Proteinuria, dyslipidemia, and hypertension were the concomitant disorders frequently found in New-DM.

Adolescent↗
PubMedDate not supplied

[Seasons of birth and psychiatry. A retrospective inpatients study].

UNLABELLED: Births of schizophrenics tend to occur more often than expected during the first months of the year. This phenomenon has been repeatedly demonstrated in large samples of patients, but data from France are not yet available. METHOD. Medical records of 2,215 inpatients born in France, have been studied with DSM III-R. Admissions were unduplicated. Inpatient population is described table I. The 230 schizophrenic patients were also classified into three groups according with family history for psychotic diseases (Positive, Negative and Unknown). The year was divided in quarters, but also in two climatic half-years (Cold and Warm). Two different populations were used as controls: first, the live births data in France collected by the INSEE; and second, the 1726 non psychotic inpatients hospitalised in the same unit as the psychotics, during the same period. RESULTS. The season of birth effect can be demonstrated from our sample. When the whole schizophrenic group is compared to the INSEE data, a significant excess of births is found for the winter quarter (p less than .04) and for the cold half-year (p less than .01). In the DSM III-R disorganized patients the seasonal variation becomes significant at a level of p less than .001. The other subtypes of schizophrenia do not show significant seasonal variations (table II). The pattern of birth of the other DSM III-R diagnoses, does not significantly differ from INSEE control data (table III). Schizophrenic patients without psychiatrically ill relatives show a slight, non significant excess of births in winter which become significant for the cold half-year (p less than .03). Subjects with possible family history do not show any trend suggesting a seasonal effect (table IV). DISCUSSION. Few reports include an entire inpatient population as we have done. Such data in our study offers an element of useful comparison with the schizophrenics. Clinic data: Most of seasonal studies have used ICD-8, ICD-9 or Tsuang and Winokur criteria, to compare only paranoid and non paranoid subjects, and some of them found a very small excess of paranoid births in winter. The discrepancies between these studies and ours, can reflect both variability among environmental factors and variability in the diagnostic criteria. CONTROL DATA: Most of the subjects were born between 1920 and 1960. All live births in France for the same years could be used as controls, but unfortunately INSEE data were not available by months or quarters before 1949. But since in western and southern European general population, the season of birth appears to be relatively uniform and stable over time, it seemed possible to use the posterior INSEE data to compare with our anterior inpatients data. Familial data: We found a birth excess in the cold season, only for schizophrenics without any family history. This finding is consistent with various other reports. CONCLUSION. In conclusion, our findings are consistent with the suggestion that the season of birth is important in the aetiology of the disorganized subgroup of schizophrenic aetiology of the disorganized subgroups of schizophrenic patients. Moreover, the excess of winter births is only observed in the "negative family history" group.

Adolescent↗
PubMed1990

Patient satisfaction with diagnostic cardiac catheterization: ambulatory vs. inpatient performance.

In a combined retrospective and historical cohort analysis, 72 patients at The Mount Sinai Hospital were studied to assess satisfaction with diagnostic cardiac catheterization and coronary arteriography performed as an ambulatory procedure (40 patients) and as an inpatient procedure (32 patients). A composite questionnaire designed to measure patient satisfaction was generated by the method of summed ranks, a common method of pooling aspects from several sources. Ten psychosocial dimensions of patient satisfaction were explored to determine if any difference existed between the ambulatory-patient population and the inpatient population. The ambulatory-patient group had a higher total mean satisfaction score than the inpatient group (4.01 vs. 3.60, p less than .001). Analysis of the specific dimensions showed that the ambulatory group had mean satisfaction scores higher than those of the inpatient group in convenience of procedure (4.12 vs. 3.13), continuity of care (3.83 vs. 3.42), technical quality (4.85 vs. 4.05), interpersonal aspects of communication (4.53 vs. 4.01), physical environment (4.14 vs. 3.18), and global satisfaction (4.71 vs. 4.25). These differences were statistically significant using the two-tailed t test (t greater than t.05,70 = 1.994). These data suggest that cardiac catheterization performed as an ambulatory procedure yields greater satisfaction than when performed as an inpatient procedure. This fact, in combination with prior published conclusions that ambulatory cardiac catheterization is more cost effective and has a statistically similar complication rate, supports the recommendation that this procedure be performed as an ambulatory procedure.

Adult↗
PubMed1990

A controlled study on the outcome of inpatient and outpatient treatment of low back pain. Part III. Long-term follow-up of pain, disability, and compliance.

The long-term outcome results of inpatient and outpatient treatment of low back pain (LBP) were studied in 476 subjects (aged 35-54, 63% men) randomly assigned to three study groups: inpatients (n = 157), outpatients (n = 159), and controls (n = 160). The study included changes in the severity of low back pain, grade and disability, compliance with self-care, data on disability pensions, and days of sickness allowance during a 2.5-year follow-up period. These variables were used as outcome criteria. Pain and disability had decreased significantly in the two treated groups up to the 3-month follow-up. LBP was still a little slighter in the inpatients at the 1.5-year and 22-month follow-ups, but there were no significant differences between the groups in disability caused by LBP. The refresher programme carried out 1.5 years after the first one did not bring about as clear short-term improvement in pain and disability as the first treatment. During the whole 2.5-year follow-up compliance with self-care was better in the two treated groups, especially in the inpatients. Days of sickness allowance had increased somewhat more in the controls than in the inpatients during the follow-up. No differences between the groups were found in the number of disability pensions granted.

Absenteeism↗