A Survey to Assess Primary Care Physician Awareness of Complications Following Critical Illness

Journal of Intensive Care Medicine, Journal Year: 2023, Volume and Issue: 38(8), P. 760 - 767

Published: March 27, 2023

Background: Survivors of critical illness are at risk for post-intensive care syndrome (PICS, comprised physical dysfunction, cognitive impairment, and neuropsychiatric disorders including anxiety, depression, post-traumatic stress). Their family members caregivers PICS-F (PICS-family, PICS increasingly recognized in care; however, the awareness among primary providers domains terms PICS/PICS-F is unknown. Objectives: To determine current practice patterns knowledge physicians regards to patients recovering from illness; barriers post-critically ill patients. Methods: A paper electronic survey were developed randomly distributed a subset North Carolina physicians. Survey questions consisted following domains: demographics, practice, providing care, common issues/complications illness, interest changing survivors illness. Results: One hundred ninety-six surveys delivered 77 completed (39% response rate) analyzed. Respondents confirmed significant lack terminology, insufficient time spend with patients, inadequate education patients/families about recovery after Fifty-seven percent respondents thought specialized transitional post-ICU clinic would be helpful. Sixty-two reported feeling comfortable caring 75% felt they aware problems encountered However, 84% also more helpful as list seen (91%). Conclusions: Significant gaps optimal by PCPs exist. Providers identified constraints educational needing attention. Dedicated clinics might provide bridge transition post-critical back providers.

Language: Английский

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Clinical and Economic impact of updated Fall 2023 COVID-19 vaccines in the Immunocompromised Population in Canada

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Nov. 11, 2023

ABSTRACT Background Immunocompromised (IC) individuals are at increased risk of COVID-19 infection-related severe outcomes. Moderna and Pfizer-BioNTech mRNA vaccines available in Canada, differences vaccine effectiveness (VE) have been found between the two IC individuals. The objective this analysis was to compare clinical economic impact a XBB.1.5 updated Fall 2023 Canadian aged ≥18 years. Methods A static decision-analytic model estimated number infections, hospitalizations, deaths, resulting quality-adjusted life years (QALYs) over one-year time horizon (September 2023-August 2024) adult population (n=894,580). Costs associated with infection were from health care societal perspectives. predicted VE based on prior variant versions, which well-matched circulating variant. calculated meta-analysis comparative both (relative for vaccine: infection=0.85 [95%CI 0.75-0.97], hospitalization=0.88 0.79-0.97]). combined estimates incidence probability related Sensitivity analyses tested uncertainty surrounding incidence, hospitalization mortality rates, costs, QALYs. Results Given expected higher against hospitalizations vaccine, its use is prevent an additional 2,411 infections (3.6%), 275 (3.7%), 47 deaths (4.0%) compared 330 QALYs gained, savings $7.4M treatment $0.9M productivity loss costs. most sensitive variations parameters, specifically relative vaccines, waning rates. Conclusions If protect similar previous using would result substantial public benefits individuals, as well provide cost savings.

Language: Английский

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Supplemental oxygen prescriptions after hospitalization for coronavirus disease 2019

Heart & Lung, Journal Year: 2024, Volume and Issue: 69, P. 208 - 216

Published: Nov. 4, 2024

Language: Английский

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Accessing Care Services for Long COVID Sufferers in Alberta, Canada: A Random, Cross-Sectional Survey Study

International Journal of Environmental Research and Public Health, Journal Year: 2023, Volume and Issue: 20(15), P. 6457 - 6457

Published: July 27, 2023

Designing appropriate rehabilitation programs for long COVID-19 remains challenging. The purpose of this study was to explore the patient experience accessing and recovery services. In cross-sectional, observational study, a telephone survey administered random sample persons with in Canadian province. Participants included adults who tested positive between March October 2021. Survey respondents (

Language: Английский

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Impact of the COVID-19 Pandemic on Health Care Utilization in the Vaccine Safety Datalink: Retrospective Cohort Study (Preprint)

JMIR Public Health and Surveillance, Journal Year: 2023, Volume and Issue: 10, P. e48159 - e48159

Published: Dec. 12, 2023

Background Understanding the long-term impact of COVID-19 pandemic on health care utilization is important to organizations and policy makers for strategic planning, as well researchers when designing studies that use observational electronic record data during period. Objective This study aimed evaluate changes in across all settings among a large, diverse, insured population United States pandemic. Methods We conducted retrospective cohort within 8 participating Vaccine Safety Datalink Project using from members ages January 1, 2017, December 31, 2021. The visit rates per person-year were calculated monthly period 4 combined by inpatient, emergency department (ED), outpatient, telehealth settings, both without COVID-19. Difference-in-difference analysis interrupted time series performed assess prepandemic (January 2017 February 2020) early (April-December later (July-December 2021), respectively. An exploratory was also trends through June 2023 at one largest sites, Kaiser Permanente Southern California. Results included more than 11 million Compared with period, we found reductions in-person settings. During overall reached 8.36 visits person-year, exceeding level 7.49 2019 (adjusted percent change 5.1%, 95% CI 0.6%-9.9%); inpatient ED returned levels members, although they remained low 0.095 0.241 indicating 7.5% 8% decrease compared pre-pandemic COVID-19, Telehealth visits, which approximately 42% volume outpatient increased 97.5% (95% 86.0%-109.7%) 0.865 2.35 California similar those entire population. Visit 2022 stable appeared be continuation observed end Conclusions services became mainstay system late Inpatient levels, evidence Our findings provide valuable information resource allocation postpandemic patient involving

Language: Английский

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Trends in Outpatient Visits and Hospital and Intensive Care Unit Admissions of Adults With COVID-19 in an Integrated US Health Care System, March 2020 to January 2022

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(1), P. e2253269 - e2253269

Published: Jan. 26, 2023

This cohort study of patients at a single integrated health system examines trends in COVID-19–related treatment location and mortality.

Language: Английский

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The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort

BMC Public Health, Journal Year: 2023, Volume and Issue: 23(1)

Published: May 18, 2023

Abstract Background Few studies have examined the effect of obesity indices on total number hospitalizations. We associations between body mass index (BMI) and waist circumference (WC) rate all-cause hospitalizations among Iranian adult participated in Tehran Lipid Glucose Study cohort. Methods This study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median 18 years. Participants categorized into three groups according to their baseline BMI: normal weight, overweight obese. In addition, they classified WC two categories: high WC. Negative Binomial regression model was used estimate incidence ratios (IRRs) 95% confidence interval (95% CI) relation indices. Results The overall crude 77.6 CI, 73.9–81.2) 76.9 (73.4–80.3) per 1000 person-year men women, respectively. covariate adjusted 27% higher obese than weight (IRR CI): 1.27 (1.11–1.42)). Among had 17% (1.17 (1.03–1.31)) 40% (1.40 (1.23–1.56)) hospitalization compared women. Having associated with 18% (1.18 (1.08–1.29)) 30% (1.30 (1.18–1.41)) Conclusions Obesity increased rates during long-term follow-up. Our findings suggests that successful prevention programs may decrease hospitalizations, particularly,

Language: Английский

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Disease and social factors associated with healthcare utilization for the treatment of SARS-CoV-2 infections in a longitudinal cohort of essential workers in Arizona

BMC Health Services Research, Journal Year: 2023, Volume and Issue: 23(1)

Published: Oct. 18, 2023

Abstract Background Demands on health systems due to COVID-19 are substantial, but drivers of healthcare utilization not well defined in non-severe SARS-CoV-2 infections. Among a prospective cohort frontline workers from July 2020 February 2023, we assessed predictors during infection. Methods Weekly specimens tested via real-time reverse transcriptase polymerase chain reaction analysis. Participants reported sociodemographic, status information, and illness experience information. Primary outcome was Predictors included sociodemographic characteristics, baseline status, measures severity. Multivariable logistic regression utilized generate odds ratios for utilization. Results 1,923 infections (1,276 first 647 reinfections 4,208 participants): 1221 (63.5%) individuals were between 40 65 years old; 1115 (58.0%) female; 449 (23.3%) Hispanic 1305 (67.9%) non-Hispanic White. 294 (15.3%) sought medical care infection, 106 (5.5%) reinfection. Sociodemographic characteristics associated with any variant infections, while age (OR 1.04, 95%CI 1.01–1.07) Omicron In number symptoms 1.16, 1.00-1.36 Origin/Alpha, OR 1.12, 1.00-1.49 Delta, 1.09, 1.01–1.16 Omicron), days spent bed 1.13, 1.02–1.33 1.23, 1.00-1.59 1.03–1.22 duration 1.01, 1.00-1.04 1.00-1.03 1.00-1.02 Omicron) related all variants. Number 1.01–1.27), 1.00-1.02), hours work missed 2.24, 1.11–4.74) positively Conclusion The main factors infection symptom severity duration. Practices therapeutics aimed at decreasing these would be most helpful easing the burden systems.

Language: Английский

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Evaluation of an outreach programme for patients with COVID-19 in an integrated healthcare delivery system: a retrospective cohort study

BMJ Open, Journal Year: 2024, Volume and Issue: 14(1), P. e073622 - e073622

Published: Jan. 1, 2024

Objectives In the first year of COVID-19 pandemic, health systems implemented programmes to manage outpatients with COVID-19. The goal was expedite patients’ referral acute care and prevent overcrowding medical centres. We sought evaluate impact such a programme, Home Care Team (CHCT) programme. Design Retrospective cohort. Setting Kaiser Permanente Northern California. Participants Adult members before vaccine availability (1 February 2020–31 January 2021) positive SARS-CoV-2 tests. Intervention Virtual programme track treat patients ‘CHCT programme’. Outcomes outcomes were (1) COVID-19-related emergency department visit, (2) hospitalisation (3) inpatient mortality or 30-day hospice referral. Measures estimated average effect comparing who not treated by CHCT. propensity scores using an ensemble super learner (random forest, XGBoost, generalised additive model multivariate adaptive regression splines) augmented inverse probability weighting. Results There 98 585 majority followed CHCT (n=80 067, 81.2%). Patients older (mean age 43.9 vs 41.6 years, p<0.001) more comorbid COmorbidity Point Score, V.2, score ≥65 (1.7% 1.1%, p<0.001). Unadjusted analyses showed visits (9.5% 8.5%, hospitalisations (3.9% 3.2%, in but lower death (0.3% 0.5%, After weighting, there higher rates (estimated intervention −0.8%, 95% CI −1.4% −0.3%) (−0.5%, −0.9% −0.1%) −0.7% Conclusions Despite following comorbidity burden, appeared be protective effect. likely present less die inpatient.

Language: Английский

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How High Public Debt Reduces the Preparedness of European Health Systems to Cope With Covid-19 Pandemic Crisis and Other Systemic Emergencies

SSRN Electronic Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Download This Paper Open PDF in Browser Add to My Library Share: Permalink Using these links will ensure access this page indefinitely Copy URL DOI

Language: Английский

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