Academic literature on the topic 'Service hospitalier des admissions'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Service hospitalier des admissions.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Journal articles on the topic "Service hospitalier des admissions"
1
KSHIRSAGAR, ABHIJIT V., SUSAN L. HOGAN, LARRY MANDELKEHR, and RONALD J. FALK. "Length of Stay and Costs for Hospitalized Hemodialysis Patients." Journal of the American Society of Nephrology 11, no. 8 (2000): 1526–33. http://dx.doi.org/10.1681/asn.v1181526.
Full textAbstract:
Abstract. The high cost of hospitalization for hemodialysis patients has become a major health care issue. To address this issue, length of hospital stay and costs for these patients were compared with services covered by nephrologists and services covered by internists. Hemodialysis patients (n = 161) were prospectively admitted 219 times on alternate days to services covered by nephrologists or by internists from July 1995 to March 1996. Admissions to nonmedical services and admissions for overnight observation were excluded. Length of stay, costs, and risk-adjusted predicted length of stay and costs, as well as the number of consultations were compared between services, using Wilcoxon rank sum tests. Readmissions and deaths were compared using χ2 tests. Mean length of stay for admissions to the nephrology service (n = 114) was 6.3 days compared with 8.1 days for admissions to internal medicine services (n = 105) (P = 0.017). The predicted length of stay was similar. Mean overall cost for admissions under the care of nephrologists was $7,925 versus $10,773 under the care of internists (P = 0.101). The internal medicine service averaged 1.5 consultations versus 0.5 consultations for the nephrology service (P = 0.001). The risk of readmission was 24% for nephrologists and 30% for internists (P = 0.328). Death within 90 days of discharge was 12% for the nephrology group and 22% for the internal medicine group (P = 0.07). The length of stay was significantly shorter for hemodialysis patients under the care of nephrologists compared with internists. The average total costs and risk of readmissions tended to be lower for nephrologists. If these results are corroborated, the care of hemodialysis patients by the nephrologist could diminish the overall expense of the ESRD program.
2
Wilson, Donna M., Ye Shen, and Gail Low. "Use of Hospitals by Older versus Younger Canadians: Myths and Misconceptions." Canadian Journal on Aging / La Revue canadienne du vieillissement 37, no. 3 (2018): 309–17. http://dx.doi.org/10.1017/s0714980818000235.
Full textAbstract:
RÉSUMÉAfin de mieux répondre aux préoccupations concernant l’utilisation intensive des hôpitaux par les personnes âgées et l’augmentation subséquente des listes d’attente et de l’attente dans les services de santé hospitaliers au Canada, les données anonymes individuelles des patients hospitalisés en 2014-2015 dans toutes les provinces et territoires (sauf le Québec) ont été analysées. Les personnes de plus de 65 ans composaient 37 % de tous les épisodes de consultation hospitalière et 41,5 % des admissions en soins spéciaux (unités de soins intensifs ou coronariens). De tous les individus admis, 32,8 % étaient des personnes âgées. Les données montrent aussi que seulement 14,3 % des aînés canadiens vivant à l’extérieur du Québec ont été admis à l’hôpital une ou plusieurs fois cette année. Cette étude indique que des problématiques qui ne sont pas liées à l’utilisation des hôpitaux par les personnes âgées devraient être prises en compte en priorité au Canada pour améliorer l’accessibilité aux soins hospitaliers. L’amélioration des soins aux personnes âgées est aussi indiquée, considérant le risque plus élevé d’admission ou de mort à l’hôpital, et leurs séjours plus longs en milieu hospitalier, qui pourraient être expliqués par un manque de services hospitaliers et communautaires adaptés aux aînés.
3
Baibergenova, Akerke, Aaron M. Drucker, and Neil H. Shear. "Hospitalizations for Cellulitis in Canada: A Database Study." Journal of Cutaneous Medicine and Surgery 18, no. 1 (2014): 33–37. http://dx.doi.org/10.2310/7750.2013.13075.
Full textAbstract:
Background: Cellulitis is the skin disease most commonly responsible for emergency department visits and inpatient admissions. Objective: To determine factors associated with prolonged admissions and mortality in inpatients with cellulitis. Methods: Data on patients with an admission diagnosis of cellulitis from 2004 to 2008 in the Canadian Discharge Abstract Database were analyzed. Factors associated with mortality and prolonged hospital stay (> 7 days) were analyzed in univariate and multivariate analysis through logistic regression. Results: During the study period, 65,454 patients were hospitalized for cellulitis. Factors associated with prolonged admission included admission to or consultation by a surgical service (OR 2.30, 95% CI 2.17–2.43) and dermatology consultation (OR 4.50,95% CI 3.92–5.17). Factors associated with mortality included surgical (OR 1.35, 95% CI 1.03–1.76) or infectious disease (OR 1.75, 95% CI 1.39–2.21) consultation. Conclusion: Misdiagnosis of cellulitis, suggested by the use of consulting services, may play a role in the morbidity and mortality of cellulitis patients.
4
Bai, Anthony D., Siddhartha Srivastava, George A. Tomlinson, Christopher A. Smith, Chaim M. Bell, and Sudeep S. Gill. "Mortality of hospitalised internal medicine patients bedspaced to non-internal medicine inpatient units: retrospective cohort study." BMJ Quality & Safety 27, no. 1 (2017): 11–20. http://dx.doi.org/10.1136/bmjqs-2017-006925.
Full textAbstract:
ObjectiveTo compare inhospital mortality of general internal medicine (GIM) patients bedspaced to off-service wards with GIM inpatients admitted to assigned GIM wards.MethodA retrospective cohort study of consecutive GIM admissions between 1 January 2015 and 1 January 2016 was conducted at a large tertiary care hospital in Canada.Inhospital mortality was compared between patients admitted to off-service wards (bedspaced) and assigned GIM wards using a Cox proportional hazards model and a competing risk model. Sensitivity analyses included propensity score and pair matching based on GIM service team, workload, demographics, time of admission, reasons for admission and comorbidities.ResultsAmong 3243 consecutive GIM admissions, more than a third (1125, 35%) were bedspaced to off-service wards with the rest (2118, 65%) admitted to assigned GIM wards. In hospital, 176 (5%) patients died: 88/1125 (8%) bedspaced patients and 88/2118 (4%) assigned GIM ward patients. Compared with assigned GIM wards patients, bedspaced patients had an HR of 3.42 (95% CI 2.23 to 5.26; P<0.0001) for inhospital mortality at admission, which then decreased by HR of 0.97 (95% CI 0.94 to 0.99; P=0.0133) per day in hospital. Competing risk models and sensitivity analyses using propensity scores and pair matching yielded similar results.ConclusionsBedspaced patients had significantly higher inhospital mortality than patients admitted to assigned GIM wards. The risk was highest at admission and subsequently declined. The results of this single centre study may not be generalisable to other hospitals and may be influenced by residual confounding. Despite these limitations, the relationship between bedspacing and patient outcomes requires investigation at other institutions to determine if this common practice represents a modifiable patient safety indicator.
5
Tacchi, Mary Jane, Suresh Joseph, and Jan Scott. "Evaluation of an emergency response service." Psychiatric Bulletin 27, no. 4 (2003): 130–33. http://dx.doi.org/10.1192/pb.27.4.130.
Full textAbstract:
Aims and MethodAn emergency response service (ERS) was introduced to streamline the assessment of individuals presenting in a crisis in one sector of a large provincial city. Data on service activity, clinical details and outcome were recorded on consecutive referrals to the service over the first 6 months of operation, and all patients were offered the opportunity to complete the Client Satisfaction Questionnaire.ResultsSeventy-five per cent of those referred accepted the offer of assessment, and the majority were seen in their own home within 2 hours. One in ten individuals were not offered any further mental health input and 17% were hospitalised. The number of admissions via primary care fell by 60% after the introduction of this service. However, at its peak of activity the service received an average of only two referrals per day and three each weekend. Only 30% of referrals were received outside of normal office hours. Service users and general practitioners were found to be more satisfied with the service than the staff that provided it.Clinical ImplicationsThe introduction of the ERS led to a faster, more consistent process of assessment of crisis referrals and assessment undertakings in the community, and appeared to increase the use of alternative treatments for individuals in crisis before resorting to admission. Funding opportunities are restricted for the development of crisis services. The development of emergency response services for the use of current staff from a number of community mental health teams is an option worth considering.
6
Tacchi, Mary Jane, Suresh Joseph, and Jan Scott. "Evaluation of an emergency response service." Psychiatric Bulletin 27, no. 04 (2003): 130–33. http://dx.doi.org/10.1192/s0955603600001811.
Full textAbstract:
Aims and Method An emergency response service (ERS) was introduced to streamline the assessment of individuals presenting in a crisis in one sector of a large provincial city. Data on service activity, clinical details and outcome were recorded on consecutive referrals to the service over the first 6 months of operation, and all patients were offered the opportunity to complete the Client Satisfaction Questionnaire. Results Seventy-five per cent of those referred accepted the offer of assessment, and the majority were seen in their own home within 2 hours. One in ten individuals were not offered any further mental health input and 17% were hospitalised. The number of admissions via primary care fell by 60% after the introduction of this service. However, at its peak of activity the service received an average of only two referrals per day and three each weekend. Only 30% of referrals were received outside of normal office hours. Service users and general practitioners were found to be more satisfied with the service than the staff that provided it. Clinical Implications The introduction of the ERS led to a faster, more consistent process of assessment of crisis referrals and assessment undertakings in the community, and appeared to increase the use of alternative treatments for individuals in crisis before resorting to admission. Funding opportunities are restricted for the development of crisis services. The development of emergency response services for the use of current staff from a number of community mental health teams is an option worth considering.
7
Soufi, Alexandra, Jack M. Colman, Qunyu Li, Erwin N. Oechslin, and Adrienne H. Kovacs. "Revision: review of non-elective hospitalisations of adults with CHD." Cardiology in the Young 27, no. 9 (2017): 1764–70. http://dx.doi.org/10.1017/s1047951117001214.
Full textAbstract:
AbstractIntroductionThe adult CHD population is increasing and ageing and remains at high risk for morbidity and mortality. In a retrospective single-centre study, we conducted a comprehensive review of non-elective hospitalisations of adults with CHD and explored factors associated with length of stay.MethodsWe identified adults (⩾18 years) with CHD admitted during a 12-month period and managed by the adult CHD service. Data regarding demographics, cardiac history, hospital admission, resource utilisation, and length of stay were extracted.ResultsThere were 103 admissions of 91 patients (age 37±10 years; 52% female). Of 91 patients, 96% had moderate or complex defects. Of 103 admissions, 45% were through the emergency department. The most common reasons for admission were arrhythmia (37%) and heart failure (28%); 29% of admissions included a stay in the ICU. The mean number of consultations by other services was 2.0. Electrophysiology and anaesthesiology departments were most frequently consulted. After removing outliers, the mean length of stay was 7.9±7.4 days (median=5 days). The length of stay was longer for patients admitted for heart failure (12.2±10.3 days; p=0.001) and admitted directly to the ward (9.6±8.9 days; p=0.009).ConclusionsAmong non-electively hospitalised adults with CHD in a tertiary-care centre, management often entails an interdisciplinary approach, and the length of stay is longest for patients admitted with heart failure. The healthcare system must ensure optimal resources to maintain high-quality care for this expanding patient population.
8
Mitchell, Rebecca J., Jacqui Close, Ian D. Cameron, and Stephen Lord. "Fall-related sub-acute and non-acute care and hospitalised rehabilitation episodes of care: what is the injury burden?" Australian Health Review 37, no. 3 (2013): 348. http://dx.doi.org/10.1071/ah12031.
Full textAbstract:
Background Falls are the leading cause of injury in older people. Rehabilitation services can assist individuals to improve mobility and function after sustaining a fall-related injury. However, the true effect of fall-related injury resulting in hospitalisation is often underestimated because of failure to consider sub-acute and non-acute care provided following the acute hospitalisation episode. Aim This study aims to describe the sub-acute and non-acute health service use of individuals hospitalised in New South Wales (NSW), Australia for a fall-related injury during 2000–01 to 2008–09, to examine the burden of fall-related inpatient rehabilitation hospital admissions from 1998–99 to 2010–11 and to estimate future demand for fall-related inpatient rehabilitation admissions in NSW to 2020. Method Retrospective review of sub-acute and non-acute records linked to hospital admission records during 2001–02 to 2008–09 in NSW. Analysis of temporal trends from 1998–99 to 2010–11 and projections to 2020 for rehabilitation-related (ICD-10-AM: Z47, Z48, Z50, Z75.1) inpatient hospital admissions. Results There were 4317 individuals with a fall-related injury admitted to hospital and subsequently admitted for sub-acute and non-acute care; 84% of these were aged 65+ years; 70.4% were female and 27.2% had femur fractures. For the rehabilitation-related admissions, total mean functional independence measure (FIM) scores improved significantly (from 78.4 to 94.6; P < 0.0001) between admission and discharge. Fall-related inpatient rehabilitation episodes increased by 9.1% each year between 1998 and 2011 for individuals aged 65 years and older and are projected to rise to 50 000 admissions annually by 2020. Conclusion This is the first study to provide an epidemiological profile of individuals using sub-acute and non-acute care in NSW using linked data. Improvements in data validity and reliability would enhance the quality of the sub-acute and non-acute care data and its ability to be used to inform resource use in this sector. The examination of temporal trends using only the inpatient hospital admissions provides a guide for resource implications for inpatient rehabilitation services. What is known about this topic? Fall-related injuries that result in inpatient hospital admissions are increasing in Australia. However, the extent of the effect of fall-related injuries in the sub-acute and non-acute sector remains unknown, due to data limitations. What does this paper add? Provides the first epidemiological profile of individuals who fall and go on to use sub-acute and non-acute care in NSW using linked data. It highlights where improvements in data quality in the sub-acute and non-acute care data could be made to improve their usefulness to inform resource use in this sector. What are the implications for clinicians? Fall injury prevention and healthy ageing strategies for older individuals remain a priority for clinicians. The current and projected future resource implications for inpatient rehabilitation and follow-up services provide an indication for clinicians of future demand in this area as the population ages. However, data quality needs to improve to provide clinicians with strongly relevant guidance to inform clinical practice.
9
Riley, Bridget, M. Packer, S. Gallier, Elizabeth Sapey, and Cat Atkin. "Acute, non-COVID related medical admissions during the first wave of COVID-19: A retrospective comparison of changing patterns of disease." Acute Medicine Journal 19, no. 4 (2020): 176–82. http://dx.doi.org/10.52964/amja.0825.
Full textAbstract:
COVID-19 may have altered the case-mix of non-COVID acute medical admissions. Retrospective analysis of acute medical admissions to University Hospitals Birmingham NHS Foundation Trust, showed that medical admissions decreased in April 2020 compared to April 2019. The proportion of young adults, non-cardiac chest pain, musculoskeletal conditions and self-discharges decreased. The proportion of admissions due to alcohol misuse, psychiatric conditions, overdoses and falls increased. There were a higher number of patients admitted to ICU and greater inpatient mortality but not once COVID diagnoses were excluded. There was a significant change in hospitalised case-mix with conditions potentially reflecting social isolation increasing and diagnoses which rarely require hospital treatment, reducing. This analysis will help inform service planning.
10
Zubiri, Leyre, Gabriel E. Molina, Meghan Mooradian, et al. "Impact of multidisciplinary severe immunotherapy complication service on outcomes for cancer patients receiving immune checkpoint inhibition." Journal of Clinical Oncology 39, no. 15_suppl (2021): 2654. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.2654.
Full textAbstract:
2654 Background: The exponential increase in FDA-approved indications for immune checkpoint inhibitors (ICI) in cancer care has resulted in therapeutic success but also in the occurrence of immune-related adverse effects (irAEs) that can represent a significant clinical challenge. On October 3 2017, the Massachusetts General Hospital (MGH) implemented the Severe Immunotherapy Complications (SIC) Service, a multi-disciplinary care team for patients hospitalized with irAEs. The objectives of this study were to evaluate the impact of SIC Service on 1) healthcare utilization and 2) patients outcomes. Methods: Using pharmacy and hospital admission databases, a list of patients was identified that both received ICI for a malignancy and were hospitalized with severe irAEs in the period prior to initiation of the SIC service and after SIC initiation. The pre-SIC period was defined as an admission between 4/2/2016 through 10/3/2017, and the post-SIC period as an admission from 10/3/2017 through 10/24/2018. The rate of readmission after the index hospitalization was the primary outcome. Secondary outcomes included lengths of stay (LOS) for both initial irAE admissions and readmissions, use of corticosteroids and non-steroidal second-line immunosuppression, ICI discontinuation, and inpatient mortality in the pre- and post-SIC periods. Results: Among 1169 patients treated in the pre-SIC service intervention period; 127 were hospitalized for irAE. Among 1159 patients treated in the post-SIC intervention 122 were hospitalized for irAE. SIC Service implementation was associated with a significant reduction in irAE readmission rates (post-SIC 14.8% vs. pre-SIC 25.9%; odds ratio [OR], 0.46; 95% CI, 0.22-0.95; p=0.036). The length of stay, rates of corticosteroid use, second-line immunosuppression, and ICI discontinuation for irAE, as well as inpatient mortality rates were not significantly different before and after SIC Service implementation. Conclusions: This is the first study to report that establishing a highly subspecialized care team focused on irAEs can be associated with improved clinical outcomes for patients receiving ICI therapy. Such care teams may play an essential part in optimizing irAE care.
Dissertations / Theses on the topic "Service hospitalier des admissions"
1
Cervoise, Hélène. "Etude des admissions au service des urgences du centre hospitalier universitaire de Fort-de-France." Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M077.
Full text
2
Borel, Marie. "Admission et non admission en réanimation : comment décider?" Paris 5, 2010. http://www.theses.fr/2010PA05T030.
Full textAbstract:
Proposer ou non un patient en réanimation, puis décider ou non de le prendre en charge s’avère être un processus complexe, sous pression, sans norme formellement établie. Pour le patient, il s’agit d’un enjeu potentiellement vital. Pour le praticien, l’enjeu est de prendre la bonne décision au bénéfice de son patient, en dehors de tout contexte d’obstination déraisonnable. Trois types de populations différentes ont été envisagés: les patients admis, les patients non admis et les patients non proposés. Les travaux se sont concentrés sur la réanimation chirurgicale du Chu de Rouen. De façon parallèle ont été étudiées les modalités décisionnelles menant à l’admission ou au refus des patients en réanimation, sur une période d'un an. Un questionnaire à des praticiens interlocuteurs privilégiés de cette même réanimation a cherché à explorer la question des patients non proposés. L’objectif a été d’analyser le processus décisionnel sous un angle éthique. 298 décisions de non admission ou d’admission ont été analysées. 21 praticiens ont répondu aux questionnaires. Le processus, malgré une absence de norme définie paraît relativement homogène. Décider n’est pas perçu comme une complexité majeure. La responsabilité de la décision est assumée par les équipes de réanimation. Des facteurs contextuels contribuent à un processus sous pression. Assurer l’autonomie des patients est difficile notamment compte-tenu de patients fréquemment inconscients. La question du manque de place est un problème persistant qui peut retentir sur le principe de justice, mais ne paraît toutefois pas crucial. L’instruction collégiale des dossiers paraît usitée mais pas forcément dans sa définition littérale. Le fruit de la résolution du processus décisionnel reste de l’ordre du vital pour bon nombre de patients. Tenter de rendre ce processus plus normé et peut-être plus éthique est possible. Le principe d’une réflexion ancrée sur les principes de bienfaisance, non malfaisance, autonomie et justice paraît pertinent. Au-delà de ces principes, l’instruction collégiale de certains dossiers peut aider à résoudre les problématiques les plus complexes. Le retour systématique sur chaque dossier de patients admis comme non admis sous la forme d’une reconstruction narrative a postériori, permet de contribuer à la construction d’un processus éthiqueTo propose or not a patient in intensive care, then to decide or not to take care of him in intensive care is a complex process, under pressure, without standards formally established. For the patient it is about to be a potentially vital stake. For the intensivist doctor, the stake is to make the good decision for the benefit of its patient, apart from any context of unreasonable obstinacy. Three types of different populations were considered: admitted patients, refused patients and not proposed patients. Study proceed in the surgical intensive care of Rouen University Hospital. In a parallel way we studied decision making to admit or to refuse patients for the intensive care, over one one year period. Privileged interlocutors of this same unit sought to explore the question of the not proposed patients. Objectives were to analyze the decision-making process under an ethical point of wiew. 298 decisions of refusal or admission were analyzed. 21 doctors answered the questionnaires. The process, in spite of an absence of definite standards appears relatively homogeneous. To decide is not perceived like a major complexity. The responsibility for the decision is assumed by the intensivist doctors. Contextual factors contribute to a process under pressure. To ensure the autonomy of the patients is difficult in particular taking into account frequently unconscious patients. The question of the lack of place is a persistent problem which can resound on the principle of justice, but does not appear however crucial. Collegiality appears used but not really in its literal definition. Fruit of the resolution of the decision-making process remains about the vital one for considerable patients. To try to make this process more normalized and perhaps more ethical is possible. The principle of a reflexion anchored on the principles of beneficence, non maleficence, autonomy and justice appears relevant. Beyond of these principles, the collegial instruction can help to solve the most complex problems. The systematic return on each file of patients admitted like refused in a narrative rebuilding, could contribute to the construction of an ethical process
3
Thiphagne, Benoît, and Gervais Vielle. "Bilan, à partir de 29 cas réalisés en 30 mois, de la thrombolyse effectuée pour infarctus du myocarde dans le service des admissions-urgences du centre hospitalier d'Alençon." Caen, 1990. http://www.theses.fr/1990CAEN3017.
Full text
4
Pécoul, Annabelle. "Le service public hospitalier." Thesis, Paris Est, 2016. http://www.theses.fr/2016PESC0109.
Full textAbstract:
Le service public hospitalier a été institué par la loi du 31 décembre 1970 qui en donne une définition fonctionnelle. Bien que le législateur promeuve un modèle hospitalo-centré, il n’exclut pas les établissements privés associés au service public hospitalier par le biais de modalités de participation qui les défavorisent. Affaibli par les réformes hospitalières successives, le service public hospitalier va s’atrophier jusqu’à la réforme du 21 juillet 2009 qui supprime la notion pour lui substituer celle de missions de service public. Cette conception fonctionnelle est conforme à la théorie du service public et compatible avec la définition du service d’intérêt général défendue par le droit de l’Union européenne, mais elle est en décalage avec les faits. À la définition fonctionnelle théorique défendue par le législateur depuis 1970, se substitue, en pratique, une conception organique résultant de modalités de mise en œuvre du service public hospitalier nettement favorables au secteur public. En effet, les établissements publics de santé bénéficient d’un statut singulier caractérisant leur prépondérance. La loi du 26 janvier 2016 confirme la prégnance de la conception organique en réhabilitant la notion de service public hospitalier, et en maintenant les établissements du secteur public dans leur rôle d’acteurs naturels de ce service public. Des interrogations demeurent, toutefois, concernant la pérennité du système de santé. Celui-ci doit céder la place à un service public de santé, intégrant le service public hospitalier, susceptible de chapeauter l’action de l’ensemble des protagonistes de la santé et de garantir le déroulement d’un parcours de santé accessible, égalitaire et qualitatifThe public hospital utility has been established by the law of December, 31st, 1970, which gives a functional definition. Although the legislator promotes a hospital-centered model, it doesn’t exclude the private establishments associated to the public hospital utility by means of methods of participation which penalize it. Weakened by successive hospital reforms, the public hospital utility will atrophy until the reform of July, 21st, 2009 which deletes the notion and substitutes it by the concept of public service missions. This functional conception is in accordance with the service public theory and compatible with the definition of general interest service defended by the European Union law, but isn’t in keeping with facts. The theoretical functional definition supported by the lawmaker is replaced, in practice, by an organic conception resulting from details of implementation of public hospital utility decidedly favorable to sector public. Indeed, public health establishments benefit from a singular status characterizing its predominance. The law of January, 26, 2016 confirms the resonance of the organic conception by rehabilitating the notion of public hospital utility, and by maintaining public sector institutions in its role of natural actors of this public utility. Questions remain, nonetheless, concerning the durability of the health system. It must step back for a public health service, integrating the public hospital utility, able to head the action of all health protagonists and to guarantee the progress of an accessible, egalitarian and qualitative fitness trail
5
Farhat, Imen, and Imen Farhat. "Inter-provider variation in resource use intensity for elderly injury admissions : a multicenter cohort study." Master's thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/38114.
Full textAbstract:
Les aînés (≥65 ans) représentent une proportion grandissante des admissions pour traumatismes. Cependant, on connait peu sur leur utilisation des ressources hospitalières. Pour améliorer les connaissances sur l’utilisation des ressources, nos objectifs étaient d’identifier les déterminants de l’utilisation des ressources, étudier la variation inter-hospitalière et évaluer l’association avec les résultats cliniques. Nous avons réalisé une étude de cohorte multicentrique en incluant tous les aînés admis dans le système de traumatologie du Québec (2013-2016) avec blessures traumatiques (N=16463) et avec fractures de fragilité (N=16721). Nous avons estimé l’utilisation des ressources avec la méthode de coûts basés sur les centres d’activité. Nous avons utilisé des modèles linéaires et logistiques multiniveaux pour nos analyses. L’utilisation des ressources augmentait avec l’âge et le nombre de comorbidités. La destination à la sortie de l’hôpital était aussi un important déterminant (soins longue durée vs domicile; blessures traumatiques; ratio de moyennes géométriques [RMG]=1,68; IC 95%=1,61-1,75; fracture de fragilité; RMG=1,28 IC 95%=1,24-1,32). L’utilisation des ressources ajustée variait significativement entre les hôpitaux. Cette variation était plus importante chez les patients avec des fractures de fragilité (coefficient de corrélation interclasse [CCI]=0,093; IC 95%=0,079-0,102) que chez ceux avec des blessures traumatiques (CCI=0,047; IC 95%=0,037-0,051). Les hôpitaux avec une plus importante utilisation des ressources avaient tendance à avoir une incidence plus élevée de mortalité (fracture de fragilité : coefficients de corrélation de Pearson [r]=0,41; IC 95%=-0,16-0,60) et de complications (blessures traumatiques : r=0,55; IC 95%=0,33-0,71; fracture de fragilité : r=0,54; IC 95%=0,32-0,70). Nos résultats suggèrent qu’il y a place à l’optimisation des ressources pour les aînés admis pour blessures. L’augmentation de mortalité et morbidité dans les hôpitaux utilisant plus de ressources pourrait être expliquée par la confondance résiduelle mais aussi par les effets indésirables reliés aux interventions ou aux journées d’hospitalisation potentiellement non-nécessaires. Ces hypothèses seront à confirmer lors d’études futures.Les aînés (≥65 ans) représentent une proportion grandissante des admissions pour traumatismes. Cependant, on connait peu sur leur utilisation des ressources hospitalières. Pour améliorer les connaissances sur l’utilisation des ressources, nos objectifs étaient d’identifier les déterminants de l’utilisation des ressources, étudier la variation inter-hospitalière et évaluer l’association avec les résultats cliniques. Nous avons réalisé une étude de cohorte multicentrique en incluant tous les aînés admis dans le système de traumatologie du Québec (2013-2016) avec blessures traumatiques (N=16463) et avec fractures de fragilité (N=16721). Nous avons estimé l’utilisation des ressources avec la méthode de coûts basés sur les centres d’activité. Nous avons utilisé des modèles linéaires et logistiques multiniveaux pour nos analyses. L’utilisation des ressources augmentait avec l’âge et le nombre de comorbidités. La destination à la sortie de l’hôpital était aussi un important déterminant (soins longue durée vs domicile; blessures traumatiques; ratio de moyennes géométriques [RMG]=1,68; IC 95%=1,61-1,75; fracture de fragilité; RMG=1,28 IC 95%=1,24-1,32). L’utilisation des ressources ajustée variait significativement entre les hôpitaux. Cette variation était plus importante chez les patients avec des fractures de fragilité (coefficient de corrélation interclasse [CCI]=0,093; IC 95%=0,079-0,102) que chez ceux avec des blessures traumatiques (CCI=0,047; IC 95%=0,037-0,051). Les hôpitaux avec une plus importante utilisation des ressources avaient tendance à avoir une incidence plus élevée de mortalité (fracture de fragilité : coefficients de corrélation de Pearson [r]=0,41; IC 95%=-0,16-0,60) et de complications (blessures traumatiques : r=0,55; IC 95%=0,33-0,71; fracture de fragilité : r=0,54; IC 95%=0,32-0,70). Nos résultats suggèrent qu’il y a place à l’optimisation des ressources pour les aînés admis pour blessures. L’augmentation de mortalité et morbidité dans les hôpitaux utilisant plus de ressources pourrait être expliquée par la confondance résiduelle mais aussi par les effets indésirables reliés aux interventions ou aux journées d’hospitalisation potentiellement non-nécessaires. Ces hypothèses seront à confirmer lors d’études futures.
Elderly trauma admissions are increasing exponentially. However, little is known about resource use for this population. To advance knowledge on resource use and its optimization, our objectives were to identify resource use determinants, assess inter-hospital variation in resource use, and examine the impact of hospital resource use on patient outcomes for elderly injured patients. We conducted a multicenter cohort study of elders (≥65 years) with trauma (N=16,463) and with fragility fractures (N=16,721) admitted in the Québec trauma system (2013-2016). We estimated resource use with activity-based costing. We used intraclass correlation coefficients (ICC) to examine inter-hospital variation in resource use, multilevel linear models to identify determinants, and Pearson correlation coefficients (r) to assess the impact of resource use on patient outcomes. Resource use increased with age and the number of comorbidities for both groups. Patients discharged to long-term care had higher resource use than those discharged home (geometric mean ratio [GMR]=1.68; 95% CI [1.61, 1.75] for trauma and GMR=1.28; 95% CI [1.24, 1.32] for fragility fractures). Risk-adjusted resource use varied significantly across trauma centers for elderly patients. There was greater variation for elders with fragility fractures (ICC=0.093; 95% CI [0.079, 0.102]) than with trauma (ICC=0.047; 95% CI [0.035, 0.051]). Trauma centers with higher risk-adjusted resource use tended to have a higher incidence of mortality (r=0.41; 95% CI [0.16, 0.60]) for fragility fractures and complications for trauma (r=0.55; 95% CI [0.33, 0.71]) and for fragility (r=0.54; 95% CI [0.32, 0.70]). Our results suggest that there is room for resource use optimisation for elders admitted for injuries. The observed increase in mortality and morbidity in hospitals with higher resource use might be due to residual confounding but could also be due to adverse effects of potentially unnecessary interventions and hospitals stays. These hypotheses need to be confirmed in future studies.
Elderly trauma admissions are increasing exponentially. However, little is known about resource use for this population. To advance knowledge on resource use and its optimization, our objectives were to identify resource use determinants, assess inter-hospital variation in resource use, and examine the impact of hospital resource use on patient outcomes for elderly injured patients. We conducted a multicenter cohort study of elders (≥65 years) with trauma (N=16,463) and with fragility fractures (N=16,721) admitted in the Québec trauma system (2013-2016). We estimated resource use with activity-based costing. We used intraclass correlation coefficients (ICC) to examine inter-hospital variation in resource use, multilevel linear models to identify determinants, and Pearson correlation coefficients (r) to assess the impact of resource use on patient outcomes. Resource use increased with age and the number of comorbidities for both groups. Patients discharged to long-term care had higher resource use than those discharged home (geometric mean ratio [GMR]=1.68; 95% CI [1.61, 1.75] for trauma and GMR=1.28; 95% CI [1.24, 1.32] for fragility fractures). Risk-adjusted resource use varied significantly across trauma centers for elderly patients. There was greater variation for elders with fragility fractures (ICC=0.093; 95% CI [0.079, 0.102]) than with trauma (ICC=0.047; 95% CI [0.035, 0.051]). Trauma centers with higher risk-adjusted resource use tended to have a higher incidence of mortality (r=0.41; 95% CI [0.16, 0.60]) for fragility fractures and complications for trauma (r=0.55; 95% CI [0.33, 0.71]) and for fragility (r=0.54; 95% CI [0.32, 0.70]). Our results suggest that there is room for resource use optimisation for elders admitted for injuries. The observed increase in mortality and morbidity in hospitals with higher resource use might be due to residual confounding but could also be due to adverse effects of potentially unnecessary interventions and hospitals stays. These hypotheses need to be confirmed in future studies.
6
Cohen, Michel. "Le service public hospitalier existe-t-il encore ?" Nice, 1997. http://www.theses.fr/1997NICE0024.
Full textAbstract:
La crise structuro-conjoncturelle de notre société implique une remise en cause de l'état et par la même du service public comme operateur idéologique, institutionnel et juridique. Le service public hospitalier n'échappe pas a ce phénomène. Cree par la loi du 31 décembre 1970, confirme par la loi du 31 juillet 1991, les ordonnances du 24 avril 1996 ont amplifie le mouvement de réforme lui-même confronte au financement de la protection sociale. Le service public hospitalier doit impérativement s'adapter afin de répondre aux progrès thérapeutiques de la médecine, condition nécessaire du maintien de sa pérennité.
7
Kadoch, Avi. "La délégation de gestion du service public hospitalier." Paris 1, 2004. http://www.theses.fr/2004PA010301.
Full textAbstract:
La gestion du service public hospitalier se décompose en deux opérations que sont l'organisation et l'exécution de ses missions. Alors que certains établissements de santé sont chargés de leur exécution, les agences régionales de l'hospitalisation sont chargées de l'organisation et du financement du service. Deux pôles a priori antinomiques, orientent l'évolution du service public hospitalier souhaitée par le législateur : maîtrise des dépenses de santé et amélioration de la qualité des soins. Liés par ces deux impératifs, les établissements de santé, dans un environnement concurrentiel partagé entre un secteur public et un secteur privé complémentaires, sont amenés à déléguer une partie de leurs services. Cette délégation peut s'opérer à travers la coopération ou par le recours à un prestataire extérieur. Notre étude a pour objet de définir les contours de la délégation de gestion du service public hospitalier et de tenter d'accorder son régime au diapason des diverses normes le régissant.
8
Juan, Térence. "Les associations d'usagers et le service public hospitalier." Aix-Marseille 3, 2003. http://www.theses.fr/2003AIX32021.
Full textAbstract:
Les associations d'usagers sont particulièrement nombreuses au sein du système de santé. Elles défendent les intérêts des usagers en les soutenant, mais aussi en les représentant dans les différentes instances du système sanitaire. Si le soutien est la fonction originelle, la fonction de représentation s'est considérablement développée au cours des dix dernières années. Le pouvoir politique s'est aujourd'hui laissé gagner à l'idée d'une démocratie sanitaire censée consacrer l'avènement d'un usager véritablement autonome mais aussi citoyen. La loi nʿ2002-303 du 4 mars 2002 traduit sur le plan juridique cette nouvelle notion. Leur étude dans cet environnement de prédilection, que constitue pour les associations d'usagers, le service public hospitalier, permet de mesurer l'écart entre l'adhésion de principe et commune à la défense de l'autonomie, de la liberté et le fait d'en assumer pleinement les conséquencesAssociations of users are particularly numerous within the system of health. They defend the interests of the users by supporting them, but also by representing them in the various authorities of the medical system. If the support is the original function, the function of representation developed considerably during ten last years. The political power was let gain with the idea of a supposed medical democracy to devote the advent of a truly autonomous user but also citizen. The law nʿ2002-303 of March 4, 2002 translate on the legal level this new concept. Their study in this environment of predilection for associations of users whom constitutes the hospital public service, makes it possible to measure the difference between the adhesion of principle and commune to the defence of autonomy, freedom and the fact of assuming the consequences fully of them
9
Daubech, Lin. "Le statut de l'usager du service public hospitalier." Bordeaux 4, 1999. http://www.theses.fr/1999BOR40016.
Full textAbstract:
Le statut de l'usager du service public hospitalier est constitue de cinq livres : le statut general de l'usager du service public hospitalier (i) - les aspects particuliers du statut de l'usager du service public hospitalier (ii) - la fin de l'hospitalisation (iii) - les prelevements et les necropsies (iv) - l'usager non pensionnaire de l'hopital (v). En prenant argument de l'analyse detaillee des principales dispositions juridiques definissant le statut de l'usager du service public hospitalier mais aussi de sa connaissance du milieu hospitalier ou encore de considerations tirees des sciences humaines, l'auteur tente d'abord de montrer que, au-dela d'une complexification juridique croissante, la situation du malade a l'hopital ne fait que traduire les conceptions dominantes, parfois contradictoires, de notre societe. S'y retrouvent a l'oeuvre tout autant des considerations de protection et de subordination que celles de respect des libertes individuelles ou de l'autonomie de la personne. Ce premier constat l'amene a considerer que, constituant en elle-meme un point d'equilibre par definition instable, la situation juridique du malade a l'hopital ne cesse d'evoluer dans le temps au rythme de la transformation de ses idees fondatrices.
10
Romanens, Jean-Louis. "Permanences, mutations et renouveau du service public hospitalier." Thesis, Montpellier 1, 2014. http://www.theses.fr/2014MON10007/document.
Full textAbstract:
Le corpus législatif initié le 21 juillet 2009 par la loi portant réforme de l’hôpital et relative aux patients, à la santé et aux territoires, a posé un nouveau paradigme juridique de service public hospitalier. Aussi avons-nous interrogé ce concept, ses servitudes, sa permanence mais aussi ses mutations et apparent renouveau. Le concept de service public hospitalier, sans doute le premier service public de notre histoire, est issu d’une lente maturation. Celle de la règle-précepte « Servir l’Autre », apparue canoniquement dès le Concile d’Orléans de 511. Depuis mille cinq cents ans, il a souvent muté mais a conservé ce contenu mental, sur lequel s’est greffée l’expérimentation hospitalière. Deux nouvelles mutations se sont développées dans la dernière décennie. Dans une rupture juridique formelle qui distingue mission de service public ouverte à tout acteur de santé, et garanties de service public d’égalité, permanence, mutabilité, le service public d’origine hospitalière s’est construit une euro-compatibilité. En retour, essentiellement porté par l’hôpital français et ses neuf millions d’hospitalisations par an, il a modelé le concept de service d’intérêt économique général de l’Union européenne. Par une autre mutation de sa gestion autonome, il a trouvé l’éthique d’une nouvelle synergie entre qualité médicale systémique, et management économique fondé sur l’activité. Cependant, pèsent sur son avenir d’autres impératifs. D’une part, les coopérations entre établissements nécessitent leur élévation au rang de missions de service public. Et une gestion des représentants des usagers et des différents personnels hospitaliers doit être intégrée au management. D’autre part, les lourds enjeux actuels de santé publique aggravant les déficits sociaux, paralysés par le corporatisme, exigent rapidement des prises en charge personnalisées en parcours de santé des affections chroniques, de la dépendance et des populations en fracture sanitaire. L’essor d’une mission de service public de santé de territoire, ouverte à tout acteur de santé, dont nous proposons la législation, permettrait de mieux contribuer à la coordination inter professionnelle et à la pertinence du système de santé. En prolongement, nous proposons des modalités législatives et organisationnelles de création d’entités spécifiques par les établissements de santé, dans des territoires d’exception convenus avec l’Agence régionale de santé. Il s’agirait de pôles hospitaliers interprofessionnels de santé de médecine ambulatoire de prévention, éducation thérapeutique, soins organiques, de santé mentale, de suivi de rééducation-réadaptation et médico-social. Ces PHIS, centres de santé inclus dans des pôles de santé, permettraient aux établissements de rétablir des accessibilités populationnelles adaptées à chaque problématique territoriale, d’améliorer la relation ville-hôpital, et un enseignement-recherche valorisant la médecine générale. Dans sa société et pour le citoyen, le service public hospitalier se doit de rester l’expérience de l’avenirPermanencies, mutations and revival of hospital public utilities : The legislative corpus initiated on July, 21st, 2009, by the law reforming the hospital and relative to the patients, health and territories, put a new legal paradigm concerning the hospital public utilities. So we have questioned this concept, its constraints, its permanencies but also mutations and apparent revival. The concept of a public hospital service, may be the first public service created in our history, emerged from a slow maturation, based on that rule: ''serve the other one'', canonically appeared during the Orleans Council, 511. Since one thousand and five hundred years, it has often mutate but has kept this mental content, on which transplanted the hospital experiment. Two new mutations were developed during the last decade. In a formal legal break-off, distinguishing public services missions opened to any health actor, and the public utilities' guaranties of equality, continuity, mutability, the public utilities originating from hospital, leaving its organicity, built for itself a euro-compatibility. In return, mainly supported by the French hospital and its nine million hospitalizations a year, it shaped the concept of general economic interest service of the European Union. Through another mutation of its autonomous management, it has found the ethic of a new synergy between systemic medical quality and economic management grounded on activeness. However, it weighs on its future, other imperatives. On one hand, the cooperations between establishments require their elevation into a public utilities mission rank. And a management of the user's representatives and the various hospital staff must be integrated to the strategy. On the other hand, the heavy current stakes in public health, worsening the social deficits, paralyzed by the corporatism and sanitary powerlessness, would quickly require a personalized coverage in health routes of chronic diseases, and of populations in social dislocation. The rise of a territory health public utilities mission opened to any health actor whose legislation we propose, would contribute to the inter-professional coordination and the relevance of the health system. In continuation, we propose legislative and organizational modalities of creation of specific entities by the health establishments, in territories of exception agreed with the Regional Health Agency (Agence Régionale de Santé). It would be a matter of Inter professional hospital poles of health (PHIS) on ambulatory medicine of prevention, therapeutic education, organic care, mental care, reeducation and rehabilitation follow-up. Health centers included into health poles, they would allow restoring population accessibilities adapted to each territory, bettering the town-hospital relationship, and a research-teaching valuing the general medicine. In its society and for the citizen, the public hospital utilities have to stay the experiment of future
Books on the topic "Service hospitalier des admissions"
1
Dennis, McCarty. Report on minority admissions: Service utilization trends. Commonwealth of Massachusetts, Executive Office of Human Service, Dept. of Pubic Health, Divisions of Alcoholism & Drug Rehabilitation, 1989.
2
NMAS. NMAS:Nursing and midwifery admissions service handbook 2005. Gloucestershire, 2004.
3
Le risque médical: Evolution de la responsabilité sans faute du service public hospitalier. L'Harmattan, 1999.
4
1950-, Capo Bernard, ed. Les hospitaliers de Malte: Neuf siècles au service des autres. 2nd ed. Oeuvres hospitalières françaises de l'Ordre de Malte, 2004.
5
Hanser, Lawrence M. United States Service Academy admissions: Selecting for success at the Military Academy/West Point and as an officer. RAND Corporation, 2015.
6
New York (State). Legislature. Senate. Higher Education Committee. Public hearing, truth in testing: Investigating the integrity of post-secondary admissions testing in New York State. [s.n., 2006.
7
Universities & Colleges Admissions Service, ed. How to complete your UCAS application: 2015 entry. Trotman, 2014.
8
Stannard, Ian. How to write a winning UCAS personal statement. Trotman, 2008.
9
Dixon, Beryl. How to complete your UCAS application: 2016 entry. Trotman, 2015.
10
Universities & Colleges Admissions Service, ed. How to complete your UCAS application: 2013 entry. Trotman, 2012.
Book chapters on the topic "Service hospitalier des admissions"
1
Webber, Carolyn. "The Mandarin Mentality: Civil Service and University Admissions Testing in Europe and Asia." In Test Policy and the Politics of Opportunity Allocation: The Workplace and the Law. Springer Netherlands, 1989. http://dx.doi.org/10.1007/978-94-009-2502-1_2.
Full text
2
Bolomé, Martine, Jacques Douchamps, and Michel Courtois. "Chapitre 24. Le pharmacien hospitalier au service du patient parkinsonien." In Traiter le Parkinson. De Boeck Supérieur, 2010. http://dx.doi.org/10.3917/dbu.vande.2004.01.0349.
Full text
3
Sureau, P., E. Sorita, C. Vignes, et al. "Approche neurosystémique intégrée en service hospitalier de médecine physique et réadaptation." In Handicap et Famille. Elsevier, 2011. http://dx.doi.org/10.1016/b978-2-294-71414-6.00009-7.
Full text
4
de Cotret, François René, and Yvan Leanza. "Chapitre 15. Recommandations pour implanter un service d’interprétation en milieu hospitalier." In La psychologie interculturelle en pratiques. Mardaga, 2019. http://dx.doi.org/10.3917/mard.heine.2019.01.0227.
Full text
5
Rothstein, William G. "Medical School Enrollments and Admissions Policies." In American Medical Schools and the Practice of Medicine. Oxford University Press, 1987. http://dx.doi.org/10.1093/oso/9780195041866.003.0025.
Full textAbstract:
After shortages of physicians developed in the 1950s and 1960s, federal and state governments undertook programs to increase the number of medical students. Government funding led to the creation of many new medical schools and to substantial enrollment increases in existing schools. Medical schools admitted larger numbers of women, minority, and low-income students. The impact of medical schools on the career choices of students has been limited. Federal funding for medical research immediately after World War II was designed to avoid politically controversial issues like federal aid for medical education and health care. The 1947 Steelman report on medical research noted that it did not examine “equally important” problems, such as financial assistance for medical education, equal access to health care, continuing medical education for physicians, or “the mass application of science to the prevention of many communicable diseases.” The same restraints prevailed with regard to early federal aid for the construction of medical school research facilities. Some medical school research facilities were built with the help of federal funds during and after World War II, but the first federal legislation specifically designed to fund construction of medical school research facilities was the Health Research Facilities Act of 1956. It provided matching grants equal to 50 percent of the cost of research facilities and equipment, and benefited practically all medical schools. In 1960, medical schools received $13.8 million to construct research facilities. This may be compared to $106.4 million for research grants and $41.5 million for research training grants in the same year. Federal grants for research and research training were often used for other activities. As early as 1951, the Surgeon General's Committee on Medical School Grants and Finances reported that “Public Health Service grants have undoubtedly improved some aspects of undergraduate instruction in every medical school,” with most of the improvements resulting from training rather than research grants. By the early 1970s, according to Freymann, of $1.3 billion given to medical schools for research, “about $800 million was 'redeployed' into institutional and departmental support. . . . The distinction between research and education became as fluid as the imagination of the individual grantees wished it to be.”
6
Bevington, Dickon, Peter Fuggle, Liz Cracknell, and Peter Fonagy. "There is no such thing as a standard AMBIT team." In Adaptive Mentalization-Based Integrative Treatment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med-psych/9780198718673.003.0009.
Full textAbstract:
The chapter offers accounts by seven different teams trained and working in AMBIT-influenced ways, illustrating a variety of settings, the ways in which AMBIT has helped to improve their practice, and the challenges they faced. The chapter starts with an analogy comparing AMBIT with the operating system of a computer, which may run multiple different types of programs to address specific issues. The seven teams are: (i) an intensive CAMHS adolescent outreach service in London, designed to reduce inpatient admissions, (ii) a Tier 4 specialist adolescent inpatient unit in East Anglia, managing high risk/highly challenging behaviors, (iii) a voluntary sector outreach team working in London with highly excluded and gang-related young people, (iv) a therapeutic residential community for children with severe disturbance in the USA, (v) an intensive CAMHS community treatment service in Scotland, (vi) a service for young people on the edge of care in London, and (vii) a young people’s substance use service in a mixed urban/rural setting in the UK.
7
Sullivan, Michael J. "Civic Membership as Reciprocity." In Earned Citizenship. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190918354.003.0002.
Full textAbstract:
Immigration enforcement regimes operate on the pretense that states have the unilateral right to exclude migrants who have entered without their consent. This chapter contends that when unauthorized long-term residents provide necessary services to their adopted countries, citizens have a normative obligation to reconsider their collective decision to exclude them. The principle of civic membership as reciprocity stands for the proposition that a person should be able to earn restitution for immigration offenses and a pathway to citizenship by working with citizens to sustain public institutions. To account for each polity’s interest in preserving its identity through admissions and naturalization decisions, an individual state can modify the principle of civic membership as reciprocity to privilege forms of service that it has historically singled out for public honors. It can then apply this principle to consider why military service by unauthorized immigrants merits regularization and naturalization in countries with a strong citizen soldier tradition.
8
Brandt, Pierre-Yves. "Pour une prise en soins globale et intégrative." In Clinique du sens. Editions des archives contemporaines, 2020. http://dx.doi.org/10.17184/eac.3270.
Full textAbstract:
La tâche d’accompagnement spirituel en milieu de santé est en pleine transformation dans nos sociétés occidentalisées. Différents signes en sont l’expression. Dans le monde hospitalier, tout d’abord, où les aumôniers tendent en de nombreux endroits à devenir des accompagnants spirituels dont l’appartenance confessionnelle n’est plus affichée et dont les compétences sont mises au service de tous. Dans les dispositifs de soins envisagés plus largement, ensuite, où d’autres acteurs présents dans ces dispositifs (médecins, infirmières, assistants sociaux, psychologues, etc.) cherchent comment intégrer la spiritualité dans les soins. Il en résulte divers modèles de prise en soins de la spiritualité dont la mise en œuvre s’étend hors du monde des hôpitaux. On en trouve des expressions dans des établissements qui accueillent des personnes âgées, par exemple. Plus récemment, des expériences en cours cherchent également comment intégrer la spiritualité dans les soins à domicile. Toutes ces démarches invitent à préciser ce que l’anglais désigne par « spiritual care ». C’était notamment l’enjeu du colloque international intitulé « Clinique du sens » qui s’est tenu à l’Université de Lausanne le 14 et 15 novembre 2019. Le texte qui suit propose quelques pistes de réflexion en vue d’une prise en soins globale et intégrée de la personne souffrante. Ces pistes ont pour but de baliser le débat sous-jacent aux diverses interventions qui ont pris place durant ce colloque.
9
Fredrickson, Rebecca, and Laura Trujillo-Jenks. "Collegiality vs. Competition." In Handbook of Research on Developing Students’ Scholarly Dispositions in Higher Education. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-7267-2.ch016.
Full textAbstract:
Learning to work with others is a trait taught from the time children are in their early schooling. However, the concept of competition begins to form at the same time. This idea of competition continues to be a fire that burns brightly in some students, and the flames are often fanned by external forces: teachers, parents, students, counselors, college admissions programs, etc. Moving from public education to the collegiate classroom has not diminished the air of competition that is often present. Working within the academy has many of these same concepts embedded into its structure. New faculty members are expected to be prepared to be academics on day one. This includes in their teaching, scholarship, and service. This demand of constant production in all three areas can cause feelings of competition among faculty members. Within this chapter are demonstrated ways of applying the 5 Cs of collegiality to the university workplace as well as to doctoral induction programs, giving faculty the opportunity to assist them in the development of a mindset of collaboration over competition.
10
Jones, David N. "Regulation and inspection of social work: costly distraction or stimulus to improve?" In Social Work. Policy Press, 2020. http://dx.doi.org/10.1332/policypress/9781447356530.003.0004.
Full textAbstract:
Has social work practice changed so much in the last fifty years that it is no longer recognisable as social work? This question is discussed and illustrated by accounts of personal experience. There has been a retrograde move from theory-based to policy-based practice, with accompanying proceduralisation, and a concentration in child and family social work on child protection, with a similar narrowing-down of work with adults to assessment. Foregrounding of safety considerations in descriptions of what social workers do has accompanied increasing numbers of care orders and formal admissions to psychiatric hospitals. On the other hand, more, although by no means enough, attention is now paid to the experiential knowledge of service users. There have been various positive developments in social work method, perhaps as reactions to the perception that previous methods were too much influenced by psychoanalytic theory. These include task-centred practice, which both requires and engenders a collaborative user-worker relationship. In the C21st there has been a shift from a deficit-based to a strengths-based approach. What has remained constant is the commitment of so many social workers to practise in accordance with the values of their profession. Whether or not collective activity and campaigning can form part of practice itself, they are greatly needed.
Conference papers on the topic "Service hospitalier des admissions"
1
Marriner, Pamela S., Joanne M. King, and Richard E. Russell. "A COPD Admission Avoidance Service Reduces Unplanned Admissions And Is Cost Effective." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5158.
Full text
2
Liu, Jun. "A theoretical framework for developing distributed admissions control over delay-sensitive media flows." In 2011 IEEE 19th International Workshop on Quality of Service (IWQoS). IEEE, 2011. http://dx.doi.org/10.1109/iwqos.2011.5931317.
Full text
3
Turner, Leanne, Miriam Davidson, Carol Lawrence, and Clare Halfhide. "A rapid response community respiratory service for children with complex needs reduces hospital admissions." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa5257.
Full text
4
Cerezo Hernández, Ana, Tomás Ruiz Albi, Andrea Crespo Sedano, et al. "Influence of air pollution on the number of hospital admissions in a Pneumology service." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa5076.
Full text
5
Gouldthorpe, Craig, Kym Wakefield, and Anne-Marie Bourke. "95 Service evaluation: identifying factors contributing to prolonged admissions at marie curie hospice, Newcastle." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 25 – 26 March 2021 | A virtual event, hosted by Make it Edinburgh Live, the Edinburgh International Conference Centre’s hybrid event platform. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/spcare-2021-pcc.113.
Full text
6
Alande, C., and C. Landric. "Autotransplantation de germes dentaires au centre hospitalier de Pau : une série de cas." In 66ème Congrès de la SFCO. EDP Sciences, 2020. http://dx.doi.org/10.1051/sfco/20206603008.
Full textAbstract:
Autotransplantation de germes dentaires au centre hospitalier de Pau : une série de cas Alande C1, Landric C2 1. Interne en Chirurgie Orale, UFR Odontologie, Service ORL et Stomatologie CH Pau 2. Spécialiste en Chirurgie Orale, Assistante hospitalière, CH Pau. INTRODUCTION : L’autotransplantation correspond au déplacement d’un organe fonctionnel (transplant) d’un site donneur vers un site receveur, sur un même patient. Dans le cadre de l’organe dentaire, le transplant est placé dans une alvéole osseuse intrabuccale naturelle ou préparée chirurgicalement. Les indications sont nombreuses : délabrement carieux, expulsion traumatique, défaut d’éruption, agénésie. C’est une technique chirurgicale peu utilisée, pourtant les métaanalyses les plus récentes font état d’un taux de succès compris entre 75 et 91% (1). Ce travail expose une série de 07 transplantations. OBSERVATION : Les 7 transplantations ont été réalisées au Centre Hospitalier de Pau entre aout 2017 et janvier 2018. Les patients étaient initialement adressés par leur dentiste ou leur othodontiste pour des avulsions. Les indications résultaient toutes d’un délabrement carieux de premières molaires maxillaires ou mandibulaires, ces dernières étant non restaurables. Les patients étaient âgés de 17 à 23 ans. Les transplants étaient tous des germes de 3ème molaire incluse situées au stade 7-8 de Nolla. Le même protocole chirurgical a été systématiquement utilisée pour chacun des patients, à savoir : avulsion de la dent délabrée, révision et rinçage alvéolaire, préparation du site receveur, avulsion du germe, temps extra-alvéolaire le plus court possible, positionnement dans le site receveur avec ajustement si nécessaire, mise en sous occlusion par améloplastie, contention. Un soin tout particulier était accordé à la préservation des cellules desmodontales du transplant. Les patients n’ont pas présenté de complication per ou postopératoire. Leur suivi post-opératoire est en cours et est réalisé de façon systématique à 1 semaine, 1 mois, 2 mois avec orthopantomogramme et 6 mois. Pour être considérées comme un succès, les transplantations devaient présenter les critères suivants : poursuite de l’édification radiculaire, absence de mobilité du transplant, absence de signes infectieux cliniques et radiologiques, visualisation radiologique d’un ligament alvéolo-dentaire sans signe d’ankylose. DISCUSSION : De plus en plus d’études tendent à montrer que la préservation des cellules desmodontales est un des facteurs majeurs pour la réussite du traitement (2). Avec l’avènement de la planification 3D (3), ce paramètre pourra être d’avantage contrôlé. Les taux de succès de cette thérapeutique, déjà élevés, pourraient être amenés à augmenter d’avantage. Les transplantations sont aujourd’hui une alternative de choix au traitement implantaire chez les jeunes patients.
7
Subramanian, D., A. Baguneid, R. Evans, R. Aldridge, and G. Lowrey. "P170 Reducing non-elective respiratory admissions: initial experience of the derby integrated ImpACT+ respiratory service." In British Thoracic Society Winter Meeting 2019, QEII Centre, Broad Sanctuary, Westminster, London SW1P 3EE, 4 to 6 December 2019, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2019. http://dx.doi.org/10.1136/thorax-2019-btsabstracts2019.313.
Full text
8
Spiro, SG, A. Ward, A. Graham, and J. Sixsmith. "41 Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?" In The APM’s Annual Supportive and Palliative Care Conference, In association with the Palliative Care Congress, “Towards evidence based compassionate care”, Bournemouth International Centre, 15–16 March 2018. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/bmjspcare-2018-aspabstracts.68.
Full text
9
Carlsson, J. A., K. Levin, C. Roux, K. Farrell, H. K. Bayes, and D. Anderson. "The Effect of a Community Respiratory Service on Chronic Obstructive Pulmonary Disease Emergency Admissions to Hospital." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4307.
Full text
10
Clarke, Jo, and Sue Varvel. "P-152 Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?" In Transforming Palliative Care, Hospice UK 2018 National Conference, 27–28 November 2018, Telford. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/bmjspcare-2018-hospiceabs.177.
Full textReports on the topic "Service hospitalier des admissions"
1
Gillen, Emily, Nicole M. Coomer, Christopher Beadles, and Amy Mills. Constructing a Measure of Anesthesia Intensity Using Cross-Sectional Claims Data. RTI Press, 2019. http://dx.doi.org/10.3768/rtipress.2019.mr.0040.1910.
Full textAbstract:
With intensifying emphasis on episodes of care and bundled payments for surgical admissions, anesthesia expenditures are increasingly important in assessing variation in expenditures for surgical episodes. When comparing anesthesia expenditures across surgical settings, adjustment for anesthesia case complexity and duration of anesthesia services, also known as anesthesia service intensity, is desirable. A single anesthesia intensity measure allows researchers to make more direct comparisons between anesthesia outcomes across settings and services. We describe a process for creating a claims-based anesthesia intensity measure using Medicare claims. We create the measure using two fields: base units associated with American Medical Association Current Procedural Terminology codes on the anesthesia claim and time units associated with the service. We rescaled the time component of the anesthesia intensity measure to equally represent base units and time units. For illustration, we applied the measure to Medicare anesthesia expenditures stratified by rural/urban location. We found that adjustments for intensity were greater in urban settings because the level of intensity is greater. Compared with rural settings, unadjusted expenditures in urban settings are roughly 26 percent higher, whereas adjusted expenditures in urban settings are only 20 percent higher. Even absent longitudinal data, researchers can adjust anesthesia outcomes for intensity using our cross-sectional claims-based intensity method.