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Artículos de revistas sobre el tema "Unplanned hospitalisations"

Autor: Grafiati

Publicado: 25 de enero de 2025

Última modificación: 31 de julio de 2025

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1

Martin, Glen Philip, Chun Shing Kwok, Harriette Gillian Christine Van Spall, et al. "Readmission and processes of care across weekend and weekday hospitalisation for acute myocardial infarction, heart failure or stroke: an observational study of the National Readmission Database." BMJ Open 9, no. 8 (2019): e029667. http://dx.doi.org/10.1136/bmjopen-2019-029667.

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ObjectivesVariation in hospital resource allocations across weekdays and weekends have led to studies of the ‘weekend effect’ for ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), heart failure (HF) and stroke. However, few studies have explored the ‘weekend effect’ on unplanned readmission. We aimed to investigate 30-day unplanned readmissions and processes of care across weekend and weekday hospitalisations for STEMI, NSTEMI, HF and stroke.DesignWe grouped hospitalisations for STEMI, NSTEMI, HF or stroke into weekday or weekend admissions. Multivari

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2

Dickins, Marissa, Angela Joe, and Judy A. Lowthian. "Ten-Year Trends and Predictors of Unplanned Hospitalisation in Community-Dwelling Older People Receiving Home-Based Care." Health & Social Care in the Community 2023 (February 9, 2023): 1–13. http://dx.doi.org/10.1155/2023/9332777.

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Older people prefer to remain living in their own home for as long as possible; however, many require support to do so through health and other care services provided in the home. This study aimed to explore the trends in usage of a home-based care service by older people in metropolitan Melbourne and factors associated with unplanned hospitalisations. This longitudinal study analysed episodes of home-based care for people aged ≥65 years between 2006 and 2015. An episode of care was defined as the period of time during which the home care services were provided to the client. Care episodes cul

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Inacio, Maria C., Robert N. Jorissen, Steve Wesselingh, et al. "Predictors of hospitalisations and emergency department presentations shortly after entering a residential aged care facility in Australia: a retrospective cohort study." BMJ Open 11, no. 11 (2021): e057247. http://dx.doi.org/10.1136/bmjopen-2021-057247.

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ObjectivesTo: (1) examine the 90-day incidence of unplanned hospitalisation and emergency department (ED) presentations after residential aged care facility (RACF) entry, (2) examine individual-related, facility-related, medication-related, system-related and healthcare-related predictors of these outcomes and (3) create individual risk profiles.DesignRetrospective cohort study using the Registry of Senior Australians. Fine-Gray models estimated subdistribution HRs and 95% CIs. Harrell’s C-index assessed risk models’ predictive ability.Setting and participantsIndividuals aged ≥65 years old ent

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Akugizibwe, Roselyne, Amaia Calderón-Larrañaga, Albert Roso-Llorach, et al. "Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults." Journal of Clinical Medicine 9, no. 12 (2020): 4001. http://dx.doi.org/10.3390/jcm9124001.

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The presence of multiple chronic conditions (i.e., multimorbidity) increases the risk of hospitalisation in older adults. We aimed to examine the association between different multimorbidity patterns and unplanned hospitalisations over 5 years. To that end, 2,250 community-dwelling individuals aged 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were studied. Participants were grouped into six multimorbidity patterns using a fuzzy c-means cluster analysis. The associations between patterns and outcomes were tested using Cox models and negative binom

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Quah, Weiren Charles, Chin Jong Leong, Edward Chong, James Alvin Low, and Heidi Rafman. "Unplanned hospitalisations among subsidised nursing home residents in Singapore: Insights from a data linkage study." Annals of the Academy of Medicine, Singapore 53, no. 11 (2024): 657–69. http://dx.doi.org/10.47102/annals-acadmedsg.2024118.

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Introduction: Hospitalisations can pose hazards and may not be an appropriate care setting for frail nursing home (NH) residents. Few studies have quantified the extent of NH resident hospitalisations in Singapore, hence we aimed to address this knowledge gap by studying characteristics of unplanned hospitalisations over a 1-year period. Method: This was a retrospective cohort study of 9922 subsidised residents across 59 NHs in Singapore, with analysis using administrative healthcare data. Key measures included inpatient admission and emergency department visit rates, final discharge diagnoses

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Mahadea, D., P. Kotecki, I. Miechowicz, A. Dobrowolska, and P. Eder. "P1138 Long-term Epidemiological Trends in Emergency Hospital Admissions and Hospitalizations of Patients with Inflammatory Bowel Diseases in one of the biggest metropolises in western Poland in years 2010 to 2021." Journal of Crohn's and Colitis 18, Supplement_1 (2024): i2037—i2038. http://dx.doi.org/10.1093/ecco-jcc/jjad212.1268.

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Abstract Background A worldwide significant dynamic shift in the incidence and clinical course of Inflammatory Bowel Diseases (IBD) has been observed in the past years. One key indicator that embodies this variability is the necessity for urgent hospitalisation due to exacerbations of Crohn's Disease (CD) and Ulcerative Colitis (UC). The objective of this study was to assess this phenomenon in the Poznan Metropolis, one of the biggest metropolises in western Poland, over a 12-year timeframe. Methods Using the National Health Fund's database, urgent hospitalisations of patients with CD or UC fr

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Moorin, Rachael E., David Youens, David B. Preen, Mark Harris, and Cameron M. Wright. "Association between continuity of provider-adjusted regularity of general practitioner contact and unplanned diabetes-related hospitalisation: a data linkage study in New South Wales, Australia, using the 45 and Up Study cohort." BMJ Open 9, no. 6 (2019): e027158. http://dx.doi.org/10.1136/bmjopen-2018-027158.

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ObjectiveTo assess the association between continuity of provider-adjusted regularity of general practitioner (GP) contact and unplanned diabetes-related hospitalisation or emergency department (ED) presentation.DesignCross-sectional study.SettingIndividual-level linked self-report and administrative health service data from New South Wales, Australia.Participants27 409 survey respondents aged ≥45 years with a prior history of diabetes and at least three GP contacts between 1 July 2009 and 30 June 2015.Main outcome measuresUnplanned diabetes-related hospitalisations or ED presentations, associ

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Zhuang, Qingyuan, Joanna SE Chan, Lionel KY See, et al. "Characteristics of unplanned hospitalisations among cancer patients in Singapore." Annals of the Academy of Medicine, Singapore 50, no. 12 (2021): 882–91. http://dx.doi.org/10.47102/annals-acadmedsg.2021212.

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Introduction: Cancer is a pervasive global problem with significant healthcare utilisation and cost. Emergency departments (EDs) see large numbers of patients with oncologic emergencies and act as “gate-keepers” to subsequent hospital admissions. A proportion of such hospital admissions are rapidly discharged within 2 days and may be potentially avoidable. Methods: Over a 6-month period, we conducted a retrospective audit of active cancer patients presenting to the ED with subsequent admission to the Department of Medical Oncology. Our aims were to identify independent factors associated with

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Pereira, Filipa, Henk Verloo, Armin von Gunten, et al. "Unplanned nursing home admission among discharged polymedicated older inpatients: a single-centre, registry-based study in Switzerland." BMJ Open 12, no. 3 (2022): e057444. http://dx.doi.org/10.1136/bmjopen-2021-057444.

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ObjectiveTo investigate patient characteristics and the available health and drug data associated with unplanned nursing home admission following an acute hospital admission or readmission.DesignA population-based hospital registry study.SettingA public hospital in southern Switzerland (Valais Hospital).ParticipantsWe explored a population-based longitudinal dataset of 14 705 hospital admissions from 2015 to 2018.Outcome measuresSociodemographic, health and drug data, and their interactions predicting the risk of unplanned nursing home admission.ResultsThe mean prevalence of unplanned nursing

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Boyde, M., R. Peters, N. New, R. Hwang, T. Ha, and D. Korczyk. "Self-care educational intervention to reduce hospitalisations in heart failure: A randomised controlled trial." European Journal of Cardiovascular Nursing 17, no. 2 (2017): 178–85. http://dx.doi.org/10.1177/1474515117727740.

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Background: A variety of educational interventions have been implemented to assist patients with heart failure to maintain their own health, develop self-care behaviours and decrease readmissions. Aims: The purpose of this study was to determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing unplanned hospital readmissions. Methods: The study, a randomised controlled trial in a large tertiary referral hospital in Australia, recruited 200 patients. Patients diagnosed with heart failure were randomly allocated 1:1 to usual education or a mu

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Cicek, Meryem, Geva Greenfield, Dasha Nicholls, Azeem Majeed, and Benedict Hayhoe. "Predictors of unplanned emergency hospital admissions among patients aged 65+ with multimorbidity and depression in Northwest London during and after the Covid-19 lockdown in England." PLOS ONE 19, no. 2 (2024): e0294639. http://dx.doi.org/10.1371/journal.pone.0294639.

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Introduction Individuals with multimorbidity have an increased likelihood of using unplanned secondary care including emergency department visits and emergency hospitalisations. Those with mental health comorbidities are affected to a greater extent. The Covid-19 pandemic has negatively impacted on psychosocial wellbeing and multimorbidity care, especially among vulnerable older individuals. Aim To examine the risk of unplanned hospital admissions among patients aged 65+ with multimorbidity and depression in Northwest London, England, during- and post-Covid-19 lockdown. Methods Retrospective c

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Ha, Ninh Thi, Mark Harris, David Preen, and Rachael Moorin. "Time protective effect of contact with a general practitioner and its association with diabetes-related hospitalisations: a cohort study using the 45 and Up Study data in Australia." BMJ Open 10, no. 4 (2020): e032790. http://dx.doi.org/10.1136/bmjopen-2019-032790.

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ObjectivesTo evaluate the relationship between the proportion of time under the potentially protective effect of a general practitioner (GP) captured using the Cover Index and diabetes-related hospitalisation and length of stay (LOS).DesignAn observational cohort study over two 3-year time periods (2009/2010–2011/2012 as the baseline and 2012/2013–2014/2015 as the follow-up).SettingLinked self-report and administrative health service data at individual level from the 45 and Up Study in New South Wales, Australia.ParticipantsA total of 21 965 individuals aged 45 years and older identified with

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Kotb, Ahmed, Susanne Armstrong, Ivelin Koev, et al. "Digitally enabled acute care for atrial fibrillation: conception, feasibility and early outcomes of an AF virtual ward." Open Heart 10, no. 1 (2023): e002272. http://dx.doi.org/10.1136/openhrt-2023-002272.

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BackgroundAtrial fibrillation (AF) represents a growing healthcare challenge, mainly driven by acute hospitalisations. Virtual wards could be the way forward to manage acute AF patients through remote monitoring, especially with the rise in global access to digital telecommunication and the growing acceptance of telemedicine post-COVID-19.MethodsAn AF virtual ward was implemented as a proof-of-concept care model. Patients presenting acutely with AF or atrial flutter and rapid ventricular response to the hospital were onboarded to the virtual ward and managed at home through remote ECG-monitori

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Aminian, Parmis, Estie Kruger, and Marc Tennant. "Association between Western Australian children’s unplanned dental presentations and the socioeconomic status of their residential area." Australian Health Review 46, no. 2 (2021): 217–21. http://dx.doi.org/10.1071/ah21006.

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Objective This study investigated the link between socioeconomic status and unplanned dental presentations at the Perth Children’s Hospital (PCH), as well as the link between the socioeconomic status of unplanned dental patients and any previous admissions to the PCH. Methods Records of 351 unplanned visits to the PCH were collected, including reason for attendance (infection, trauma, other), the patient’s residential location (suburb) and the history of any previous presentations at the PCH. The socioeconomic status of each patient was based on the Index of Relative Socio-Economic Disadvantag

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Leutgeb, Rüdiger, Sarah Jane Berger, Joachim Szecsenyi, and Gunter Laux. "Potentially avoidable hospitalisations of German nursing home patients? A cross-sectional study on utilisation patterns and potential consequences for healthcare." BMJ Open 9, no. 1 (2019): e025269. http://dx.doi.org/10.1136/bmjopen-2018-025269.

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ObjectivesDemand for nursing home (NH) care is soaring due to gains in life expectancy and people living longer with chronic illness and disability. This is dovetailing with workforce shortages across the healthcare profession. Access to timely and appropriate medical care for NH residents is becoming increasingly challenging and can result in potentially avoidable hospitalisations (PAHs). In light of these factors, we analysed PAHs comparing NH patients with non-NH patients.DesignCross-sectional study with claims data from 2015 supplied by a large German health insurance company within the fe

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Mitchell, Rebecca, Brian Draper, Lara Harvey, Henry Brodaty, and Jacqueline Close. "56 Examining Fall-Related HIP Fractures in Long-Term Residential Aged Care and the Community: Trends, Health Outcomes and Treatment Costs." Age and Ageing 48, Supplement_4 (2019): iv13—iv17. http://dx.doi.org/10.1093/ageing/afz164.56.

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Abstract Background Hip fracture risk is higher for older adults living in residential aged care facilities (RACF) and their health outcomes worse compared to older adults living in the community. Pre-hip fracture residential status is not well recorded within hospital records, necessitating linkage of hospital and residential aged care data to better ascertain residential location pre-fracture. Aim To examine temporal trends, characteristics and health outcomes following a fall-related hip fracture hospitalisation of people living in RACFs to those living in the community. Method A retrospect

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Machowska, Anna, Mark D. Alscher, Satyanarayana Reddy Vanga, et al. "Dialysis Access, Infections, and Hospitalisations in Unplanned Dialysis Start Patients: Results from the Options Study." International Journal of Artificial Organs 40, no. 2 (2017): 48–59. http://dx.doi.org/10.5301/ijao.5000557.

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Introduction Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. Methods In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients. PD tec

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Yudi, M., N. Andrianopoulos, J. O’Brien, et al. "Predictors of Recurrent Acute Coronary Syndrome Hospitalisations and Unplanned Revascularisation Following Acute Myocardial Infarction." Heart, Lung and Circulation 25 (August 2016): S58. http://dx.doi.org/10.1016/j.hlc.2016.06.130.

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Rana, Santu, Truyen Tran, Wei Luo, Dinh Phung, Richard L. Kennedy, and Svetha Venkatesh. "Predicting unplanned readmission after myocardial infarction from routinely collected administrative hospital data." Australian Health Review 38, no. 4 (2014): 377. http://dx.doi.org/10.1071/ah14059.

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Objective Readmission rates are high following acute myocardial infarction (AMI), but risk stratification has proved difficult because known risk factors are only weakly predictive. In the present study, we applied hospital data to identify the risk of unplanned admission following AMI hospitalisations. Methods The study included 1660 consecutive AMI admissions. Predictive models were derived from 1107 randomly selected records and tested on the remaining 553 records. The electronic medical record (EMR) model was compared with a seven-factor predictive score known as the HOSPITAL score and a m

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Shannon, Brendan, Kelly-Ann Bowles, Cylie Williams, Tanya Ravipati, Elise Deighton, and Nadine Andrew. "Does a Community Care programme reach a high health need population and high users of acute care hospital services in Melbourne, Australia? An observational cohort study." BMJ Open 13, no. 9 (2023): e077195. http://dx.doi.org/10.1136/bmjopen-2023-077195.

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ObjectiveThe Community Care programme is an initiative aimed at reducing hospitalisations and emergency department (ED) presentations among patients with complex needs. We aimed to describe the characteristics of the programme participants and identify factors associated with enrolment into the programme.DesignThis observational cohort study was conducted using routinely collected data from the National Centre for Healthy Ageing data platform.SettingThe study was carried out at Peninsula Health, a health service provider serving a population in Melbourne, Victoria, Australia.ParticipantsWe inc

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Green, Mark Alan, Martin McKee, Jon Massey, et al. "Trends in inequalities in avoidable hospitalisations across the COVID-19 pandemic: a cohort study of 23.5 million people in England." BMJ Open 14, no. 1 (2024): e077948. http://dx.doi.org/10.1136/bmjopen-2023-077948.

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ObjectiveTo determine whether periods of disruption were associated with increased ‘avoidable’ hospital admissions and wider social inequalities in England.DesignObservational repeated cross-sectional study.SettingEngland (January 2019 to March 2022).ParticipantsWith the approval of NHS England we used individual-level electronic health records from OpenSAFELY, which covered ~40% of general practices in England (mean monthly population size 23.5 million people).Primary and secondary outcome measuresWe estimated crude and directly age-standardised rates for potentially preventable unplanned hos

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Garattini, Silvio Ken, Alessandro Marco Minisini, Francesca Valent, et al. "Effects of the growing prevalence in oncology: A real-world study on the estimated workload." Journal of Clinical Oncology 38, no. 15_suppl (2020): e14148-e14148. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e14148.

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e14148 Background: The increasing prevalence of cancer patients due to new effective treatments is leading to a growing demand in oncology activities, thus requiring a re-modelling towards more sustainable systems. The aim of this study is to estimate the workload generated by each new cancer patient referred to the Oncology Department of the Academic Cancer Center of Udine, Italy, within the two years from first consultation. Methods: We have utilised our electronic “Data Warehouse” accountability system to retrieve anonymous aggregate data of the 2-year oncology workload generated by each ne

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Heinsbroek, Ellen, Daniel Hungerford, Richard P. D. Cooke, et al. "Do hospital pressures change following rotavirus vaccine introduction? A retrospective database analysis in a large paediatric hospital in the UK." BMJ Open 9, no. 5 (2019): e027739. http://dx.doi.org/10.1136/bmjopen-2018-027739.

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ObjectiveHospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in ‘hospital pressures’ (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK.DesignRetrospective hospital database analysis between July 2007 and June 2015.SettingA large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK.ParticipantsHospital adm

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Congdon, Peter. "Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes." International Journal of Environmental Research and Public Health 13, no. 9 (2016): 870. http://dx.doi.org/10.3390/ijerph13090870.

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Ranasinghe, Isuru, Sadia Hossain, Anna Ali, et al. "SAFety, Effectiveness of care and Resource use among Australian Hospitals (SAFER Hospitals): a protocol for a population-wide cohort study of outcomes of hospital care." BMJ Open 10, no. 8 (2020): e035446. http://dx.doi.org/10.1136/bmjopen-2019-035446.

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IntroductionDespite global concerns about the safety and quality of health care, population-wide studies of hospital outcomes are uncommon. The SAFety, Effectiveness of care and Resource use among Australian Hospitals (SAFER Hospitals) study seeks to estimate the incidence of serious adverse events, mortality, unplanned rehospitalisations and direct costs following hospital encounters using nationwide data, and to assess the variation and trends in these outcomes.Methods and analysisSAFER Hospitals is a cohort study with retrospective and prospective components. The retrospective component use

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Kumar, Sunil, Parth Godhiwala, Amrutha Garikapati, and Shraddha Jain. "Polypill therapy and frailty in elderly: Time to stop treating everything." Asian Journal of Medical Sciences 12, no. 4 (2021): 39–42. http://dx.doi.org/10.3126/ajms.v12i4.33182.

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Background: Frailty is a reversible age-related condition of increased vulnerability and risk of death or unplanned hospitalization. Frailty and polypill therapy are common in elderly, although little is known about the impact, they may have on each other. Aims and Objective: The study was a prospective observational study, designed with an aim to observe the six-month and one-year outcomes of elderly patients on polypill therapy. Material and Methods: Three hundred forty-two patients aged more than 60 years on polypill treatment were enrolled in this study, which were on regular f

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Smith, Robert W., Kerry Kuluski, Andrew P. Costa, et al. "Investigating the effect of sociodemographic factors on 30-day hospital readmission among medical patients in Toronto, Canada: a prospective cohort study." BMJ Open 7, no. 12 (2017): e017956. http://dx.doi.org/10.1136/bmjopen-2017-017956.

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ObjectiveTo examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city.DesignProspective cohort study.Setting and participantsPatients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control. Included in the final analysis was a di

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Johnston, Jennifer, Jo Longman, Dan Ewald, Jonathan King, Sumon Das, and Megan Passey. "Study of potentially preventable hospitalisations (PPH) for chronic conditions: what proportion are preventable and what factors are associated with preventable PPH?" BMJ Open 10, no. 11 (2020): e038415. http://dx.doi.org/10.1136/bmjopen-2020-038415.

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IntroductionThe proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.SettingThree hospitals in NSW, Australia.ParticipantsCommunity-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for cong

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Searle, Ben, Robert O. Barker, Daniel Stow, Gemma F. Spiers, Fiona Pearson, and Barbara Hanratty. "Which interventions are effective at decreasing or increasing emergency department attendances or hospital admissions from long-term care facilities? A systematic review." BMJ Open 13, no. 2 (2023): e064914. http://dx.doi.org/10.1136/bmjopen-2022-064914.

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ObjectiveUK long-term care facility residents account for 185 000 emergency hospital admissions each year. Avoidance of unnecessary hospital transfers benefits residents, reduces demand on the healthcare systems but is difficult to implement. We synthesised evidence on interventions that influence unplanned hospital admissions or attendances by long-term care facility residents.MethodsThis is a systematic review of randomised controlled trials. PubMed, MEDLINE, EMBASE, ISI Web of Science, CINAHL and the Cochrane Library were searched from 2012 to 2022, building on a review published in 2013. W

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van Eijk, Jorna, Kim Luijken, Tiny Jaarsma, et al. "RELEASE-HF study: a protocol for an observational, registry-based study on the effectiveness of telemedicine in heart failure in the Netherlands." BMJ Open 14, no. 1 (2024): e078021. http://dx.doi.org/10.1136/bmjopen-2023-078021.

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IntroductionMeta-analyses show postive effects of telemedicine in heart failure (HF) management on hospitalisation, mortality and costs. However, these effects are heterogeneous due to variation in the included HF population, the telemedicine components and the quality of the comparator usual care. Still, telemedicine is gaining acceptance in HF management. The current nationwide study aims to identify (1) in which subgroup(s) of patients with HF telemedicine is (cost-)effective and (2) which components of telemedicine are most (cost-)effective.Methods and analysisThe RELEASE-HF (‘REsponsible

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Costa, Andrew P., Connie Schumacher, Aaron Jones, et al. "DIVERT-Collaboration Action Research and Evaluation (CARE) Trial Protocol: a multiprovincial pragmatic cluster randomised trial of cardiorespiratory management in home care." BMJ Open 9, no. 12 (2019): e030301. http://dx.doi.org/10.1136/bmjopen-2019-030301.

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IntroductionHome care clients are increasingly medically complex, have limited access to effective chronic disease management and have very high emergency department (ED) visitation rates. There is a need for more appropriate and targeted supportive chronic disease management for home care clients. We aim to evaluate the effectiveness and preliminary cost effectiveness of a targeted, person-centred cardiorespiratory management model.Methods and analysisThe Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) — Collaboration Action Research and Evaluation (CARE) trial is

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Harron, Katie, Francesca Cavallaro, Jan van der Meulen, Eilis Kennedy, and Ruth Gilbert. "Effects of the Family Nurse Partnership on all eligible mothers: a data linkage cohort study in England." PLOS ONE 20, no. 4 (2025): e0320810. https://doi.org/10.1371/journal.pone.0320810.

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Background An intensive programme of home visiting, the Family Nurse Partnership (FNP), is received by around one in four first-time adolescent mothers in selected areas in England. During home visits, nurses support mothers to make choices about healthy pregnancies, improving child development, and fulfilling their own aspirations and ambitions. Evidence is needed of the wider effects of the FNP, including for mothers not enrolled in the programme (who might experience unintended effects). We evaluated child and maternal outcomes for all eligible mothers giving birth before, during, and after

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Downing, Jennifer, Tanith C. Rose, Pooja Saini, et al. "Impact of a community-based cardiovascular disease service intervention in a highly deprived area." Heart 106, no. 5 (2019): 374–79. http://dx.doi.org/10.1136/heartjnl-2019-315047.

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ObjectiveTo examine the effects on emergency hospital admissions, length of stay and emergency re-admissions of providing a consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service, based in a highly deprived area in the North West of England.MethodsA longitudinal matched controlled study using difference-in-differences analysis compared the change in outcomes in the intervention population, to the change in outcomes in a matched comparison population that had not received the intervention, 5 years before and after implementation. The outcomes were emerge

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Been, Jasper V., Daniel F. Mackay, Christopher Millett, et al. "Smoke-free legislation and paediatric hospitalisations for acute respiratory tract infections: national quasi-experimental study with unexpected findings and important methodological implications." Tobacco Control 27, e2 (2017): e160-e166. http://dx.doi.org/10.1136/tobaccocontrol-2017-053801.

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ObjectivesWe investigated whether Scottish implementation of smoke-free legislation was associated with a reduction in unplanned hospitalisations or deaths (‘events’) due to respiratory tract infections (RTIs) among children.DesignInterrupted time series (ITS).Setting/participantsChildren aged 0–12 years living in Scotland during 1996–2012.InterventionNational comprehensive smoke-free legislation (March 2006).Main outcome measureAcute RTI events in the Scottish Morbidity Record-01 and/or National Records of Scotland Death Records.Results135 134 RTI events were observed over 155 million patient

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Robijn, Annelies L., Bronwyn K. Brew, Megan E. Jensen, et al. "Effect of maternal asthma exacerbations on perinatal outcomes: a population-based study." ERJ Open Research 6, no. 4 (2020): 00295–2020. http://dx.doi.org/10.1183/23120541.00295-2020.

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BackgroundAlthough there is a growing body of literature about the impact of asthma exacerbations during pregnancy on adverse perinatal outcomes, it is still unclear whether asthma exacerbations themselves or asthma severity are the driving factor for negative outcomes. This study aimed to estimate the associations between maternal asthma exacerbations and perinatal outcomes, and whether this differed by asthma treatment regime as a proxy for severity.MethodsWe included births of women with asthma in Sweden from July 2006 to November 2013 (n=33 829). Asthma exacerbations were defined as unplan

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Wilson, Andrew M., Allan B. Clark, Anthony Cahn, et al. "Co-trimoxazole to reduce mortality, transplant, or unplanned hospitalisation in people with moderate to very severe idiopathic pulmonary fibrosis: the EME-TIPAC RCT." Efficacy and Mechanism Evaluation 8, no. 9 (2021): 1–110. http://dx.doi.org/10.3310/eme08090.

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Background Idiopathic pulmonary fibrosis is an irreversible fibrosing lung disorder with a poor prognosis. Current treatments slow the rate of decline in lung function and may influence survival, but they have a significant side-effect profile and so additional therapeutic options are required. People with idiopathic pulmonary fibrosis have altered innate immunity and altered lung microbiota, with the bacterial burden relating to mortality. Two randomised controlled trials have demonstrated beneficial effects with co-trimoxazole (SEPTRIN®; Essential Generics Ltd, Egham, UK; Chemidex Generics L

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Walsh, Timothy Simon, Ellen Pauley, Eddie Donaghy, et al. "Does a screening checklist for complex health and social care needs have potential clinical usefulness for predicting unplanned hospital readmissions in intensive care survivors: development and prospective cohort study." BMJ Open 12, no. 3 (2022): e056524. http://dx.doi.org/10.1136/bmjopen-2021-056524.

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ObjectivesIntensive care (ICU) survivors are at high risk of long-term physical and psychosocial problems. Unplanned hospital readmission rates are high, but the best way to triage patients for interventions is uncertain. We aimed to develop and evaluate a screening checklist to help predict subsequent readmissions or deaths.DesignA checklist for complex health and social care needs (CHSCNs) was developed based on previous research, comprising six items: multimorbidity; polypharmacy; frequent previous hospitalisations; mental health issues; fragile social circumstances and impaired activities

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Previsdomini, Marco, Andreas Perren, Alessandro Chiesa, et al. "Changes in diagnostic patterns and resource utilisation in Swiss adult ICUs during the first two COVID-19 waves: an exploratory study." Swiss Medical Weekly 154, no. 2 (2024): 3589. http://dx.doi.org/10.57187/s.3589.

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BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) outbreak deeply affected intensive care units (ICUs). We aimed to explore the main changes in the distribution and characteristics of Swiss ICU patients during the first two COVID-19 waves and to relate these figures with those of the preceding two years. METHODS: Using the national ICU registry, we conducted an exploratory study to assess the number of ICU admissions in Switzerland and their changes over time, characteristics of the admissions, the length of stay (LOS) and its trend over time, ICU mortality and changes in therapeutic

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Taylor, Monica L., Emma E. Thomas, Centaine L. Snoswell, Anthony C. Smith, and Liam J. Caffery. "Does remote patient monitoring reduce acute care use? A systematic review." BMJ Open 11, no. 3 (2021): e040232. http://dx.doi.org/10.1136/bmjopen-2020-040232.

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ObjectiveChronic diseases are associated with increased unplanned acute hospital use. Remote patient monitoring (RPM) can detect disease exacerbations and facilitate proactive management, possibly reducing expensive acute hospital usage. Current evidence examining RPM and acute care use mainly involves heart failure and omits automated invasive monitoring. This study aimed to determine if RPM reduces acute hospital use.MethodsA systematic literature review of PubMed, Embase and CINAHL electronic databases was undertaken in July 2019 and updated in October 2020 for studies published from Januar

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Pound, Catherine M., Jaime McDonald, Ken Tang, et al. "Dexamethasone versus prednisone for children receiving asthma treatment in the paediatric inpatient population: protocol for a feasibility randomised controlled trial." BMJ Open 8, no. 12 (2018): e025630. http://dx.doi.org/10.1136/bmjopen-2018-025630.

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IntroductionAsthma exacerbations are a leading cause of paediatric hospitalisations. Corticosteroids are key in the treatment of asthma exacerbations. Most current corticosteroids treatment regimens for children admitted with asthma exacerbation consist of a 5-day course of prednisone or prednisolone. However, these medications are associated with poor taste and significant vomiting, resulting in poor compliance with the treatment course. While some centres already use a short course of dexamethasone for treating children hospitalised with asthma, there is no evidence to support this practice

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Pereira, Filipa, Carla Meyer-Massetti, María del Río Carral, Armin von Gunten, Boris Wernli, and Henk Verloo. "Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study." BMJ Open 13, no. 9 (2023): e072738. http://dx.doi.org/10.1136/bmjopen-2023-072738.

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ObjectiveThis study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management and prevent adverse health outcomes associated with medication-related problems (MRPs).DesignExplanatory, sequential, mixed methods study based on detailed quantitative and qualitative findings reported previously.SettingHospital and community healthcare in the French-speaking part of Switzerland.ParticipantsThe quantitative strand retrospectively examined 3

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Beckman, Adam L., Maike Tietschert, Andrew Old, E. John Orav, Sara J. Singer, and Jose F. Figueroa. "High-performing primary care clinics across high-need, high-cost Medicare populations." BMJ Open Quality 12, no. 3 (2023): e002271. http://dx.doi.org/10.1136/bmjoq-2023-002271.

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BackgroundTo reduce spending and improve quality, some primary care clinics in the USA have focused on high-need, high-cost (HNHC) Medicare beneficiaries, which include clinically distinct subpopulations: older adults with frailty, adults under 65 years with disability and beneficiaries with major complex chronic conditions. Nationally, the extent to which primary care clinics are high-performing ‘Bright Spots’—clinics that achieve favourable outcomes at lower costs across HNHC beneficiary subpopulations—is not known.ObjectiveTo determine the prevalence of primary care clinics that perform hig

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Koehler, Friedrich, Kerstin Koehler, Oliver Deckwart, et al. "Telemedical Interventional Management in Heart Failure II (TIM-HF2), a randomised, controlled trial investigating the impact of telemedicine on unplanned cardiovascular hospitalisations and mortality in heart failure patients: study design and description." European Journal of Heart Failure 20, no. 10 (2018): 1485–93. http://dx.doi.org/10.1002/ejhf.1300.

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Holland, Anne E., Arwel W. Jones, Ajay Mahal, et al. "Implementing a choice of pulmonary rehabilitation models in chronic obstructive pulmonary disease (HomeBase2 trial): protocol for a cluster randomised controlled trial." BMJ Open 12, no. 4 (2022): e057311. http://dx.doi.org/10.1136/bmjopen-2021-057311.

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IntroductionThere is compelling evidence that either centre-based or home-based pulmonary rehabilitation improves clinical outcomes in chronic obstructive pulmonary disease (COPD). There are known health service and personal barriers which prevent potentially eligible patients from accessing the benefits of pulmonary rehabilitation. The aim of this hybrid effectiveness-implementation trial is to examine the effects of offering patients a choice of pulmonary rehabilitation locations (home or centre) compared with offering only the traditional centre-based model.Method and analysisThis is a two-

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Archambault, P. M., H. Vaillancourt, V. Drouin, et al. "P009: Improving elderly care transitions through the local adaptation and implementation of the Acute Care for Elderly (ACE) program." CJEM 19, S1 (2017): S80. http://dx.doi.org/10.1017/cem.2017.211.

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Introduction: Decreasing readmission rates and return emergency department (ED) visits represent a major challenge for health organizations. Seniors are especially vulnerable to discharge adverse events which can result in unplanned readmissions and loss of physical, functional and/or cognitive capacity. The ACE Collaborative is a national quality improvement initiative that aims to improve care of elderly patients. We aimed to adapt Mount Sinai’s Care Transitions program to our local context in order to decrease avoidable readmissions and ED visits among seniors. Methods: We performed a prosp

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Kessler, Romain, Pere Casan-Clara, Dieter Koehler, et al. "COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD." European Respiratory Journal 51, no. 1 (2018): 1701612. http://dx.doi.org/10.1183/13993003.01612-2017.

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The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned

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Kwok, Chun Shing, Mary Norine Walsh, Annabelle Volgman, et al. "Discharge against medical advice after hospitalisation for acute myocardial infarction." Heart 105, no. 4 (2018): 315–21. http://dx.doi.org/10.1136/heartjnl-2018-313671.

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BackgroundDischarge against medical advice (AMA) occurs infrequently but is associated with poor outcomes. There are limited descriptions of discharges AMA in national cohorts of patients with acute myocardial infarction (AMI). This study aims to evaluate discharge AMA in AMI and how it affects readmissions.MethodsWe conducted a cohort study of patients with AMI in USA in the Nationwide Readmission Database who were admitted between the years 2010 and 2014. Descriptive statistics were presented for variables according to discharge home or AMA. The primary end point was all-cause 30-day unplann

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Tamisier, Renaud, Thibaud Damy, Jean-Marc Davy, et al. "Cohort profile: FACE, prospective follow-up of chronic heart failure patients with sleep-disordered breathing indicated for adaptive servo ventilation." BMJ Open 10, no. 7 (2020): e038403. http://dx.doi.org/10.1136/bmjopen-2020-038403.

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PurposeFACE is a prospective cohort study designed to assess the effect of adding adaptive servoventilation (ASV) to standard care on morbidity and mortality in patients with chronic heart failure (HF) with preserved (HFpEF), mid-range (HFmrEF) or reduced ejection fraction (HFrEF) who have sleep-disordered breathing (SDB) with an indication for ASV. We describe the study design, ongoing data collection and baseline participant characteristics.ParticipantsConsecutive patients with HFpEF, HFmrEF or HFrEF plus SDB with central sleep apnoea (CSA) and indication for ASV were enrolled in the study c

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Maitin-Casalis, N., T. Neeman, and A. Thomson. "Protective effect of advanced age on post-ERCP pancreatitis and unplanned hospitalisation." Internal Medicine Journal 45, no. 10 (2015): 1020–25. http://dx.doi.org/10.1111/imj.12844.

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Downs, Murna, Alan Blighe, Robin Carpenter, et al. "A complex intervention to reduce avoidable hospital admissions in nursing homes: a research programme including the BHiRCH-NH pilot cluster RCT." Programme Grants for Applied Research 9, no. 2 (2021): 1–200. http://dx.doi.org/10.3310/pgfar09020.

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Background An unplanned hospital admission of a nursing home resident distresses the person, their family and nursing home staff, and is costly to the NHS. Improving health care in care homes, including early detection of residents’ health changes, may reduce hospital admissions. Previously, we identified four conditions associated with avoidable hospital admissions. We noted promising ‘within-home’ complex interventions including care pathways, knowledge and skills enhancement, and implementation support. Objectives Develop a complex intervention with implementation support [the Better Health

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