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Journal of the American Heart... Jul 2020
Topics: Diuretics; Heart Failure; Humans; Outpatients
PubMed: 32662304
DOI: 10.1161/JAHA.120.017485 -
Journal of Healthcare Engineering 2021In order to study the construction method of long- and short-term memory neural network model, which is based on particle swarm optimization algorithm and its...
In order to study the construction method of long- and short-term memory neural network model, which is based on particle swarm optimization algorithm and its application in hospital outpatient management, we have selected historical data of outpatient volume of relevant departments in our hospital. Furthermore, we have designed and developed the outpatient volume prediction model, which is based on long- and short-term memory neural network. Additionally, we have used particle swarm optimization algorithm (PSO) to optimize various parameters of long- and short-term memory network and then utilized this optimized model to accurately predict the outpatient volume. Experimental observations, which are collected through the results of monthly outpatient volume prediction, show that Root Mean Square Error (RMSE) of the particle swarm optimized LTMN model on the test set is reduced by 48.5% compared with the unoptimized model. The particle swarm optimization algorithm has efficiently optimized the prediction model, which makes the model better predict the trend of outpatient volume and thus provide decision support for medical staff's outpatient management.
Topics: Algorithms; Humans; Neural Networks, Computer; Outpatients
PubMed: 34868529
DOI: 10.1155/2021/7246561 -
Psychotherapy and Psychosomatics 2023Treatment non-response occurs regularly, but psychotherapy is seldom examined for such patients. Existing studies targeted single diagnoses, were relatively small, and...
INTRODUCTION
Treatment non-response occurs regularly, but psychotherapy is seldom examined for such patients. Existing studies targeted single diagnoses, were relatively small, and paid little attention to treatment under real-world conditions.
OBJECTIVE
The Choose Change trial tested whether psychotherapy was effective in treating chronic patients with treatment non-response in a transdiagnostic sample of common mental disorders across two variants of treatment delivery (inpatient and outpatient).
METHODS
The controlled nonrandomized effectiveness trial was conducted between May 2016 and May 2021. The study took place in two psychiatric clinics with N = 200 patients (n = 108 inpatients and n = 92 outpatients). Treatment variants were integrated inpatient care versus outpatient care based on acceptance and commitment therapy (ACT) for approximately 12 weeks. Therapists delivered individualized and non-manualized ACT. Main outcome measures were symptoms (Brief Symptom Checklist [BSCL]); well-being (Mental Health Continuum-Short Form [MHC-SF]), and functioning (WHO Disability Assessment Schedule [WHO-DAS]).
RESULTS
Both inpatients and outpatients showed decreases in symptomatology (i.e., BSCL: d = 0.68) and increases in well-being and functioning (MHC-SF: d = 0.60 and WHO-DAS: d = 0.70), with more improvement in the inpatients during treatment. Both groups maintained gains 1 year following treatment, and the groups did not significantly differ from each other at this timepoint. Psychological flexibility moderated impact of stress on outcomes.
CONCLUSIONS
Psychotherapy as practiced under routine conditions is effective for a sample of patients with common mental disorders, a long history of treatment experience and burden of disease, in both inpatient and outpatient settings.
TRIAL REGISTRATION
This study was registered in the ISRCTN registry on May 20, 2016, with the registration number ISRCTN11209732.
Topics: Humans; Outpatients; Acceptance and Commitment Therapy; Psychotherapy; Mental Disorders; Ambulatory Care; Treatment Outcome
PubMed: 37023742
DOI: 10.1159/000529411 -
Circulation Journal : Official Journal... Nov 2022
Topics: Humans; Cardiac Rehabilitation; Outpatients; Heart Diseases; Ambulatory Care
PubMed: 35858824
DOI: 10.1253/circj.CJ-22-0375 -
The American Journal of Cardiology Oct 2023
Topics: Humans; Outpatients; Syncope; Hospitals
PubMed: 37659867
DOI: 10.1016/j.amjcard.2023.08.025 -
Soins. Pediatrie, Puericulture 2022Adolescence is a pivotal period in the construction of identity. The individuation process at stake creates a fragile context. However, the quality of this process is... (Review)
Review
Adolescence is a pivotal period in the construction of identity. The individuation process at stake creates a fragile context. However, the quality of this process is what determines the development of the young adult. In this perspective, this period of life is often described as a time of rupture, of great reorganisation. When an acute psychiatric crisis occurs at the heart of this complex movement, the Consultado system intervenes. This meeting between the care provider, the young person and his or her family constitutes a time that is both singular and central, set in a short time frame.
Topics: Adolescent; Female; Humans; Male; Outpatients
PubMed: 35902152
DOI: 10.1016/j.spp.2022.03.010 -
The International Journal of Health... Jul 2022In this study, we explored the strategies and suggestions for the outpatient diversion system of large hospitals in Chinese underdeveloped areas of primary medical care,...
In this study, we explored the strategies and suggestions for the outpatient diversion system of large hospitals in Chinese underdeveloped areas of primary medical care, under the consideration of balancing patients' intention and compliance with the referral system. An empirical study was conducted on the relationship among medical need, visiting intention and health-seeking behaviour to verify the effect of intention-system mixed outpatient diversion mode in China's large hospitals. Examination of the demographic characteristics, insurance, and residence information revealed that outpatients could be divided into three categories before the application of the referral system. Then, due to the implementation of the referral system, the willingness of some patients to seek medical treatment has changed. Consequently, the service path for outpatients could be consolidated into two categories with differentiated behavioural characteristics, which were respectively driven by personal intention and service system. According to the utility value intervention of the referral system for outpatient seeking behaviour, some measures and strategies can be explored to build a new system that combines personal connotation and system utility to realise the effective distribution and management of outpatients in large hospitals in Chinese underdeveloped areas.
Topics: China; Hospitals; Humans; Intention; Outpatients; Referral and Consultation
PubMed: 35212026
DOI: 10.1002/hpm.3436 -
The New Zealand Medical Journal Jun 2021A capacity and demand improvement initiative commenced in January 2019 with the goal of reducing the growing outpatient waiting list for magnetic resonance imaging (MRI)...
INTRODUCTION
A capacity and demand improvement initiative commenced in January 2019 with the goal of reducing the growing outpatient waiting list for magnetic resonance imaging (MRI) at Counties Manukau District Health Board (CMDHB). Initial work showed that the capacity (MRI machines and staff) actually outstripped demand, which challenged pre-existing assumptions. This became the basis for interventions to improve efficiency in the department. Interventions undertaken can be split into three distinct categories: (1) matching capacity to demand, (2) waiting list segmentation and (3) redesigning operational systems.
METHODS
A capacity and demand time series during 2019 and 2020 was used as the basis for improving waiting list and operational systems. A combination of the Model for Improvement and Lean principles were used to embed operational improvements. Multiple small tests of change were implemented to various aspects of the MRI waiting list process. Staff engagement was central to the success of the quality improvement (QI) initiatives. The radiological information system (RIS) provided the bulk of the data, and this was supplemented with manual data collection.
RESULTS
The number of people waiting for an MRI scan decreased from 1,954 at the start of the project to 413 at its conclusion-an overall reduction of 75%. Moreover, the average waiting time reduced from 96.4 days to 23.1. Achieving the Ministry of Health's (MoH) Priority 2 (P2) target increased from 23% to 87.5%.
CONCLUSION
A partnership between Ko Awatea and the radiology department at CMDHB, examining capacity and demand for MRI and using multiple QI techniques, successfully and sustainably reduced the MRI waiting list over a two-year period. The innovative solutions to match capacity to demand may be instructive for other radiology departments, and other waiting list scenarios.
Topics: Diagnostic Imaging; Efficiency, Organizational; Health Services Needs and Demand; Humans; Magnetic Resonance Imaging; National Health Programs; New Zealand; Outpatients; Quality Improvement; Waiting Lists; Workload
PubMed: 34239159
DOI: No ID Found -
Infection Control and Hospital... Jul 2020Antimicrobial misuse is still a significant problem, and most inappropriate use occurs in the outpatient setting. In this article, we provide a review of available... (Review)
Review
Antimicrobial misuse is still a significant problem, and most inappropriate use occurs in the outpatient setting. In this article, we provide a review of available literature on outpatient antimicrobial stewardship in primary care settings, and we propose a novel implementation framework.
Topics: Anti-Infective Agents; Antimicrobial Stewardship; Humans; Outpatients
PubMed: 32342826
DOI: 10.1017/ice.2020.94 -
BMC Health Services Research May 2021The level of outpatient satisfaction plays a significant role in improving the quality and utilization of healthcare services. Patient satisfaction gives providers...
BACKGROUND
The level of outpatient satisfaction plays a significant role in improving the quality and utilization of healthcare services. Patient satisfaction gives providers insights into various aspects of services including the effectiveness of care and level of empathy. This study aimed to evaluate the level of patient satisfaction in the outpatient department and to explore its influencing factors in large hospitals (accommodating over 1000 beds) of Henan province, China.
METHODS
We analyzed data from Henan Large Hospitals Patient Satisfaction Survey conducted in the year 2018 and included 630 outpatients. Structural Equation Model (SEM) was used to explore the relationship among evaluation indicators of outpatient satisfaction levels. We used Dynamic Matter-Element Analysis (DMA) to evaluate the status of outpatient satisfaction. Binary Logistic Regression (BLR) was adopted to estimate the impact of personal characteristics towards outpatient satisfaction.
RESULTS
The overall score for outpatient satisfaction in large hospitals was 66.28±14.73. The mean outpatient satisfaction scores for normal-large, medium-large, and extra-large hospitals were 63.33±12.12, 70.11±16.10, 65.41±14.67, respectively, and were significantly different (F = 11.953, P < 0.001). Waiting time, doctor-patient communication, professional services, and accessibility for treatment information were shown to have directly positive correlations with outpatient satisfaction (r = 0.42, 0.47, 0.55, 0.46, all P < 0.05). Results from BLR analysis revealed that patients' age and frequency of hospital visits were the main characteristics influencing outpatient satisfaction (P < 0.05).
CONCLUSIONS
The outpatient satisfaction of large hospitals is moderately low. Hospital managers could shorten the waiting time for outpatients and improve the access to treatment information to improve the satisfaction of outpatients. It is also necessary to enhance service provision for outpatients under the age of 18 as well as the first-time patients.
Topics: China; Hospitals; Humans; Outpatients; Patient Satisfaction; Personal Satisfaction
PubMed: 34034724
DOI: 10.1186/s12913-021-06520-2