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Current Pain and Headache Reports Aug 2020Headaches are not only responsible for restrictions in everyday life in adults. In children and adolescents, regular headaches lead also to reduced life quality and... (Review)
Review
PURPOSE OF REVIEW
Headaches are not only responsible for restrictions in everyday life in adults. In children and adolescents, regular headaches lead also to reduced life quality and limitations in the social sphere, in school education, and in professional careers. Here, we provide an overview on the frequency of headache in children and adolescents with the aim of increasing awareness about this particular health issue.
RECENT FINDINGS
Overall, headache prevalence in children and adolescents has been increasing in recent years. From various regions worldwide, data describing headache, its forms, and consequences are growing. In addition, factors frequently correlated with headache are repeatedly investigated and named: besides genetic factors, psychosocial and behavioral factors are linked to the prevalence of headache. Increasing evidence indicates that headache is underestimated as a common disorder in children and adolescents. Accordingly, too little emphasis is placed by society on its prevention and treatment. Thus, the extent of the social and health economic burden of frequent headaches in children and adolescents needs to be better illustrated, worldwide. Furthermore, the data collected in this review should support the efforts to improve outpatient therapy paths for young headache patients. Factors correlating with headache in pupils can draw our attention to unmet needs of these patients and allow physicians to derive important therapy contents from this data.
Topics: Adolescent; Child; Headache; Humans; Outpatients; Prevalence; Quality of Life; Surveys and Questionnaires
PubMed: 32840694
DOI: 10.1007/s11916-020-00892-6 -
BMJ Open Sep 2021Patient satisfaction is an important indicator of hospital healthcare quality. Little up-to-date information of patient satisfaction in China is available. This study...
OBJECTIVES
Patient satisfaction is an important indicator of hospital healthcare quality. Little up-to-date information of patient satisfaction in China is available. This study attempts to gain a holistic understanding of patient satisfaction in China and identify the key antecedents of patient satisfaction.
DESIGN
A cross-sectional national survey was conducted in 2018.
SETTING
Hospitals in 27 provinces and 4 municipalities in 4 regions of China.
PARTICIPANTS
A random sample of 15 699 patients who visited 1304 hospitals were surveyed, with around 500 from each of the 27 provinces and 4 municipalities.
PRIMARY AND SECONDARY OUTCOME MEASURES
The Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire was used to measure patients' overall satisfaction and willingness to recommend the hospital.
RESULTS
We found significant variation in overall patient satisfaction but little variation in hospital recommendation across the four broad regions. Moreover, we examined determinants of patient satisfaction and their likelihood to recommend the hospital. The overall satisfaction for inpatients and outpatients is commonly influenced by communication with doctors (inpatient: β=0.524, p<0.001; outpatient: β=0.541, p<0.001), hospital cleanness (inpatient: β=0.165, p<0.05; outpatient: β=0.144, p<0.001) and acceptable charges (inpatient: β=1.481, p<0.001; outpatient: β=1.045, p<0.001). Both inpatients and outpatients are more likely to recommend the hospital if there are communication with doctors (inpatient: OR=1.743, p<0.001; outpatient: OR=1.647, p<0.001), acceptable charges (inpatient: OR=2.660, p<0.001; outpatient: OR=2.433, p<0.001). Outpatient satisfaction and hospital recommendation are also influenced by time spent with doctors (satisfaction: β=0.301, p<0.001; recommend: OR=1.430, p<0.001) and waiting time (satisfaction: β=-0.318, p<0.001; recommend: OR=0.844, p<0.001).
CONCLUSIONS
There are regional differences of patient satisfaction in China. Patient satisfaction is influenced by a variety of hospital factors and province/municipality factors. The influencing factors of patient satisfaction may not motivate patients to recommend the hospital.
Topics: China; Cross-Sectional Studies; Humans; Inpatients; Outpatients; Patient Satisfaction; Surveys and Questionnaires
PubMed: 34493518
DOI: 10.1136/bmjopen-2021-049570 -
American Family Physician Dec 2020Approximately 1% of primary care office visits are for chest pain, and 2% to 4% of these patients will have unstable angina or myocardial infarction. Initial evaluation...
Approximately 1% of primary care office visits are for chest pain, and 2% to 4% of these patients will have unstable angina or myocardial infarction. Initial evaluation is based on determining whether the patient needs to be referred to a higher level of care to rule out acute coronary syndrome (ACS). A combination of age, sex, and type of chest pain can predict the likelihood of coronary artery disease as the cause of chest pain. The Marburg Heart Score and the INTERCHEST clinical decision rule can also help estimate ACS risk. Twelve-lead electrocardiography is recommended to look for ST segment changes, new-onset left bundle branch block, presence of Q waves, and new T-wave inversions. Patients with suspicion of ACS or changes on electrocardiography should be transported immediately to the emergency department. Those at low or intermediate risk of ACS can undergo exercise stress testing, coronary computed tomography angiography, or cardiac magnetic resonance imaging. In those with low suspicion for ACS, consider other diagnoses such as chest wall pain or costochondritis, gastroesophageal reflux disease, and panic disorder or anxiety states. Other less common, but important, diagnostic considerations include acute pericarditis, pneumonia, heart failure, pulmonary embolism, and acute thoracic aortic dissection.
Topics: Acute Coronary Syndrome; Chest Pain; Coronary Angiography; Electrocardiography; Exercise Test; Female; Humans; Male; Myocardial Infarction; Outpatients; Risk Assessment
PubMed: 33320506
DOI: No ID Found -
International Journal of Environmental... Sep 2019Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is...
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician's behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach's Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the health care services, and whether or not the physician's behavior moderates the link of patient satisfaction and healthcare services. SPSS Hayes process was used for the moderation effect of the physician's behavior. The main results of the regression analysis validate that health care services, such as laboratory and diagnostic care, preventive healthcare, and prenatal care, have a significant and positive effect on patient satisfaction. Specifically, the study suggests that the physician's behavior significantly moderates the effect of health care services on the satisfaction of patients. The overall opinions about the satisfaction level of patients for the availability of health services in the hospitals were good. The degree of satisfaction was satisfactory with respect to laboratory and diagnostic care, preventive healthcare, and prenatal care services. Based on the outcomes, the study confirms that the proposed hypotheses are statistically significant. Furthermore, the directions for future research of the study are offered.
Topics: Adult; Aged; Aged, 80 and over; Female; Health Services; Hospitals, Public; Humans; Male; Middle Aged; Outpatients; Pakistan; Patient Satisfaction; Physicians; Young Adult
PubMed: 31505840
DOI: 10.3390/ijerph16183318 -
Urologie (Heidelberg, Germany) Aug 2022Over the past 30 years, outpatient surgery has developed into an indispensable pillar of patient care in Germany, without its full potential coming to light. (Review)
Review
BACKGROUND
Over the past 30 years, outpatient surgery has developed into an indispensable pillar of patient care in Germany, without its full potential coming to light.
QUESTION
What are the reasons for the stagnation of further development of outpatient surgery and its suboptimal status quo?
MATERIALS AND METHODS
Presentation and comparison of outpatient surgery numbers from clinics and practices, and a critical analysis of their development.
RESULTS
After reaching a maximum number of outpatient operations in practices and clinics in 2015, there has been a location-independent decrease and stagnation due to underfunding of outpatient surgical structures and a shortage of resources.
CONCLUSION
Outpatient surgery represents a patient-friendly and cost-effective alternative to inpatient interventions, provided that that medical and social indications rule out an increased risk. The expansion of outpatient surgery has so far provided relieve to the cost-intensive hospital sector and-in view of the shortage of nurses and physicians-will do so to an even greater extent as soon as politicians and payers commit to remuneration that is performance-related and actually covers the costs. Furthermore, the future of the healthcare system also depends on the future of outpatient surgery, which is to be assessed as positive.
Topics: Ambulatory Surgical Procedures; Cost-Benefit Analysis; Germany; Hospital Costs; Humans; Outpatients
PubMed: 35925293
DOI: 10.1007/s00120-022-01878-5 -
Chirurgie (Heidelberg, Germany) Mar 2023Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite... (Review)
Review
Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite the announced political willingness and the increasing pressure from the legislator to avoid costly inpatient treatment by carrying out as many outpatient operations as possible, outpatient treatment has so far played a subordinate role in the DACH region. The Boards of the specialist societies the German Hernia Society (DHG), the Surgical Working Group Hernia (CAH of the DHG), the Austrian Hernia Society (ÖHG) and the Swiss Working Group Hernia Surgery (SAHC) make inroads into this problem, describe the initial position and assess the current situation.
Topics: Humans; Hernia, Inguinal; Outpatients; Germany; Herniorrhaphy
PubMed: 36786812
DOI: 10.1007/s00104-023-01818-9 -
Frontiers in Endocrinology 2023With the development of medical care, the safety of thyroidectomy is improving year by year. Due to economic benefits and other advantages of the overnight and... (Review)
Review
With the development of medical care, the safety of thyroidectomy is improving year by year. Due to economic benefits and other advantages of the overnight and outpatient thyroidectomy, more and more patients and medical institutions have favored overnight and outpatient thyroidectomy, and its proportion in thyroidectomy has increased year by year. However, overnight and outpatient thyroidectomy still faces many challenges and remains to be improved. In this review, we focused on the recent progress and the relevant clinical features of overnight and outpatient thyroidectomy, including its safety, economic benefits, etc., which may bring valuable clues and information for further improvements of patient benefits and promotions of overnight or outpatient thyroidectomy in the future.
Topics: Humans; Thyroidectomy; Outpatients
PubMed: 37091845
DOI: 10.3389/fendo.2023.1110038 -
Deutsches Arzteblatt International May 2022
Topics: Ambulatory Care; Humans; Neoplasms; Outpatients; Palliative Care
PubMed: 35971253
DOI: 10.3238/arztebl.m2022.0192 -
Annals of Internal Medicine Apr 2022This article summarizes the ACP/ COVID-19 Forum VIII held on 9 February 2022.
This article summarizes the ACP/ COVID-19 Forum VIII held on 9 February 2022.
Topics: Ambulatory Care; COVID-19; Humans; Outpatients; SARS-CoV-2
PubMed: 35157494
DOI: 10.7326/M22-0403 -
Journal of Orthopaedic Surgery and... Sep 2023Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and safety of outpatient versus home-based rehabilitation persists.
METHODS
A thorough literature review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across four databases. Two researchers independently identified eligible studies centering on knee arthroplasty patients undergoing either outpatient or home-based rehabilitation. Study quality was assessed using the Cochrane Collaboration's risk of bias tool, while continuous outcomes were subject to meta-analyses using Stata 17 software.
RESULTS
Our analysis identified no significant differences in primary outcomes, including Range of Motion, Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, and the Knee Society Score, between home-based and outpatient rehabilitation across different follow-up points. Adverse reactions, readmission rates, the need for manipulation under anesthesia, reoperation rate, and post-surgery complications were also similar between both groups. Home-based rehabilitation demonstrated cost-effectiveness, resulting in substantial annual savings. Furthermore, quality of life and patient satisfaction were found to be comparable in both rehabilitation methods.
CONCLUSIONS
Home-based rehabilitation post-knee arthroplasty appears as an effective, safe, and cost-efficient alternative to outpatient rehabilitation. Despite these findings, further multicenter, long-term randomized controlled trials are required to validate these findings and provide robust evidence to inform early rehabilitation choices post-knee arthroplasty.
Topics: Humans; Outpatients; Arthroplasty, Replacement, Knee; Quality of Life; Knee Joint; Anesthesia; Multicenter Studies as Topic
PubMed: 37726800
DOI: 10.1186/s13018-023-04160-2