Hospital practice (1995)最新文献

{"title":"Patient outcomes after interhospital transfer: the impact of early intensive care unit upgrade.","authors":"Saqib H Baig, James D Lee, Erika J Yoo","doi":"10.1080/21548331.2025.2470107","DOIUrl":"10.1080/21548331.2025.2470107","url":null,"abstract":"<p><strong>Background: </strong>There is little known about the prevalence and outcomes of medical patients requiring early intensive care unit upgrade (EIU) following interhospital transfer, and previous studies of EIU focus on patients admitted through the emergency room. We aimed to examine the characteristics and risk factors for poor outcome among medical patients undergoing EIU after interhospital transfer.</p><p><strong>Materials and methods: </strong>The publicly available Medical Information Mart for Intensive Care (MIMIC) IV database (2008-2019) was queried to identify non-surgical patients undergoing interhospital transfer. Patients who subsequently underwent EIU, defined as ICU admission within 24 hours of arrival after interhospital transfer, were compared to those who did not experience EIU for differences in mortality and length-of-stay (LOS.) We used multivariate logistic regression to identify risk factors for hospital death in this population and negative binomial regression to estimate the impact of EIU on hospital LOS.</p><p><strong>Results: </strong>We identified 5,619 patients who underwent interhospital transfer, of which 339 (6.0%) experienced EIU and 5280 (94.0%) did not. Patients undergoing EIU after interhospital transfer were significantly older (median age 69 vs. 64 years; <i>p</i> = 0.001,) but there was no difference in sex. After risk-adjustment, we found an association between EIU and a higher risk of mortality (aOR 6.9, 95%CI 5.24-9.08). Increased comorbidity burden as measured by Charlson Comorbidity Index (CCI) was linked to higher odds of death (aOR 1.26, 95% CI 1.22-1.31,) as was nonwhite race (aOR 1.69, 95% CI 1.34-2.14). EIU was associated with a longer hospital LOS (IRR 1.40, 95%CI 1.28-1.54).</p><p><strong>Conclusion: </strong>EIU after interhospital transfer is associated with higher mortality and longer LOS. Further study will help identify process features of transfer and patient characteristics contributing to poor outcome after arrival from an outlying facility and guide efforts to mitigate risk and provide equitable care across the transfer continuum.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2470107"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified infusion of recombinant tissue plasminogen activator in high-risk pulmonary thromboembolism with high bleeding risk: a case report.","authors":"Mohammad Hussein Hasin, Mostafa Ahmadi, Vafa Baradaran Rahimi, Bahram Shahri, Asal Yadollahi","doi":"10.1080/21548331.2024.2433934","DOIUrl":"10.1080/21548331.2024.2433934","url":null,"abstract":"<p><p>High-risk pulmonary thromboembolism (PTE) is a form of venous thromboembolism that refers to severe obstruction of pulmonary vessels, which causes right ventricular failure and hemodynamic instability. High-risk PTE has a high mortality rate unless immediate reperfusion treatment is done. Systemic thrombolysis is recommended for patients with high-risk PTE. The approved regimen for high-risk PTE is the accelerated intravenous administration of recombinant tissue-type plasminogen activator (rtPA) 100 mg over 2 hours. Herein, we present a case of high-risk PTE in a 74-year-old woman with a high risk of bleeding due to a recent pelvic fracture and head trauma who was successfully treated with a slower infusion of 100 mg rtPA over 4 hours. The modified infusion rate of 100 mg rtPA over 4 hours is an effective regimen for thrombolysis in acute high-risk PTE. It might have a lower risk of bleeding complications, which makes it a good option for patients with high bleeding risk.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2433934"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient complications and mortality in cirrhotic patients undergoing bariatric surgery: a comprehensive analysis.","authors":"Eun Seo Kwak, Abdulmajeed Alharbi, Ahmad Bosaily, Anas Alsughayer, Amna Igbal, Oscar Salichs, Sadik Khuder, Matthew Fourman, Ragheb Assaly","doi":"10.1080/21548331.2025.2455921","DOIUrl":"10.1080/21548331.2025.2455921","url":null,"abstract":"<p><strong>Introduction: </strong>Liver cirrhosis, a complex and progressive disease, imposes a significant global health burden, characterized by irreversible liver tissue scarring and various life-threatening complications. Traditionally linked to factors like chronic alcohol consumption and viral hepatitis infections, the rising prevalence of obesity introduces a new dimension to its etiology. As obesity rates continue to climb worldwide, the confluence of liver cirrhosis and bariatric surgery has become an increasingly pertinent and clinically relevant topic of inquiry.</p><p><strong>Methods: </strong>In this study, we aimed to investigate the impact of liver cirrhosis on patients who underwent bariatric surgery, using data from the 2020 National Inpatient Sample (NIS) database. We compared the outcomes of 82,414 patients who had bariatric surgery, stratifying them based on the presence or absence of liver cirrhosis. We assessed baseline demographic characteristics and comorbidities, in-hospital outcomes, and complications related to the surgery.</p><p><strong>Results: </strong>Patients with liver cirrhosis who underwent bariatric surgery demonstrated several distinct trends. On average, they were older (mean age 63 years) and predominantly female (52%) compared to those without cirrhosis (mean age 52, 71% female). Furthermore, comorbidities such as hypertension, diabetes with chronic complications, and alcohol abuse were more prevalent in the cirrhosis group. In terms of outcomes, patients with liver cirrhosis faced significantly higher inpatient mortality rates (4%) compared to those without cirrhosis (1%) with <i>p</i> < 0.001. They also experienced a notably longer average length of hospital stay (2.35 days longer, 95% CI: -3.46 --1.25, <i>p</i> < 0.001) and incurred higher hospitalization costs (add AOR and <i>p</i> value here). Additionally, patients with cirrhosis had increased odds of experiencing acute heart failure (adjusted odds ratio: 1.87, 95% CI: 1.14-2.57, <i>p</i> = 0.01) and requiring blood transfusions (adjusted odds ratio: 1.71,95% CI: 1.13-3.09, <i>p</i> = 0.009). Although the adjusted odds ratio for inpatient mortality was higher in cirrhosis patients (1.58, 95% CI: 0.76-3.30, <i>p</i> = 0.21), it did not reach statistical significance.</p><p><strong>Conclusion: </strong>This study highlights the substantial impact of liver cirrhosis on post-bariatric surgery outcomes. Patients with cirrhosis who undergo bariatric surgery face higher inpatient mortality rates and a greater risk of complications, particularly acute heart failure and the need for blood transfusions. The longer hospital stays and increased costs further emphasize the challenges in managing this unique patient population. These findings emphasize the need for careful patient selection, risk assessment, and a multidisciplinary approach when considering bariatric surgery for individuals with both liver cirrhosis and obesity.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2455921"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of crisis and disaster preparedness among Jordanian healthcare providers: a cross-sectional study.","authors":"Mohammad Dar Assi, Saleh H Hammad, Rima M Al-Odeh","doi":"10.1080/21548331.2025.2520740","DOIUrl":"10.1080/21548331.2025.2520740","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess Jordanian healthcare providers' preparedness for crises and disasters.</p><p><strong>Methods: </strong>A descriptive design was utilized, recruiting a convenience sample of 282 healthcare providers from five governmental hospitals. Data were collected using the Emergency Preparedness Information Questionnaire (EPIQ).</p><p><strong>Results: </strong>The results indicate that Jordan's healthcare providers have a moderate crisis and disaster preparedness level. The average total score was 136.51, SD ± 31.26, with scores ranging from 47 to 205. The score at the 50th percentile for healthcare providers' crisis and disaster preparedness was 135. The highest score was for the ethical issues in the triage dimension, while the lowest score was for the participant's overall familiarity dimension. There was no relationship between the level of crisis and disaster preparedness and the healthcare providers demographic characteristics age, gender, years of experience, hospital experience, monthly income, and education level. The crises and disaster preparedness scores were significantly different across the various job specializations.</p><p><strong>Conclusions: </strong>The findings indicated that the level of preparedness among health providers was moderate, and they perceived themselves to be familiar with crisis and disaster preparedness. Significant differences were found based on job specialization, with high preparedness levels among midwives and doctors, while the lowest was found among pharmacists and technicians. However, training in the competencies specified in the Emergency Preparedness Information Questionnaire (EPIQ) may enhance preparedness for crises and disasters, along with proactive planning and scenario-based drills and exercises.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2520740"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication error reporting system: barriers and challenging issues among HCPs in Saudi Arabia - a cross-sectional study.","authors":"Saja Mohammed A Alasmari, Maryam Alwan Mousa Ali, Jawharah Mubarak Alqhtani, Ma'an Jumah Al-Alwani, Waad Fahad Alotaibi, Noha Tashkandi, Asma Malawi Alshahrani","doi":"10.1080/21548331.2025.2520745","DOIUrl":"10.1080/21548331.2025.2520745","url":null,"abstract":"<p><strong>Objectives: </strong>Medication errors pose a significant threat to patient safety globally, including in Saudi Arabia. This study aimed to assess healthcare professionals' (HCPs) understanding, attitudes, and challenges regarding medication error reporting in Saudi hospitals.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a self-administered online questionnaire among HCPs (physicians, pharmacists, and nurses) from various hospitals across Saudi Arabia. The questionnaire explored their knowledge, attitudes, and experiences related to medication error reporting.</p><p><strong>Results: </strong>A total of 170 hCPs participated in the study, with the majority being under 35 years old (67.06%), female (70.59%), and Saudi nationals (74.71%). A majority of participants (87.06%) had heard of the medication error report form, and 73.53% reported medication errors before. Participants aged less than 35 years had significantly lower knowledge scores compared to those aged 35-45 years (<i>p</i> = 0.021), and male participants had significantly higher knowledge scores compared to female participants (<i>p</i> = 0.005). Pharmacists had the highest knowledge scores among all health professions (<i>p</i> < 0.001), and participants working in government hospitals had significantly higher knowledge scores compared to those working in private hospitals (<i>p</i> = 0.034). In terms of attitude scores, male participants had significantly higher attitude scores compared to female participants (<i>p</i> = 0.046).</p><p><strong>Conclusions: </strong>This study highlights progress in medication error reporting among HCPs in Saudi Arabia but identifies gaps in knowledge, reporting, and systemic barriers. Addressing these challenges through education, process optimization, and a non-punitive reporting culture is key to improving safety. Future research should expand beyond hospitals and assess policy and training impacts over time.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2520745"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is temporary staffing a solution to the deeper crisis of the hospital workforce shortage?","authors":"Suyog Mokashi, Peter Cappelli","doi":"10.1080/21548331.2025.2472734","DOIUrl":"10.1080/21548331.2025.2472734","url":null,"abstract":"","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2472734"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct oral anticoagulant assay utilization and associated bleeding events: a multi-center cohort study.","authors":"Brandon Stretton, Joshua Kovoor, Stephen Bacchi, Aashray Gupta, Suzanne Edwards, Jir Ping Boey, Samuel Gluck, Benjamin Reddi, Guy Maddern, Mark Boyd","doi":"10.1080/21548331.2024.2433937","DOIUrl":"10.1080/21548331.2024.2433937","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of evidence regarding direct oral anticoagulant (DOAC) assay plasma concentrations and their association with bleeding events or transfusion requirements. This multicenter study aimed to characterize the use and plasma levels of DOAC assays of anticoagulated patients who present to emergency with a bleeding event and their association with bleeding severity.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study of consecutive emergency bleeding presentations with a DOAC assay over a five-year period was conducted. Linear regressions were performed for continuous outcomes, binary logistic regression for categorical outcomes.</p><p><strong>Results: </strong>There were 86 patients on a DOAC, who presented with a major bleeding event, and had a DOAC assay performed. Assays were performed within a median time of 4.8 hours (IQR = 9,14.4) from presentation and had a median result of 122.9 ng/ml(IQR = 42,160). DOAC assay plasma level was not significantly associated with type or severity of bleed however, for every 10 unit increase in DOAC assay plasma level, the odds of administering reversal increases by 4% (OR = 1.04, 95%CI:1.00-1.08).</p><p><strong>Conclusion: </strong>A wide range of plasma levels can be expected in patients who present with bleeding events. Higher DOAC plasma levels do not necessarily confer a worse bleeding event or increased transfusion requirements; however, it is associated with an increased likelihood of anticoagulant reversal administration.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2433937"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of human hematin and heme arginate in the management of porphyria attacks: an observational study across three hospitals in Colombia.","authors":"Enyd-E Rave-B, Natalia A Rojas-Henao, Andres-Felipe Valencia-Quintero, Emmanuel Salvador Nieto-López","doi":"10.1080/21548331.2025.2520743","DOIUrl":"10.1080/21548331.2025.2520743","url":null,"abstract":"<p><strong>Background: </strong>Porphyria is an orphan disease classified as a genetic disorder caused by a partial or high-grade deficiency of enzymes involved in the synthesis of heme, an essential component of hemoglobin. This deficiency results in the accumulation of porphyrins (ALAS1 and PBG), intermediates in the heme metabolic pathway. This accumulation triggers porphyria attacks. In Colombia the Heme Arginate and Human Hematin are the therapeutics alternatives for the management of porphyria Attacks.</p><p><strong>Objective: </strong>To evaluate the comparative effectiveness of heme arginate versus human hemin for treating porphyria attacks in hospitalized patients across three institutions in Medellin, Colombia.</p><p><strong>Methods: </strong>An observational and analytical study was conducted to compare the outcomes of treatment with human hematin versus heme arginate in clinical episodes of patients diagnosed with porphyria between 2015-2021.</p><p><strong>Results: </strong>In episodes treated with heme arginate (ArgH), 75% achieved pain control or reduction, 41.6% showed a reduction in opioid dosage, and 88.8% achieved resolution of the Porphyria attack. For episodes treated with human hematin (HH), 85.3% achieved pain control or reduction, 53.6% showed a reduction in opioid dosage, and 90.2% achieved resolution of the attack. When evaluating the effectiveness of both treatments, no statistically significant differences were observed across the three predefined effectiveness outcomes of the study.</p><p><strong>Conclusions: </strong>This study provides a comparative evaluation of heme arginate (ArgH) and human hematin (HH) in the management of Porphyria attacks, demonstrating that both treatments are similarly effective in achieving pain control, reducing opioid use, and resolving clinical attacks.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":"53 1","pages":"2520743"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of transition from use of alteplase to tenecteplase in the treatment of acute ischemic stroke in a large system of community hospitals.","authors":"Adam Hasse, Kimberly Korwek, Jeffrey Guy, Russell E Poland","doi":"10.1080/21548331.2024.2438592","DOIUrl":"10.1080/21548331.2024.2438592","url":null,"abstract":"<p><strong>Objective: </strong>Pharmacologic thrombolytic treatment for acute ischemic stroke has primarily been managed by intravenous alteplase. Tenecteplase is a variant that has been shown to be non-inferior to alteplase in clinical trials. In this study, we present a real-world assessment of patient outcomes with the facility-wide transition to the use of tenecteplase versus altepase for acute ischemic stroke in a large system of community hospitals in the United States.</p><p><strong>Methods: </strong>This retrospective analysis assessed adult patients who received either alteplase or tenecteplase between 1 April 2020 and 31 March 2023. Propensity matching was used to estimate the covariate-adjusted association with outcomes of discharge expired/hospice, intracranial hemorrhage and readmission to a facility in the same healthcare system within 30, 60, or 90 days.</p><p><strong>Results: </strong>Among 12,766 patients, gross mortality was 7.6% (<i>n</i> = 285) with tenecteplase and 8.2% (<i>n</i> = 739) with alteplase (<i>p</i> = 0.314); intracranial hemorrhage was 2.4% with either. The propensity match analysis found that the relative risk of mortality/hospice for patients given tenecteplase versus alteplase was 0.993 (95% CI: 0.848-1.162, <i>p</i> = 1.000). When limited to five facilities with the highest volume of thrombolytic use, there were no significant differences in outcomes. While the time from emergency department arrival to thrombolytic administration (door-to-needle) was shorter among patients receiving tenecteplase, there was no significant difference in the odds of mortality based on door-to-needle time.</p><p><strong>Conclusion: </strong>In alignment with previous studies, these findings demonstrate the lack of potential harm with a transition from alteplase to tenecteplase in clinical practice for acute ischemic stroke patients treated in community hospitals.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2438592"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of proactive care model for patients with chronic kidney disease stage 4-5 to clinical outcomes and quality of life: an action research.","authors":"Malinee Jitnuk, Waree Jullaket, Ausanee Wanchai","doi":"10.1080/21548331.2024.2437977","DOIUrl":"10.1080/21548331.2024.2437977","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease often struggle to control clinical symptoms and need help from the healthcare team. This study aimed to develop a proactive care model for stage 4-5 chronic kidney disease patients and investigate its effectiveness on their clinical outcomes and quality of life in Thailand.</p><p><strong>Methods: </strong>The study was a comprehensive, collaborative effort conducted in North Thailand involving a multidisciplinary team of healthcare professionals. This team, which included physicians, professional nurses, pharmacists, and nutritionists from the Chronic Kidney Disease Clinic at a secondary hospital, worked together to develop and implement a proactive care model for stage 4-5 chronic kidney disease patients. The research instruments used were a proactive care model for CKD stages 4-5 patients, the clinical outcomes assessment form, and the Kidney Disease Quality of Life Short Form. Quantitative data were analyzed using descriptive statistics, Chi-Square, and dependent t-tests, while qualitative data were analyzed using content analysis.</p><p><strong>Results: </strong>The proactive care model for patients with chronic kidney disease stage 4-5 consists of 1) a multidisciplinary team providing chronic kidney disease standards, 2) providing knowledge and counseling for behavior change, and 3) supporting self-management of patients with chronic kidney disease. After the experiment, mean systolic blood pressure, diastolic blood pressure, and mean potassium were significantly lower than before, and Hematocrit significantly increased. In contrast, glomerular rate, fasting blood sugar, and hemoglobin A1C did not change after the intervention compared to before (<i>p</i> > .05). After the experiment, patients' overall quality of life significantly increased.</p><p><strong>Conclusions: </strong>This study demonstrated that the proactive care model for Chronic Kidney Disease stage 4-5 patients significantly improved clinical outcomes and profoundly impacted quality of life. Therefore, all components of the proactive care model should be applied, including working as a multidisciplinary team and helping patients adjust their behaviors and manage their health.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2437977"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}