Hospital practice (1995)最新文献

{"title":"Trends of trauma team physicians toward patients with bleeding in Saudi Arabia: a cross-sectional study.","authors":"Abdulaziz Mohammad Al-Sharydah, Faisal Ahmad Katbi, Razan Essam AlHarbi, Faisal Al-Ghamdi, Saleh AlShreadah","doi":"10.1080/21548331.2024.2442299","DOIUrl":"10.1080/21548331.2024.2442299","url":null,"abstract":"<p><strong>Objectives: </strong>Trauma poses a significant health burden in Saudi Arabia, with high rates of morbidity and mortality rates. We evaluated the trends among trauma team (TT) physicians in Saudi Arabia regarding their awareness and referral practices for percutaneous endovascular arterial embolization (EAE) in bleeding patients.</p><p><strong>Methods: </strong>A 13-question survey developed by consultants from various specialties assessed the knowledge of TT physicians regarding decision-making and appropriate approaches for managing traumatic bleeding. The surveys were administered in person to 135 TT physicians.</p><p><strong>Results: </strong>Among them, 38.52% had five or more years of independent practice, and 87.41% routinely encountered patients with bleeding patients. Physicians who routinely treated patients with bleeding patients exhibited higher median scores, in line with current management standards (<i>p</i> = 0.634). Tertiary care physicians and academic- and military-affiliated physicians exhibited higher median scores (<i>p</i> =  <0.001 and <i>p</i> < 0.006, respectively). Amongst TT physicians, 47.41% preferred EAE for unstable pelvic ring fractures with active bleeding, while 68.15% favored splenectomy for unstable patients with grade V splenic injuries. For traumatic aortic injuries, 67.42% considered TEVAR/EVAR safer options. Notably, 84.44% viewed an INR > 3 as a contraindication for EAE in hemodynamically stable patients. General surgeons scored the highest in management decision-making, followed by neurosurgeons (<i>p</i> = 0.001). Orthopedics, emergency medicine, intensive care (ICU), and anesthesia specialists exhibited similarly high median scores for appropriate management approaches (<i>p</i> = 0.003). Overall, general surgeons, orthopedic surgeons, and ICU specialists exhibited the highest median correct responses, adhering to the current standard of practice (<i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>To address the potentially life-threatening condition of traumatic bleeding, raising awareness of the appropriate management and referral patterns for EAE is crucial.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2442299"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819427","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":"Venous thromboembolism prevention practice and associated factors among orthopedic surgical patients in Ethiopia: a cross-sectional study.","authors":"Banchamlak Teferi Mekonen, Tewodros Shibabaw Molla, Abaynesh Fentahun Bekalu, Abdisa Gemedi Jara, Saron Naji Gebremariam, Nega Nigussie Abrha, Adugnaw Sitotie Redie, Esileman Abdela Muche","doi":"10.1080/21548331.2025.2503697","DOIUrl":"https://doi.org/10.1080/21548331.2025.2503697","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is the third leading cause of death from cardiovascular conditions. Very limited research has been done on venous thromboembolism prevention in clinical practice in orthopedic surgery patients in Ethiopia. Thus, this study aims to evaluate the prevention practice against venous thromboembolism and its identified associated factors among orthopedic surgery patients.</p><p><strong>Method: </strong>A cross-sectional study was conducted among orthopedic surgery patients. The appropriateness of prevention practice was evaluated using the 2012 VTE guidelines from the American College of Chest Physicians. This guideline helps as a blueprint to determine whether the available prevention strategies are in line with the standard recommendation for providing better patient care. Data was entered using Epidata 7 and exported to SPSS version 25. In a multivariate logistic regression model, a p-value ≤0.05 was used to claim statistical significance.</p><p><strong>Result: </strong>From a total of 375 study subjects, the majority (88.3%) were males, and the mean age was 29 ± 10.4 years. Overall, 176 (46.4%) participants received appropriate venous thromboembolism prevention practices. Unfractionated heparin was the most widely used thromboprophylaxis regimen. Having restricted mobility (low level of physical activity) [AOR = 9.73 (95% CI 2.0-45.7, <i>p</i> = 0.004)], being bedridden [AOR = 8.86 (95% CI 2.0-39.2, <i>p</i> = 0.01)] and having ASA classification score of >3 [AOR = 9.6 (95% CI 1.7-52.1, <i>p</i> = 0.009)] were associated with inappropriate VTE prevention practice.</p><p><strong>Conclusion: </strong>Our study revealed that only 46.4% orthopedic surgical patients at risk of developing venous thromboembolism received adequate VTE prevention practices. Factors that contribute to inadequate prevention include low levels of physical activity, bedridden, and higher ASA classification scores. Hence, by addressing these risk factors and increasing awareness and application of standard VTE prevention protocols, it's possible to reduce contributing factors, improve the utilization of thromboprophylaxis, and lower the rate of VTE.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":"53 1","pages":"2503697"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050182","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":"Assessing the effectiveness of a rural distribution program in reducing time to prothrombin complex concentrate administration in patients taking warfarin.","authors":"Abigail Polzin, Joel Stroman, Riley Schaap, Rebecca Baird, David Sturdevant, Aarabhi Gurumoorthy","doi":"10.1080/21548331.2025.2455930","DOIUrl":"10.1080/21548331.2025.2455930","url":null,"abstract":"<p><strong>Study objectives: </strong>Reversal of warfarin-induced anticoagulation using prothrombin complex concentrate (PCC4) is more rapidly achieved than with traditional methods, such as fresh frozen plasma (FFP). In many rural facilities, the availability of both FFP and PCC4 has been limited. A tertiary hospital instituted a program to provide PCC4 to rural sites using an air transport team and pharmacy exchange. We hypothesized that increasing accessibility of PCC4 would shorten time to INR reversal.</p><p><strong>Methods: </strong>This was a retrospective study with the primary outcome being time to INR reversal (INR ≤ 1.6) and time to PCC4 administration from outside hospital admission. Active warfarin prescription, transfer to a tertiary facility, and administration of anticoagulation reversal between January 2013 and December 2020 were required for inclusion. Patients were grouped by dates before and after implementation of the program in August 2016. Linear regressions were performed to determine the effect of the variable and INR reversal methods on the time to INR reversal as well as the time to PCC4 administration. Time-to-event analysis was used to analyze the primary outcome between comparison groups. <i>p</i> values of less than 0.05 were considered significant.</p><p><strong>Results: </strong>Chart review identified 189 patients: 56 within the pre-implementation group and 133 within the post-implementation group. Statistics were compared between these two groups. The post-implementation group had a shorter time to INR reversal (median 9.97 h) compared with the pre-implementation group (median 14.58 h, <i>p</i> = 0.00004). Time to PCC4 administration was also significantly decreased (<i>p</i> = 0.023). No statistically significant differences were found for hospital survival or 30-day mortality.</p><p><strong>Conclusion: </strong>In rural hospitals, increasing availability of PCC4 using air medical transport along with a medication exchange program significantly reduces time to PCC4 administration in warfarin anticoagulated patients.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2455930"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the unforeseen: anuric acute kidney injury induced by alectinib.","authors":"Viet Nghi Tran, Yusuf Hussein Kebato, Chau Doan Nguyen, Tahira Qadeer, Shehzad Ali, Amro Taha","doi":"10.1080/21548331.2025.2470606","DOIUrl":"10.1080/21548331.2025.2470606","url":null,"abstract":"<p><strong>Introduction: </strong>Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is pivotal in managing ALK-positive non-small cell lung cancer (NSCLC) due to its efficacy and favorable safety profile. However, severe renal toxicity, including acute kidney injury (AKI), remains a rare but significant adverse effect.</p><p><strong>Case report: </strong>We present the case of a 71-year-old female with a history of diabetes and recently diagnosed ALK-positive NSCLC. She had been on alectinib therapy (600 mg twice daily) for two months. The patient was admitted with symptoms of shortness of breath and anuria. Initial laboratory results revealed a significant rise in serum creatinine from a baseline of 1.0 mg/dL to 3.64 mg/dL, indicating AKI. Alectinib was discontinued, and the patient underwent a single session of hemodialysis. The patient exhibited rapid clinical improvement with significant recovery of renal function, and she was discharged without the need for further dialysis. A subsequent switch to brigatinib was well-tolerated, with stable renal function observed at the 4-month follow-up.</p><p><strong>Conclusion: </strong>This case underscores the potential for severe AKI associated with alectinib therapy, highlighting the importance of vigilant renal function monitoring in patients undergoing treatment, especially those with predisposing conditions. Early recognition and prompt intervention are crucial to mitigate renal complications and optimize patient outcomes. Brigatinib may serve as a suitable alternative for patients intolerant to alectinib.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2470606"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468921","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":"Strategies used by patients when getting in and out of bed early after hip fracture surgery - The HIP-ME-UP cohort.","authors":"Maria Swennergren Hansen, Jeanette Wassar Kirk, Morten Tange Kristensen, Camilla Kampp Zilmer, Kira Marie Skibdal, Thomas Bandholm, Mette Merete Pedersen","doi":"10.1080/21548331.2025.2491305","DOIUrl":"10.1080/21548331.2025.2491305","url":null,"abstract":"<p><strong>Objectives: </strong>In patients hospitalized following hip fracture, basic mobility status early after surgery and at discharge is associated with long-term outcomes. Getting in and out of bed is the basic mobility activity identified as one of the most challenging. Therefore, this study described strategies used by patients when getting in and out of bed early after hip fracture surgery.</p><p><strong>Methods: </strong>We conducted an observational cross-sectional study (the HIP-ME-UP cohort; NCT05756517) at Copenhagen University Hospital Hvidovre. We filmed patients getting in and out of bed during physiotherapy sessions on post operative days 3-5 by using an iPad. We analyzed the recordings using a quantitative film analysis with all recordings structured into three phases: preparation, lie-to-sit (out of bed)/sit-to-lie (into bed) and positioning.</p><p><strong>Results: </strong>42 patients (23 women) with a mean (SD) age of 78.7 (7.6) years were enrolled. For getting out of bed, we identified five strategies in the preparation phase, seven strategies in the lie-to-sit phase, and two strategies in the positioning phase. For getting into bed, we identified five strategies within each of the three phases. The choice of strategies for patients who were independent in getting in/out of bed was similar to patients in need of assistance.</p><p><strong>Conclusion: </strong>Patients hospitalized following hip fracture surgery use different strategies when getting in and out of bed. Patients requiring assistance and those being independent used similar strategies, which suggests that it is important to tailor rehabilitation to each patient's specific needs rather than their level of independence.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier is NCT05756517.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":"53 1","pages":"2491305"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040116","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":"Nomophobia: a challenge among healthcare professionals in Africa.","authors":"Reena Shah, Shan Lakhani, Jasmit Shah, Annastacia Mbithi, Aakanksha Singh, Zainab Gandhi, Priyal Mehta, Rahul Kashyap, Salim Surani","doi":"10.1080/21548331.2024.2432858","DOIUrl":"10.1080/21548331.2024.2432858","url":null,"abstract":"<p><strong>Objectives: </strong>This study delves into implementing Global Provider's phone-lessness phobia (Global 3-P Study) within the healthcare sector in Africa through a multinational, cross-sectional, web-based survey from April 1st to 30 June 2023.</p><p><strong>Methods: </strong>Utilizing a modified Nomophobia Questionnaire (NMP-Q), the research explores four dimensions of nomophobia: the inability to communicate, loss of connectedness, difficulty accessing information, and sacrificing convenience. The Global Remote Research Scholars Program (GRRSP) conducted the study, employing a 'snowball technique' for survey dissemination.</p><p><strong>Results: </strong>A total of 1636 responses were collected from healthcare professionals in Africa, predominantly aged 26-45, with a majority identifying as Black-African (86.5%) and residing mainly in Kenya (61.6%). The survey revealed a higher prevalence of Android smartphone users (71.4%) than Apple iOS (25.6%). Participants reported spending substantial time on personal (3.1-5 hours) and work-related (up to 3 hours) smartphone activities. A significant portion of respondents felt uncomfortable (74.3%), annoyed (72.0%), and nervous (61.4%) at the prospect of not having constant smartphone access to information. Concerns about disruptions to smartphone connections, such as running out of battery or data, were prevalent among participants. Analysis of nomophobia levels revealed that 46.9% experienced moderate Nomophobia Level I and 41.1% reported severe levels, while Nomophobia Level II was reported by 51.8% with moderate levels and 37.2% with severe levels. Comparative analysis based on gender and age groups showed statistically significant differences. Males exhibited lower severity levels of nomophobia compared to females, and the 36-45 age group reported the highest prevalence of severe nomophobia.</p><p><strong>Conclusion: </strong>This study highlights the significant impact of nomophobia among healthcare professionals in Africa, indicating a need for interventions to mitigate its effects and promote healthy smartphone habits in this critical sector.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2432858"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711287","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":"Prescribing patterns of SGLT-2 inhibitors and their association with heart failure readmissions: a single-center cross-sectional study from a low- and middle-income country.","authors":"Abrar Ali Chhachhar, Saadia Sattar, Farhala Baloch, Umair Javed, Maria Wajid, Salva Shariq, Muhammad Qamar Masood","doi":"10.1080/21548331.2025.2463879","DOIUrl":"10.1080/21548331.2025.2463879","url":null,"abstract":"<p><strong>Objectives: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to reduce cardiovascular death and heart failure (HF) hospitalizations in patients with reduced and mildly reduced or preserved ejection fraction. This study assesses the effectiveness of SGLT2 inhibitors in reducing HF readmission rates and examines prescription patterns in hospitalized patients.</p><p><strong>Methods: </strong>This single-center retrospective cross-sectional study evaluated the impact of SGLT2 inhibitors on HF readmission rates when initiated during index hospitalization or within 14 days of discharge. Patients were divided into an SGLT2 group and a non-SGLT2 group, with 6-month readmission rates compared to the groups.</p><p><strong>Results: </strong>Of the 234 patients, 85 (36.3%) were prescribed SGLT2 inhibitors, while 149 (63.7%) were not. SGLT2 inhibitors were prescribed less frequently to patients with chronic kidney disease (CKD) and patients admitted under cardiology services were more likely to receive SGLT2 inhibitors. Among those prescribed SGLT2 inhibitors, the median ejection fraction was significantly lower compared to those not prescribed, while the median estimated glomerular filtration rate was higher. There were 107 total readmissions (45.7%), with most (55%) occurring within 30 days of the index hospitalization. Total readmissions and 30-day readmissions were significantly lower in the SGLT2 inhibitor group (31.8% vs 53.7%, <i>p</i> = 0.001) and (33.33% vs 62.50%, <i>p</i> = 0.029), respectively. Heart failure readmissions were also lower in the SGLT2 group (29.6% vs 21.3%, <i>p</i> = 0.37).</p><p><strong>Conclusion: </strong>Our study demonstrated a significant reduction in heart failure readmission rates among patients prescribed with SGLT2 inhibitors. However, we also observed a gap in the prescription of SGLT2 inhibitors.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2463879"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190830","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":"Factors leading to escalations in hospital-at-home: a scoping review.","authors":"Cesar A Gomez-Cabello, Sahar Borna, Syed Ali Haider, Ariana Genovese, Srinivagasam Prabha, Antonio J Forte, Jennifer B Cowart, Michael J Maniaci","doi":"10.1080/21548331.2025.2520741","DOIUrl":"10.1080/21548331.2025.2520741","url":null,"abstract":"<p><strong>Objective: </strong>Hospital-at-Home (H@H) models are safe and cost-effective alternatives for patients with acute or subacute conditions, offering care in the comfort and familiarity of their homes. Escalations, where patients are transferred back to traditional inpatient settings, are key performance metrics but represent significant challenges for H@H programs by interrupting the continuity and advantages of home-based treatment. This scoping review analyzes the factors leading to escalations across H@H programs.</p><p><strong>Methods: </strong>We searched 5 databases: Embase, Google Scholar, PubMed, Scopus, and Web of Science. Our search focused on papers reporting the reasons why patients needed further escalations to Brick and Mortar (B&M) and the sociodemographic characteristics of these patients from 2005 to date. Besides factors leading to escalations, we charted the H@H program's objective, diseases treated, type of visit and personnel visiting, and predictors of escalation.</p><p><strong>Results: </strong>Our search yielded 2932 papers, with 23 meeting our inclusion criteria. Common reasons for escalation included falling, lack of treatment response, exacerbation of the primary disease, cardiac symptoms, and medication adverse effects. Among our studies, higher escalation rates were observed in patients with infectious diseases (16%) and heart failure (9%). Significant predictors included older age, higher Charlson Comorbidity Index (CCI), and comorbidities such as diabetes and chronic kidney disease.</p><p><strong>Conclusion: </strong>Escalations in H@H settings are influenced by primary underlying conditions, patient comorbidities, and care complexity. The novelty and ambiguity of the term 'escalation' and the diverse patient populations and H@H protocols limit statistical analysis. Standardizing definitions and consistent documentation of the number of patients needing care escalations and the reasons behind them is pivotal for proper analysis, nuanced understanding, and plausible prevention.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2520741"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303101","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 costs of severe hypoglycemia events in individuals with diabetes mellitus: a perspective from the Colombian health system - a single-center study.","authors":"Natalia A Rojas-Henao, Michael Garcia-Rivera, Ana C Hernandez-Herrera, Juliana Díaz-Giraldo, Carlos E Builes-Montaño","doi":"10.1080/21548331.2024.2439775","DOIUrl":"10.1080/21548331.2024.2439775","url":null,"abstract":"<p><strong>Background and aims: </strong>Diabetes mellitus is one of the more prevalent chronic diseases globally, and healthcare expenditures for diabetes care are on the rise. Intensive diabetes treatment has been associated with reducing the risk of chronic complications. However, hypoglycemia, the most common adverse effect, poses a significant risk to individuals' lives and is linked to high costs for healthcare systems.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study to determine direct costs by identifying emergency room visits due to hypoglycemia events using diagnostic codes during January 2017 to June 2019. Direct costs were calculated using billed data from the payer and information on outpatient treatment regimens. Differences in median costs were estimated based on length of stay and type of outpatient treatment.</p><p><strong>Results: </strong>Data from 101 patients and the same number of events were included. Women represented (62.4%) of the patients, the median age was 70 (IQR 59.5-80). Blood glucose levels at admission ranged from 12 mg/dL to 67 mg/dL. Most patients were on insulin for outpatient treatment. The median cost of care per hypoglycemia episode was US $345.35 (IQR US $202-727.8), and the cost per episode was higher in patients treated with regimens that included sulfonylureas.</p><p><strong>Conclusions: </strong>The management of patients admitted to the emergency department with a diagnosis of hypoglycemia places a significant burden on the Colombian healthcare system, primarily due to the associated hospitalization costs. Patients treated with regimens that included sulfonylureas incurred higher costs per episode. Prevention, patient education, and individualized treatment approaches could help alleviate the burden of hypoglycemia on both patients and the healthcare system.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2439775"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796182","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 analysis of patient demographics and outcomes in teaching and non-teaching hospitals in Iran.","authors":"Niusha Shahidi Sadeghi, Mohammadreza Maleki, Hassan Abolghasem Gorji, Soudabeh Vatankhah, Bahram Mohaghegh, Ali Behmanesh","doi":"10.1080/21548331.2025.2455931","DOIUrl":"10.1080/21548331.2025.2455931","url":null,"abstract":"<p><strong>Aims: </strong>This study investigates the differences in patient demographics and outcomes between teaching and non-teaching hospitals in Iran. By analyzing these differences, it aims to provide useful information for policymakers to optimize resource allocation, improve patient care, and balance educational and service delivery goals in teaching hospitals.</p><p><strong>Materials and methods: </strong>In this cross-sectional investigation, both teaching and non-teaching general hospitals were examined. A comprehensive analysis was carried out on 13 non-teaching and 25 teaching hospitals with homogeneity, utilizing Health Information System (HIS) data comprising 10,611,647 records through census sampling in 2019. Before employing the logistic regression models to clarify the relationship between a binary dependent variable (distinguishing teaching or non-teaching hospitals) and independent variables, we utilize the Recursive Feature Elimination (RFE) technique to select the most crucial predictor variables.</p><p><strong>Findings: </strong>the optimal logistic regression model revealed that the teaching status of hospitals played a crucial role as an indirect predictor for variables including referral patients, length of stay (<24 hours), patients with partial improvement, and those who received less than 3 services. It also emerged as a direct predictor for variables such as length of stay (>30 days), patients receiving more than the mean services, death rate, and patients with complete improvement. Moreover, the teaching status had an indirect impact on variables like outpatient cases, length of stay (>30 days), and paraclinical services, while directly predicting variables such as patients with supplementary insurance and vulnerable groups insurance type, rehabilitation services, clinic wards, and length of stay (between 4-30 days).</p><p><strong>Conclusion: </strong>In Iranian teaching hospitals, we observed an increase in patient numbers, extended length of stay, a rise in both the quantity and complexity of services, and more intricate patient admissions. It appears that small teaching hospitals in Iran have transitioned from being referral centers to functioning as outpatient centers with active clinics.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2455931"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013164","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}