Journal of Healthcare Quality Research最新文献_第10页

Applying machine learning methods to predict the hospital re-admission within 30 days of total hip arthroplasty and hemiarthroplasty 应用机器学习方法预测全髋关节置换术和半髋关节置换术后30天内再次住院

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-07-01 DOI: 10.1016/j.jhqr.2022.11.009

J.-M. Wu , B.-W. Cheng , C.-Y. Ou , J.-E. Chiu , S.-S. Tsou

{"title":"Applying machine learning methods to predict the hospital re-admission within 30 days of total hip arthroplasty and hemiarthroplasty","authors":"J.-M. Wu , B.-W. Cheng , C.-Y. Ou , J.-E. Chiu , S.-S. Tsou","doi":"10.1016/j.jhqr.2022.11.009","DOIUrl":"10.1016/j.jhqr.2022.11.009","url":null,"abstract":"<div><h3>Background</h3><p>Total hip arthroplasty (THA) and hemiarthroplasty are common treatments for severe hip joint disease. To predict the probability of re-admission after discharge when patients are hospitalized will support providing appropriate health education and guidance.</p></div><div><h3>Methods</h3><p>The research aims to use logistic regression (LR), decision trees (DT), random forests (RF), and artificial neural networks (ANN) to establish predictive models and compare their performances on re-admissions within 30 days after THA or hemiarthroplasty. The data of this study includes patient demographics, physiological measurements, disease history, and clinical laboratory test results.</p></div><div><h3>Results</h3><p>There were 508 and 309 patients in the THA and hemiarthroplasty studies respectively from September 2016 to December 2018. The accuracies of the four models LR, DT, RF, and ANN in the THA experiment are 94.3%, 93.2%, 97.3%, and 93.9%, respectively. In the hemiarthroplasty experiment, the accuracies of the four models are 92.4%, 86.1%, 94.2%, and 94.8%, respectively. Among these, we found that the RF model has the best sensitivity and ANN model has the best area under the receiver operating characteristic (AUROC) score in both experiments.</p></div><div><h3>Conclusions</h3><p>The THA experiment confirmed that the performance of the RF model is better than the other models. The key factors affecting the prognosis after THA surgery are creatinine, sodium, anesthesia duration, and dialysis. In the hemiarthroplasty experiment, the ANN model showed more accurate results. Poor kidney function increases the risk of hospital re-admission. This research highlights that RF and ANN model perform well on the hip replacement surgery outcome prediction.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777136","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}

引用次数: 0

El caballo de Troya como una metodología de gestión del cambio en una organización sanitaria: la experiencia y perspectiva de GiPSS, Tarragona 作为卫生组织变革管理方法的特洛伊木马:GiPSS的经验和观点，塔拉戈纳

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-07-01 DOI: 10.1016/j.jhqr.2022.11.004

R. Qanneta

引用次数: 0

Factors from healthcare delivery affecting breast cancer survival in a health area of Northern of Spain 在西班牙北部的一个卫生保健区，保健服务影响乳腺癌生存的因素

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-07-01 DOI: 10.1016/j.jhqr.2023.04.001

N. Robles-Rodríguez , A. Llaneza-Folgueras , A. Lana

{"title":"Factors from healthcare delivery affecting breast cancer survival in a health area of Northern of Spain","authors":"N. Robles-Rodríguez , A. Llaneza-Folgueras , A. Lana","doi":"10.1016/j.jhqr.2023.04.001","DOIUrl":"10.1016/j.jhqr.2023.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Clinical breast cancer decision-making significantly affects life expectancy and management of hospital resources. The aims of the present study were to estimate the time of survival for breast cancer patients and to identify independent factors from healthcare delivery associated with survival rates in a specific health area of Northern of Spain.</p></div><div><h3>Methods</h3><p>Survival analysis was conducted among a cohort of 2545 patients diagnosed with breast cancer between 2006 and 2012 from the population breast cancer registry of Asturias-Spain and followed up till 2019. Adjusted Cox proportional hazard models were used to identify the independent prognostic factors of all-cause from death.</p></div><div><h3>Results</h3><p>The 5-year survival rate was 80%. Advanced age (>80 years) (hazard ratio, HR: 4.35; 95% confidence interval, CI: 3.41–5.54), hospitalization in small hospitals (HR: 1.46; 95% CI: 1.09–1.97), treatment in oncology wards (HR: 3.57; 95% CI: 2.41–5.27), and length of stay >30 days (HR: 2.24; 95% CI: 1.32–3.79) were the main predictors of death. By contrast, breast cancer suspected via screening was associated with a lower risk of death (HR: 0.55; 95% CI: 0.35–0.87).</p></div><div><h3>Conclusion</h3><p>There is room for improvement in survival rates after breast cancer in the health area of Asturias (Northern of Spain). Some healthcare delivery factors, and other clinical characteristics of the tumor influence the survival of breast cancer patients. Strengthening population screening programs could be relevant to increasing survival rates.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783732","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}

引用次数: 0

Patient experience among adolescents in a Spanish paediatric emergency department 西班牙儿科急诊科的青少年患者经验

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-07-01 DOI: 10.1016/j.jhqr.2022.11.005

C. Parra , M. Boada , A. Rojas , A. Pallache , V. Trenchs , C. Luaces

引用次数: 0

Algunas reflexiones sobre el estado mental de las segundas víctimas de COVID-19 de las áreas de cuidados críticos 对重症护理领域第二名COVID-19受害者精神状态的一些思考

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-07-01 DOI: 10.1016/j.jhqr.2022.08.003

A. Diaz , F. Astochado , J. Moya-Salazar , V. Rojas-Zumaran , M.C. Ruiz , A.N. Vasquez , C. Alcarraz

引用次数: 1

Adherencia a las guías de práctica clínica, de la teoría a la acción en un hospital de Colombia 哥伦比亚一家医院坚持临床实践指南，从理论到行动

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-05-01 DOI: 10.1016/j.jhqr.2022.11.001

A. de la Torre , A. Franco

引用次数: 0

Coste-efectividad de la oxigenoterapia de alto flujo en el tratamiento de la neumonía por SARS-CoV-2 大流量氧疗治疗SARS-CoV-2肺炎的成本-效果

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-05-01 DOI: 10.1016/j.jhqr.2022.10.004

A. González-Castro , E. Cuenca Fito , A. Fernandez , Y. Peñasco , V. Modesto i Alport , A. Medina Villanueva , A. Fajardo , P. Escude-Acha

{"title":"Coste-efectividad de la oxigenoterapia de alto flujo en el tratamiento de la neumonía por SARS-CoV-2","authors":"A. González-Castro , E. Cuenca Fito , A. Fernandez , Y. Peñasco , V. Modesto i Alport , A. Medina Villanueva , A. Fajardo , P. Escude-Acha","doi":"10.1016/j.jhqr.2022.10.004","DOIUrl":"https://doi.org/10.1016/j.jhqr.2022.10.004","url":null,"abstract":"<div><h3>Introduction</h3><p>high-oxygen nasal cannulas in patients with respiratory failure secondary to SARS-CoV-2 pneumonia have not been studied from a cost-effectiveness point of view.</p></div><div><h3>Methods</h3><p>Retrospective analysis of patients who had entered the COVID-area of an intensive medicine service in a third reference hospital, between March-December 2020. An effectiveness cost analysis was carried out comparing 2therapeutic decisions: the experimental strategy was defined as a mixed strategy consisting of the initial application of high flow nasal oxygen (HFNO) and application of VMI only to HFNO failures. The optimal rational decision was defined as maximizing expected profit, and economic efficiency was assessed by calculating the Incremental Cost-Effectiveness Ratio (ICER) for years of life gained.</p></div><div><h3>Results</h3><p>Of the 185 patients tested, 101 (55%) received invasive mechanical ventilation immediately and 84 (45%) were treated with HFNO at the outset. In the cost-effectiveness analysis, comparing both therapeutic strategies, the probability that the experimental strategy would be more effective was 0.974, reaching statistical significance: Difference in average proportions -0.113; 95% CI:-0.018 to -0.208. This corresponds to an NNT of 9 patients. The optimal decision was HFNO's strategy followed by VMI in HFNO failures. This option had an RCEI of 5582 euros per year of life gained.</p></div><div><h3>Conclusions</h3><p>It is important to establish in the future reliable markers in the use of HFNO so that this therapy improves its cost-effective benefits.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50175793","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}

引用次数: 0

Consideraciones sobre el tratamiento de la epilepsia infantil con lamotrigina 拉莫三嗪治疗儿童癫痫的思考

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-05-01 DOI: 10.1016/j.jhqr.2022.08.009

D. Molina Herranz , A. Moreno Sánchez , J. López Pisón , B. Salinas Salvador , G. Carmen Marcen , M. Lafuente Hidalgo , J.P. García Íñiguez

引用次数: 1

La muerte de los niños. Debates éticos en torno a la limitación del esfuerzo terapéutico 孩子们的死亡。关于限制治疗努力的伦理辩论

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-05-01 DOI: 10.1016/j.jhqr.2022.11.010

Mónica Clara Bonete Román , Gabriel Campos Rivera

引用次数: 1

Análisis de las «estancias cero» pediátricas en un hospital de nivel 2 a lo largo de 25 años 25年来二级医院儿科“零住院”情况分析

IF 1.2

Journal of Healthcare Quality Research Pub Date : 2023-05-01 DOI: 10.1016/j.jhqr.2022.11.003

I. Doval Alcalde , S. Corral Hospital , C. González García , J.F. Soltero Carracedo , A. Macías Panedas , J.M. Andrés de Llano , M.P. Barrio Alonso

{"title":"Análisis de las «estancias cero» pediátricas en un hospital de nivel 2 a lo largo de 25 años","authors":"I. Doval Alcalde , S. Corral Hospital , C. González García , J.F. Soltero Carracedo , A. Macías Panedas , J.M. Andrés de Llano , M.P. Barrio Alonso","doi":"10.1016/j.jhqr.2022.11.003","DOIUrl":"https://doi.org/10.1016/j.jhqr.2022.11.003","url":null,"abstract":"<div><h3>Introduction</h3><p>It is essential to admit patients to hospital in an efficient way in order to use resources rationally. Short hospitalary stays are hospitalizations which does not include 00:00h and are considered avoidable. This study describes trends and characteristics of short stays throughout 25 years in our hospital.</p></div><div><h3>Patients and methods</h3><p>We analyzed hospital pediatric discharges in a second-level hospital through the registration system «conjunto mínimo básico de datos». We categorized pediatric patients and newborn patients in two groups according to length of hospital stay: «short stays» and «prolonged stays». We analyzed and compared the following variables: gender, age, type of admission, month, diagnosis-related groups (DRG) and admission service. Binary logistic regression analysis and assessment of trends through joinpoint regression analysis were performed.</p></div><div><h3>Results</h3><p>From 1993 to 2017, 45710 children were admitted to our hospital, of which 7.3% were short stays. The trend analysis showed a point of change upwards–downwards at the beginning of the millennium. Pediatric short stays: the most important variables were emergency admissions (89%), urgent transfers (9%), month December (11%) and main diagnosis category: nervous system (18%). Mean diagnosis-related groups cost was 2432±1115€ in short stays group and 2549±1065€ in prolonged stays.</p></div><div><h3>Conclusions</h3><p>Short stays and prolonged stays show a falling trend in our hospital. Short stays percentage in our environment is similar to other neighbor countries. Some of our short stays are urgent transfers and admissions for clinical observation. We did not find clinical significance in weight or cost of pediatric patients’ DRG comparing to prolonged stays.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50175794","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}

引用次数: 0