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Determining the relative risk of hospitalisation and surgery of fall injury patients. 确定跌倒损伤患者住院和手术的相对风险。
IF 1.8
Health Systems Pub Date : 2021-08-17 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1966323
Dinesh R Pai, Hengameh M Hosseini, Stephen R Rosito
{"title":"Determining the relative risk of hospitalisation and surgery of fall injury patients.","authors":"Dinesh R Pai,&nbsp;Hengameh M Hosseini,&nbsp;Stephen R Rosito","doi":"10.1080/20476965.2021.1966323","DOIUrl":"https://doi.org/10.1080/20476965.2021.1966323","url":null,"abstract":"<p><p>Falls are one of the most common cause of nonfatal and fatal injuries in the U.S. costing over an estimated $54 billion annually. A significant percentage of patients presenting to hospital emergency departments (ED) for falls are hospitalised. This paper analyzes a regional hospital data pertaining to adults presenting to the ED because of falls. We use patient demographics and medical conditions to help identify patients at risk for immediate undesirable outcomes after a fall. Furthermore, we determine the relative risk of patient hospitalisation and surgery and their characteristics. Our results indicate that older patient's, patients arriving by ambulance, patients with higher severity levels and patients with pre-existing comorbidities were at a higher relative risk of hospitalisation and surgery. Furthermore, patients with medical conditions pertaining to femur and tibia fractures, pelvis, renal failure, ambulatory dysfunction, and cellulitis, among others, and non-Hispanic whites were at a much higher relative risk of hospitalisation and surgery.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9621258/pdf/THSS_11_1966323.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451312","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}
引用次数: 1
Home testing for COVID-19 and other virus outbreaks: The complex system of translating to communities. COVID-19 和其他病毒爆发的家庭检测：向社区转化的复杂系统。
IF 1.8
Health Systems Pub Date : 2021-07-26 eCollection Date: 2021-01-01 DOI: 10.1080/20476965.2021.1952905
Victoria Lyon, Cynthia LeRouge, Ann Fruhling, Matthew Thompson
{"title":"Home testing for COVID-19 and other virus outbreaks: The complex system of translating to communities.","authors":"Victoria Lyon, Cynthia LeRouge, Ann Fruhling, Matthew Thompson","doi":"10.1080/20476965.2021.1952905","DOIUrl":"10.1080/20476965.2021.1952905","url":null,"abstract":"<p><p>Home testing is an emerging innovation that can enable nations and health care systems to safely and efficiently test large numbers of patients to manage COVID-19 and other viral outbreaks.  In this position paper, we explore the process of moving home testing across the translational continuum from labs to households, and ultimately into practice and communities for optimal public health impact. We focus on the four translational science drivers to accelerate the implementation of systems-wide home testing programmes 1) collaboration and team science, 2) technology, 3) multilevel interventions, and 4) knowledge integration. We use the Socio Ecological Model (SEM) as a framework to illustrate our vision for the ideal future state of a comprehensive system of stakeholders utilising tech-enabled home testing for COVID-19 and other virus outbreaks, and we suggest SEM as a tool to address key translational readiness and response questions.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567871/pdf/THSS_10_1952905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39597977","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}
引用次数: 0
Offering transportation services to economically disadvantaged patients at a family health center: a case study. 在家庭保健中心为经济困难的病人提供交通服务:个案研究。
IF 1.8
Health Systems Pub Date : 2021-07-25 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1936658
Jia Guo, Jonathan F Bard, Douglas J Morrice, Carlos R Jaén, Ramin Poursani
{"title":"Offering transportation services to economically disadvantaged patients at a family health center: a case study.","authors":"Jia Guo,&nbsp;Jonathan F Bard,&nbsp;Douglas J Morrice,&nbsp;Carlos R Jaén,&nbsp;Ramin Poursani","doi":"10.1080/20476965.2021.1936658","DOIUrl":"https://doi.org/10.1080/20476965.2021.1936658","url":null,"abstract":"<p><p>It has been established that high no-show rates of publicly supported health systems in economically depressed areas are largely due to a lack of inexpensive, reliable transportation. The purpose of this paper is to determine the financial feasibility of offering transportation and investigate the net cost savings by reducing no-show rates. The approach starts with a data analysis on 636 patients at the Family Health Center (FHC) in San Antonio, Texas, followed by logistic regression to determine the impact of various transportation factors on cancellations/no-shows and late arrivals. We then investigate the costs savings that could be realised by reducing the no-show rate from 24.3% by up to 60%. Finally, we analyse the expenses that would be incurred should the FHC provide transportation. The full analysis indicates a cost reduction of more than $15,000 per month can be achieved when the no-show rate is reduced by 25% down to 18.2%.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1936658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451311","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}
引用次数: 0
Incorporating the six aims for quality in the analysis of trauma care 将六个目标纳入创伤护理质量分析
IF 1.8
Health Systems Pub Date : 2021-07-20 DOI: 10.1080/20476965.2021.1906763
Lucy G. Aragon, K. Schieman, Laila Cure
{"title":"Incorporating the six aims for quality in the analysis of trauma care","authors":"Lucy G. Aragon, K. Schieman, Laila Cure","doi":"10.1080/20476965.2021.1906763","DOIUrl":"https://doi.org/10.1080/20476965.2021.1906763","url":null,"abstract":"ABSTRACT The Institute of Medicine proposed six aims for healthcare quality improvement. Nevertheless, trauma care quality research still focuses on one aim at a time. This research investigates how to incorporate all aims into trauma care quality assessments using data from the Michigan Trauma Quality Improvement Program. Through a literature review, we identified quantifiable metrics for most aims, except for equity and patient-centeredness. We proposed two approaches to build composite scores accounting for equity via an adjustment procedure based on observed disparities. The single- and multi-aim approaches were compared through correlation, concordance of trauma centre categorisations, and hypothetical incentives. The differences in the approaches stemmed mainly from the weights allocated to the different aims. Results indicated the potential value of multi-aim quality assessment and provided insights about implementation challenges and opportunities. The methods are applicable to the preferred metrics; nevertheless, further research is needed in measuring patient-centeredness.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1906763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46355140","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
Patterns of health information exchange strategies underlying health information technologies capabilities building. 卫生信息交流战略模式是卫生信息技术能力建设的基础。
IF 1.8
Health Systems Pub Date : 2021-07-16 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1952113
Placide Poba-Nzaou, Sylvestre Uwizeyemungu, Mamadou Dakouo, Anicet Tchibozo, Bocar Mboup
{"title":"Patterns of health information exchange strategies underlying health information technologies capabilities building.","authors":"Placide Poba-Nzaou,&nbsp;Sylvestre Uwizeyemungu,&nbsp;Mamadou Dakouo,&nbsp;Anicet Tchibozo,&nbsp;Bocar Mboup","doi":"10.1080/20476965.2021.1952113","DOIUrl":"https://doi.org/10.1080/20476965.2021.1952113","url":null,"abstract":"<p><p>The combination of electronic health records (EHRs), health information exchange (HIE), and telehealthholds a high potential for improving the coordination of care and saving lives. As well, the benefits of the three HIT on hospitals' depend on the patterns of capabilities that are available and used by clinicians. However, little is known about how the three HIT, actually empirically coexist and about the strategies underlying the use of HIE in hospital settings. Based on data from a European Union survey, we use a combination of hierarchical and non-hierarchical clustering and discriminant analysis to identify patterns of hospitals' HIT capabilities. Five statistically significantly separated configurations were derived from a data set of 1038 acute care hospitals. The actual empirical coexistence of the three HIT capabilities and associated HIE strategies revealed by this study can be counter-intuitive and shed light on misalignments that may impede the realisation of the potential benefits.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1952113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33477123","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}
引用次数: 1
Simulation optimisation for mixing scheduled and walk-in patients. 模拟优化混合预约和预约病人。
IF 1.8
Health Systems Pub Date : 2021-06-28 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1943010
Jacob Wing, Peter Vanberkel
{"title":"Simulation optimisation for mixing scheduled and walk-in patients.","authors":"Jacob Wing,&nbsp;Peter Vanberkel","doi":"10.1080/20476965.2021.1943010","DOIUrl":"https://doi.org/10.1080/20476965.2021.1943010","url":null,"abstract":"<p><p>Mixed registration type clinics accept both walk-in and scheduled patients. Such clinics provide patients with an additional option for how they access care while patient bookings help providers ensure a full workday. The model described in this paper determines how many patients to schedule (and when) in mixed registration type clinics. The methodology, simulation optimisation allows stochastic features found in such clinic to be modelled and provides optimisation techniques to identify solutions. A general simulation optimisation formulation for mixed registration type clinics is presented. Furthermore, the methodology is applied to a case study of a collaborative emergency centre in Nova Scotia, Canada. We demonstrate how the model can be used in clinics with multiple providers and multiple objectives. We compare the simulation optimisation generated schedule with existing schedules and show the advantages the collaborative emergency centre can expect when using schedules developed with the presented methods.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1943010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451314","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}
引用次数: 2
Predicting non-attendance in hospital outpatient appointments using deep learning approach. 利用深度学习方法预测医院门诊预约的缺勤情况。
IF 1.8
Health Systems Pub Date : 2021-05-24 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1924085
M Dashtban, Weizi Li
{"title":"Predicting non-attendance in hospital outpatient appointments using deep learning approach.","authors":"M Dashtban,&nbsp;Weizi Li","doi":"10.1080/20476965.2021.1924085","DOIUrl":"https://doi.org/10.1080/20476965.2021.1924085","url":null,"abstract":"<p><p>The hospital outpatient non-attendance imposes a substantial financial burden on hospitals and roots in multiple diverse reasons. This research aims to build an advanced predictive model for predicting non-attendance regarding the whole spectrum of probable contributing factors to non-attendance that could be collated from heterogeneous sources including electronic patients records and external non-hospital data. We proposed a new non-attendance prediction model based on deep neural networks and machine learning models. The proposed approach works upon sparse stacked denoising autoencoders (SDAEs) to learn the underlying manifold of data and thereby compacting information and providing a better representation that can be utilised afterwards by other learning models as well. The proposed approach is evaluated over real hospital data and compared with several well-known and scalable machine learning models. The evaluation results reveal the proposed approach with softmax layer and logistic regression outperforms other methods in practice.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1924085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33477127","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}
引用次数: 7
Modelling changes in healthcare demand through geographic data extrapolation 通过地理数据外推模拟医疗保健需求的变化
IF 1.8
Health Systems Pub Date : 2021-05-02 DOI: 10.1080/20476965.2021.1906764
Geraint I. Palmer, P. Harper, Vincent A. Knight, Cathy Brooks
{"title":"Modelling changes in healthcare demand through geographic data extrapolation","authors":"Geraint I. Palmer, P. Harper, Vincent A. Knight, Cathy Brooks","doi":"10.1080/20476965.2021.1906764","DOIUrl":"https://doi.org/10.1080/20476965.2021.1906764","url":null,"abstract":"ABSTRACT Stay Well Plans are a new programme of care offered to frail and elderly people in Newport. In 2016 a roll out the programme to be offered in all five counties serviced by Aneurin Bevan University Health Board was planned. This paper presents the data analysis and modelling used to determine the programme's effects on the demand of the wider system, and the effects of a Gwent-wide roll out. We extrapolate information from data from a geographical subset of the model domain to a larger geographical area, adjusting for population sizes, deprivation, and distances to healthcare facilities. These parametrise a Markov model and Monte Carlo simulation to predict changes in demand due to different levels of roll out. We conclude that a programme roll out may result in a large reduction on demand at residential care, however at the expense of an increase in demand at community care services.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1906764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42965403","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: 1
A pull-strategy for the appointment scheduling of surgical patients in a hospital-integrated facility. 医院综合设施中外科病人预约调度的拉策略。
IF 1.8
Health Systems Pub Date : 2021-04-23 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1908851
Safa Chabouh, Sondes Hammami, Eric Marcon, Hanen Bouchriha
{"title":"A pull-strategy for the appointment scheduling of surgical patients in a hospital-integrated facility.","authors":"Safa Chabouh,&nbsp;Sondes Hammami,&nbsp;Eric Marcon,&nbsp;Hanen Bouchriha","doi":"10.1080/20476965.2021.1908851","DOIUrl":"https://doi.org/10.1080/20476965.2021.1908851","url":null,"abstract":"<p><p>This paper addresses the daily appointment scheduling (AS) of patients in a hospital-integrated facility where outpatients and inpatients are treated simultaneously and share critical resources. We propose a lean approach based on the pull-strategy \"Constant Work in Process\" (ConWIP) to develop robust and easy-to-implement AS rules. Our objective is to reduce patients' waiting time and maximise the use rate of resources while considering the global surgical process and stochastic service times. The AS rules based on ConWIP are evaluated using a Discrete-Event-Simulation model. Numerical experiments based on a real-life case study are carried out to assess the proposed appointment rules' performance and compare them to AS rules developed in the literature. The results highlight the robustness of our approach and demonstrate its usefulness in practice.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1908851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33477124","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}
引用次数: 0
Using a genetic algorithm to solve a non-linear location allocation problem for specialised children's ambulances in England and Wales. 利用遗传算法解决了英格兰和威尔士儿童救护车的非线性位置分配问题。
IF 1.8
Health Systems Pub Date : 2021-04-18 eCollection Date: 2022-01-01 DOI: 10.1080/20476965.2021.1908176
Enoch Kung, Sarah E Seaton, Padmanabhan Ramnarayan, Christina Pagel
{"title":"Using a genetic algorithm to solve a non-linear location allocation problem for specialised children's ambulances in England and Wales.","authors":"Enoch Kung,&nbsp;Sarah E Seaton,&nbsp;Padmanabhan Ramnarayan,&nbsp;Christina Pagel","doi":"10.1080/20476965.2021.1908176","DOIUrl":"https://doi.org/10.1080/20476965.2021.1908176","url":null,"abstract":"<p><p>Since 1997, special paediatric intensive care retrieval teams (PICRTs) based in 11 locations across England and Wales have been used to transport sick children from district general hospitals to one of 24 paediatric intensive care units. We develop a location allocation optimisation framework to help inform decisions on the optimal number of locations for each PICRT, where those locations should be, which local hospital each location serves and how many teams should station each location. Our framework allows for stochastic journey times, differential weights for each journey leg and incorporates queuing theory by considering the time spent waiting for a PICRT to become available. We examine the average waiting time and the average time to bedside under different number of operational PICRT stations, different number of teams per station and different levels of demand. We show that consolidating the teams into fewer stations for higher availability leads to better performance.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2021.1908176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33477125","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}
引用次数: 5
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