Risk Management and Healthcare Policy最新文献

{"title":"Impact of China's Diagnosis-Intervention Packet Policy on Hospitalization Costs for Patients With Malignant Tumors: A 2019-2022 Interrupted Time Series Analysis.","authors":"Mingmin Zhang, Guoping Wang, Hairong Liu, Yufeng Wen, Lingling Chen","doi":"10.2147/RMHP.S502474","DOIUrl":"10.2147/RMHP.S502474","url":null,"abstract":"<p><strong>Purpose: </strong>China's diagnosis-intervention packet (DIP) policy, a medical insurance payment system leveraging big data, was implemented in Wuhu, China, in January 2021. Studies have proven that the DIP has been effective in reducing medication costs for elderly hospital patients with hypertension. However, research on hospitalization costs for other patients remains limited. As the incidence of malignant tumors has increased dramatically in China, this study assesses the system's impact on hospitalization costs for patients with malignant tumors to confirm its broader effects.</p><p><strong>Patients and methods: </strong>Data on patients with malignant tumors (ICD codes C00-C97) were collected from a tertiary medical institution in Wuhu, using the policy's implementation in January 2021 as the beginning timepoint. Outcome indicators included average monthly hospitalization expenses and sub-expenses for hospitalized patients with malignant tumors. A 48-month time-series database was constructed and the interruption time series model used to evaluate the changing trends in expenses before and after the DIP implementation.</p><p><strong>Results: </strong>After DIP implementation, average hospitalization costs for patients with malignant tumors showed a statistically significant downward trend. Subgroup analysis revealed that patients with shorter hospital stays (1-5 days) and cured outcomes saw the biggest expense drop from hospital cost-control effects. The DIP policy also affected cost structures, initially increasing diagnostic fees and consumable costs, but significantly reducing treatment fees, medication costs, and other related costs.</p><p><strong>Conclusion: </strong>The study confirmed the effectiveness of the DIP policy in controlling hospitalization costs for patients with malignant tumors. Going forward, the government should optimize DIP rules to clarify cost calculation methods and prevent excessive use of high-cost diagnostics and consumables. Continued monitoring and evaluation are essential to ensure that the policy's benefits are maintained over time. Medical institutions should improve resource allocation, diagnosis, and treatment efficiency; reduce unnecessary stays; and provide tailored treatment plans and cost support for patients with poor prognosis.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"655-665"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of Avoiding Emergency Department Visits During the COVID-19 Pandemic Among Patients With Acute Ischemic Heart Events.","authors":"Tzu-Ching Sung, Yu-Ching Wang, Hsiang-Chin Hsu, Yi-Ting Huang, Hsin-I Shih","doi":"10.2147/RMHP.S508088","DOIUrl":"10.2147/RMHP.S508088","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic significantly disrupted healthcare services as individuals avoided medical facilities to reduce the risk of infection. Despite Taiwan's effective public health measures and low SARS-CoV-2 case numbers in 2020, emergency department (ED) utilization patterns still changed, particularly for cases with acute ischemic heart events. This study investigated how the pandemic influenced medical avoidance in such cases and assessed potential collateral damage and adverse outcomes in an ED that managed limited COVID-19 instances during this period.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted on adult ED visits at a tertiary hospital from January 2017 to December 2020, focusing on symptoms associated with acute ischemic heart events and complications. Data was retrospectively collected from electronic medical records (EMRs), including demographics, clinical characteristics, visit times, discharge times, disposition types, triage levels, International Classification of Diseases-9th Revision (ICD-9) and International Classification of Diseases-10th Revision (ICD-10)-based diagnoses, and vital signs.</p><p><strong>Results: </strong>The study observed a 20-30% decline in adult ED visits in 2020, with a notable 29% decrease in semi-urgent (level 3) triage visits from February to May. The largest declines occurred among patients aged 80 and above, with reductions up to 44.4% in March. Acute ischemic heart cases decreased in early 2020 but rebounded by April and May. However, acute ischemic heart-related complications increased consistently throughout the year, particularly in January (61% vs 77%, p=0.02) and October (59% vs 77%, p=0.04).</p><p><strong>Conclusion: </strong>These findings highlight the indirect impact of the pandemic on critical care access, even in regions with low prevalence. Medical avoidance reduced ED visits but increased the risk of complications of acute ischemic heart. Addressing barriers to timely care and implementing targeted response strategies are essential to ensure access to life-saving treatments and mitigate long-term adverse health consequences during public health crises.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"569-578"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Knowledge and Outcomes of Nomophobia Among Students at a Selected Degree College in Riyadh.","authors":"Abdulaziz M Alodhialah, Ashwaq A Almutairi, Mohammed T Almutairi","doi":"10.2147/RMHP.S508434","DOIUrl":"10.2147/RMHP.S508434","url":null,"abstract":"<p><strong>Introduction: </strong>Nomophobia, the fear of being without a mobile phone, is increasingly prevalent among university students, impacting their psychological well-being and academic performance. This study assesses the level of knowledge and the psychological, academic, and social outcomes associated with nomophobia among students at King Saud University, Riyadh, Saudi Arabia.</p><p><strong>Methods: </strong>A descriptive cross-sectional design was employed, involving 350 undergraduate students recruited via convenience sampling. Data were collected using a structured questionnaire adapted from the Nomophobia Questionnaire (NMP-Q). Statistical analyses, including descriptive statistics, Pearson correlation, and multiple regression, were conducted using IBM SPSS.</p><p><strong>Results: </strong>The majority of participants (51.4%) exhibited moderate knowledge of nomophobia. Higher nomophobia scores were significantly associated with lower academic performance (r = -0.35, p < 0.001) and greater psychological distress, including anxiety (mean score = 5.2) and panic when phone battery was low (mean score = 4.8). Regression analysis identified gender (β = 0.28, p = 0.001) and smartphone ownership (β = 0.20, p = 0.003) as predictors of nomophobia.</p><p><strong>Discussion: </strong>The findings highlight nomophobia's negative impact on students' academic and psychological well-being, emphasizing the need for educational interventions to promote healthier smartphone usage. Addressing nomophobia through targeted strategies could improve academic outcomes and overall student wellness.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"667-678"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Determinants of Living Kidney Donors: A Cross-Sectional Study.","authors":"Arwa Alumran, Eman Hussain Aljanoubi, Amal Salman Bureqa, Reem Alturki, Saja A Alrayes, Zahra Alakrawi, Fatima Alshakhs, Mona Aljuwair","doi":"10.2147/RMHP.S487721","DOIUrl":"10.2147/RMHP.S487721","url":null,"abstract":"<p><strong>Background: </strong>End-stage renal disease (ESRD) is a global health issue that significantly impacts patient mortality and morbidity. Living kidney donors play a crucial role in addressing the shortage of available organs for transplantation.</p><p><strong>Objective: </strong>This study aims to identify the characteristics of potential kidney donors at King Fahad Specialist Hospital in Dammam (KFSH-D), Saudi Arabia and to assess the psychosocial factors influencing their willingness to proceed with the donation process.</p><p><strong>Methods: </strong>This cross-sectional study included 1523 individuals who applied to donate kidneys at KFSH-D. Data were retrieved from the hospital's transplant department electronic database, encompassing psychosocial variables such as gender, marital status, and age, along with the outcomes of donation intentions (ie, proceeded with donation, did not proceed due to unwillingness). Descriptive data analysis was conducted using chi-square tests and independent sample <i>t</i>-tests.</p><p><strong>Results: </strong>Of the 1523 potential donors, 997 proceeded with the donation. Key factors influencing the willingness to donate included gender (χ2=5.098, P=0.024), age (t=2.175, P=0.030), and existing relationships with recipients (χ2=162.664, P=0.001). However, marital status, nationality, blood group, BMI, weight, and height were not significantly associated with the decision to donate.</p><p><strong>Conclusion: </strong>Several psychosocial factors significantly influence the willingness of potential donors to complete the donation process. Understanding these factors can enhance predictive models and improve donor recruitment strategies, ultimately increasing the availability of kidneys for transplantation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"629-635"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicriteria Risk Evaluation Model: Utilizing Fuzzy Logic for Improved Transparency and Quality of Risk Evaluation in Healthcare.","authors":"Rok Drnovšek, Marija Milavec Kapun, Simona Šteblaj, Uroš Rajkovič","doi":"10.2147/RMHP.S490598","DOIUrl":"10.2147/RMHP.S490598","url":null,"abstract":"<p><strong>Introduction: </strong>Risk management is essential for quality assurance in modern healthcare organizations. Risk matrices are widely used to evaluate risks in healthcare settings; however, this approach has noteworthy weaknesses and limitations. This paper introduces a novel risk evaluation model that utilizes multicriteria decision-making and fuzzy logic, to enhance the transparency and quality of the risk evaluation process in healthcare.</p><p><strong>Methods: </strong>The Multicriteria Evaluation Model was developed using the Decision Expert method and expert knowledge integration. Fuzzy logic was integrated within the model, using partial degrees of membership and probabilistic analysis, to address uncertainties inherent to healthcare risk evaluation. The evaluation model was tested with healthcare professionals active in the field of risk management in clinical practice and compared with the risk matrix.</p><p><strong>Results: </strong>The designed evaluation model utilizes multicriteria decision-making while encompassing the risk matrix framework to boost user understanding and enable meaningful comparison of results. Compared with the risk matrix, the model provided similar or marginally higher risk-level evaluations. The use of degrees of membership enables evaluators to articulate a wide range of plausible risk consequences, which are often overlooked or ambiguously addressed in the traditional risk matrix approach.</p><p><strong>Discussion and conclusions: </strong>The evaluation model demonstrates increased transparency of the decision-making process and facilitates in-depth analysis of the evaluation results. The utilization of degrees of membership revealed distinct strategies for handling uncertainty among participants, highlighting the weaknesses of using single value evaluation approach for the presented and similar decision problems. The presented approach is not limited to healthcare-related risk evaluation, but has the capacity to improve risk evaluation practices in diverse settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"637-653"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse Pressure and Other Cardiovascular Risk Factors Associated with Multiple Carotid Plaques in a Rural Chinese Population: A Population-Based Cross-Sectional Study.","authors":"Chunxia Yan, Juan Hao, Xiaoqian Sun, Yanan Ding, Taofeng Tan, Xiaoqian Yang, Jun Tu, Xianjia Ning, Jinghua Wang, Lingling Bai","doi":"10.2147/RMHP.S491001","DOIUrl":"https://doi.org/10.2147/RMHP.S491001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the association between these Blood pressure (BP) components examined in this study, including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP), with the presence of multiple carotid plaques in a low-income rural Chinese population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This population-based cross-sectional study was conducted from April 2014 to January 2015, involving participants from the Tianjin Brain Study. Participants aged 45 years and older with diagnosed carotid plaques were included. Data on demographics, medical history, and lifestyle factors were collected through interviews and existing records. Blood pressure measurements were taken in a quiet room, following the standard procedures recommended by the American Hypertension Association (AHA), and ultrasonographic examinations were performed to identify and quantify carotid plaques. Multivariate logistic regression model was used to explore the association between blood pressure components and multiple plaques. The blood pressure component with a positive univariate analysis was included in different models, each adjusted for age, sex, body mass index (BMI), and the ratio of high-density lipoprotein cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study found that 41.8% of participants had multiple carotid plaques, with a higher prevalence in men compared to women. Multivariate logistic regression analysis revealed that each 1-mmHg increase in systolic BP (SBP) was associated with a 0.9% increase in the prevalence of multiple carotid plaques (OR = 1.009; 95% CI 1.004-1.014; P &lt; 0.001). Each 1-mmHg increase in pulse pressure (PP) was associated with a 1.2% increase (OR = 1.012; 95% CI 1.006-1.018; P &lt; 0.001), and each 1-mmHg increase in mean arterial pressure (MAP) was associated with a 1.1% increase (OR = 1.011; 95% CI 1.003-1.019; P = 0.005). Participants with a history of hypertension had a significantly higher prevalence of multiple carotid plaques compared to normotensive individuals. Notably, grade 2 hypertension showed a significant association with multiple carotid plaques (OR = 1.554; 95% CI 1.135-2.127; P = 0.006). In addition, male sex, older age, and low BMI were all associated with a higher risk of multiple carotid plaques (P all&lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study provides critical evidence on the relationship between BP components and multiple carotid plaques, with significant implications for patients, physicians, and society. By prioritizing BP management, particularly focusing on PP, which demonstrates the strongest association with carotid plaques, as well as targeting higher-risk populations such as males, older individuals, and those with low BMI, preventive measures against carotid atherosclerosis can be enhanced. This will ultimately contribute to better cardiovascular ","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"617-628"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Smoking Awareness Among Nursing Students and Professionals in Spain.","authors":"Mario García-Suárez, Beatriz Ordás-Campos, Jesús Antonio Fernández-Fernández, Carlos Méndez-Martínez, Juan Gómez-Salgado, Daniel Fernández-García","doi":"10.2147/RMHP.S501043","DOIUrl":"https://doi.org/10.2147/RMHP.S501043","url":null,"abstract":"<p><strong>Background: </strong>Tobacco consumption is considered one of the main risk factors in the development of non-communicable diseases such as respiratory, cardiovascular, or oncological diseases, among others. Nurses play an important role in identifying smokers and making them aware of the consequences of tobacco use, advising them on smoking cessation.</p><p><strong>Objective: </strong>The aim of this study was to carry out a comparative analysis of the level of smoking awareness among nursing students and professionals.</p><p><strong>Methods: </strong>Descriptive cross-sectional study using an anonymous self-administered questionnaire, previously validated. This questionnaire was given to nursing students between March and June 2022 and to nursing professionals between January and March 2023.</p><p><strong>Results: </strong>The prevalence of tobacco use was found to be 14.5% among nursing students and 19.1% among nursing professionals. Regarding the level of awareness, professionals always obtained better results than students, with statistically significant differences when analysing the mean scores obtained in the questionnaires regarding awareness of the effects of tobacco consumption in active smokers (8.72 vs 8.07; p<0.001) and of the pathologies that could manifest in passive smokers (5.49 vs 5.27; p=0.008).</p><p><strong>Conclusion: </strong>The results of the analysis show that professionals seem to be better educated and to use tobacco more than students. The awareness that professionals have about the different consequences of active and/or passive smoking does not lead to a decrease in the prevalence of smoking, probably because the number of years they have been using cigarettes is much higher than that of students. Similarly, proving an acceptable level of awareness does not result in professionals promoting smoking cessation programmes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"605-616"},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia, Depressive Symptoms, and Fall Risk: Insights from a National Cohort Study in the Chinese Population.","authors":"Xiaoming Zhang, Dongmei Ye, Qingli Dou, Fayi Xie, Rui Zeng, Ke Zhu, Wan Zhu, Aizhang Zhu, Lihuan Chen, Yishan Wu, Tenghui Fan, Pai Peng, Yuxu Huang, Shunrui Xiao, Jiahui Bian, Mengxia Shi, Jiang Wang, Wenwu Zhang","doi":"10.2147/RMHP.S497087","DOIUrl":"10.2147/RMHP.S497087","url":null,"abstract":"<p><strong>Background: </strong>Previous investigations have indicated that both sarcopenia and depressive symptoms are linked to a heightened risk of falls. However, the potential synergistic effect of these conditions on fall risk remains unclear. This study aims to assess the combined influence of sarcopenia and depressive symptoms on the occurrence of falls in the Chinese population.</p><p><strong>Methods: </strong>The analysis included 8,405 participants from the China Health and Retirement Longitudinal Study (CHARLS), conducted from 2011 to 2015. Sarcopenia was confirmed using the 2019 Asian Working Group for Sarcopenia (AWGS) algorithm consisting of muscle strength, appendicular skeletal muscle mass (ASM), and physical performance. ASM was calculated using the formula: 0.193 × weight (kg) + 0.107 × height (cm) - 4.157 × sex - 0.037 × age (years) - 2.631. The Center for Epidemiological Research Depression Scale was utilized to assess depressive symptoms, with a cut-off score of 12 points. Depressive sarcopenia is defined as the coexistence of sarcopenia and depression. Multiple logistic regression analyses were conducted to explore the associations among sarcopenia, depressive symptoms, and fall occurrences.</p><p><strong>Results: </strong>During the four-year follow-up, 1,275 participants reported experiencing falls. A significant synergistic effect was identified between sarcopenia and depressive symptoms regarding fall risk. Compare to robust individuals, those with sarcopenia alone or depression alone had increased falls risks, but those with both conditions exhibited the highest fall risk, with adjusted odds ratios (OR) of 1.21 (95% CI 1.03, 1.42; <i>P</i> = 0.0174), 1.53 (95% CI 1.24, 1.88; <i>P</i> < 0.001), and 1.78 (95% CI 1.48, 2.15; <i>P</i> < 0.001), respectively.</p><p><strong>Conclusion: </strong>The findings highlight a synergistic effect between sarcopenia and depressive symptoms on fall risk. This study highlights the importance of early detection and intervention for both conditions, especially in older and middle-aged individuals, to mitigate fall risk.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"593-603"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Kiosk-Model Self-Triage System for COVID-19 Triage.","authors":"Asli Gorek Dilektasli, Vahide Aslihan Durak, Erol Armagan, Engin Korkmaz, Gorsel Kiras, Aykut Sen, Emel Bulbul Baskan, Sehime G Temel","doi":"10.2147/RMHP.S497053","DOIUrl":"10.2147/RMHP.S497053","url":null,"abstract":"<p><strong>Purpose: </strong>Pandemics put healthcare workers (HCWs) at risk of infections, making emergency department (ED) triage critical. This study aims to compare smart innovative self-kiosk triage (SKT) with routine triage (RT).</p><p><strong>Patients and methods: </strong>COVID-19-suspected ED patients enrolled. Volunteers received RT after completing SKT. The key outcomes were HCW exposure and total exposure time (TET). Secondary outcomes included participants' satisfaction with SKT.</p><p><strong>Results: </strong>The study included 115 patients with a mean age of 32.54±10.84 years old. SKT significantly reduced HCW exposures (median 0 [IQR 0-1] vs 2 [IQR 2-3], p<0.0001) and triage time (median 3 [IQR 2-3] vs 8 [IQR 5-10] minutes, p<0.0001), compared to RT. Elevated body temperature increased RT time (p=0.003), while higher education levels reduced SKT time (p=0.019). Oxygen saturation influenced HCW exposure in both methods, with higher saturation decreasing HCW exposure during RT (p=0.008) and increasing it during SKT (p=0.017). A PCR-positive status was associated with increased RT time but fewer HCW exposures. 80.0% of participants completed SKT independently. The majority of participants (72.8-82.9%) agreed or strongly agreed, based on a 4-point Likert scale, that the SKT procedure was user-friendly (mean score: 3.40±1.08), with clear instructions (3.35±1.16), easy-to-use oximetry and thermometer (3.12±1.29 and 3.31±1.16, respectively), and a reasonable time requirement (3.37±1.23).</p><p><strong>Conclusion: </strong>Our findings suggest that emergency department self-kiosk triage can minimize medical staff exposure and time spent with COVID-19-risk patients, without compromising patient satisfaction.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"579-592"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Emergency Department Crowding and Adverse Occurrences in an Academic Hospital: A Retrospective Cohort Study.","authors":"Wajdan Alassaf, Razan Albrahim, Jana K Abukhaled, Mujahid Aldhaif, Mashaer Ahmed Mohammed, Alia Al Baiz, Muna Aljahany","doi":"10.2147/RMHP.S504578","DOIUrl":"10.2147/RMHP.S504578","url":null,"abstract":"<p><strong>Background: </strong>Emergency care predominantly involves the treatment of abrupt clinical status deteriorations, illness exacerbation, and potentially life-threatening injuries. However, crowding and excessive delays in the emergency department (ED) affect the quality of care and are associated with undesirable outcomes.</p><p><strong>Objective: </strong>This study aimed to determine the association of emergency department (ED) crowding with patient outcomes at a teaching hospital in Saudi Arabia's Central Province.</p><p><strong>Methods: </strong>Using a retrospective chart review of electronic medical records, we extracted mortality, morbidity, and safety events-related data of all adult, pediatric, and obstetric patients who presented to the King Abdullah Bin Abdulaziz University Hospital (KAAUH) emergency department (ED) between January 2019 and December 2022. Based on the emergency department (ED) census, these data were cross-referenced by date with the emergency department (ED) situation.</p><p><strong>Results: </strong>Sixty patients had safety events; medication-related safety events were the most prevalent (38%), followed by care-coordination events (30%). Twenty cases of mortality and morbidity were reported. Crowding significantly affected adverse medication-related and care-coordination events (<i>p</i> = 0.0212), with a more significant effect on moderate safety events than on mild safety events (<i>p</i> = 0.0348). Influence of emergency department (ED) crowding (<i>p</i> = 0.3740) was on mortality or morbidity outcomes was detected. The data was extracted from a total of 139176 emergency visits for all categories.</p><p><strong>Conclusion: </strong>In Saudi Arabia, emergency department (ED) crowding signifies a critical healthcare crisis, potentially compromising quality of care. Our findings provide evidence of increased errors in medication, care coordination, and medical care due to emergency department (ED) crowding. Implementing micro and macro-level strategies to reduce emergency department (ED) crowding could help improve patient outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"561-568"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}