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At least 19 recordsLinked to original sources
PubMed1977

[Hygienic and bacteriological comparative studies in 50 hospitals. VI. The efficacy of a hospital-hygienic instruction regarding 6 hospitals].

The efficacy of hospital hygienic measures was checked in six hospitals. The programme was started by determining the effective state. Subsequently a two-day extension course for the training and instruction of the responsible personnel in charge (physicians, nurses and administrative staff) in the essential problems of hospital hygiene was held. The next measure consisted in giving advice in the preparation of hygiene plans which had to make allowance for the prevailing personal and constructional situation as well as for the hospital equipment. The hygiene plans represented the written concept of the measures to be implemented. Then enquiries, local inspections as well as hygienic-bacteriological ambient analyses were carried out to determine the hygienic situation in the hospital after adoption of the measures and the findings were compared with the situation preceding the initiation of the hygienic programme. The results show that the proposed improvements were mostly realised as far as such administrative measures as the procurement of disinfectant dispensers, throwaway towels and suitable disinfectants were concerned. The instructions given for the implementation of suitable methods of application were complied with to a lesser extent. Moreover, considerable improvements were achieved with regard to the operation and efficiency of the sterilizers. On the whole, the present study demonstrates that suitable measures largely reduce the extensive gaps in information on the part of the staff on hospital hygiene and that the resulting intensification of efforts can greatly contribute towards an improvement of the overall hygiene in hospitals.

Air Microbiology↗
PubMed1992

[Variations in hospitalization rates of non-neonatal hospital admissions to pediatric departments of three district hospitals].

Hospitalization rates of children from three health districts were analyzed. The rates ranged from 30 to 40 admissions per 1000 children. The length of hospital stay, the rates of transfers and deaths were similar. Admission rates were different for certain selected diagnoses: gastroenteritis, pneumonia, bronchiolitis, head trauma and ear, nose and throat procedures. The variations were not related to differences in physician or bed supply, nor to severity or the disease of a delay in getting medical care. The demographic and geographic characteristics and the different patterns of practice can be associated with the observed variations. The health status of these children must be determined before considering which rate is correct.

Age Factors↗
PubMed2025

Hospitalization for child physical abuse before hospitalization for osteogenesis imperfecta or severe hemophilia: A nationwide cohort study in France.

BACKGROUND: Timely and accurate diagnosis of early child physical abuse (CPA) is crucial to avoid recurrence and protect victims. Ruling out differential diagnoses is also important to avoid misdiagnosis of CPA. We evaluated the risk of hospitalization for early CPA before hospitalization for its 2 main differential diagnoses: osteogenesis imperfecta (OI) and severe hemophilia (SH). METHODS: This population-based cohort study used the national administrative database covering all hospitals in France. We followed infants born from 2010 to 2019 until age 2. We identified infants with a first discharge code for early CPA, OI, and SH and calculated crude absolute and relative risks. RESULTS: Among the 6,315,216 infants included, 2088 (33/100,000 infants per year) were hospitalized for early CPA, 160 (3/100,000) for OI, and 402 (6/100,000) for SH before age 2. Among infants hospitalized for early CPA, 2085 (99.86 %) had no further hospitalization for OI or SH, 3 (0.14 %) were further hospitalized for OI with a 9-month median interval between hospitalizations, and 0 were further hospitalized for SH. The absolute risk of hospitalization for early CPA before hospitalization for OI was 1.9 % (3/160, 95 % confidence interval [CI] 0.39-5.38), and the relative risk as compared with infants without hospitalization for OI was 56.8 (95 % CI 18.5-174.3). CONCLUSIONS: The very low to null absolute risks of hospitalization for early CPA before OI or SH probably reflect excellent current clinical practices in ruling out differential diagnoses. A better implementation of existing guidelines could further shorten the time to diagnosis of OI before age 2.

Humans↗
PubMedDate not supplied

[Some problems of psychiatric care unit in a general hospital I: Concerning decision of admission to hospital (author's transl)].

Over a thousand patients a year request hospitalization at the Psychiatric Admission Unit of the Region General Hospital of Santa Maria Nuova in Florence. About five hundred are actually hospitalized, less than half. Decision to hospitalize depends on several factors: a) factors relating to the patient (the psychopathological picture, the severity of his condition, his family background etc.); b) factors relating to the doctor on duty (degree of experience, attitude toward the patients, theoretical view toward hospitalization etc.); c) practical and administrative factors (service situation, day of the week, time of the day etc.). On the other hand the doctor's attitude may be that of undertaking care of the patient's psychiatric needs or not. This behaviour is largely independent from the decision to hospitaliz or not. Hospitalization does not necessarily mean taking care of the patient from a psychiatric point of view (hospital seen as a parking place, for example) and, vice versa, treatment can be planned without hospitalizing the patient who asks for it. Thus, there are four possibilities in a Psychiatric Admission Unit: a) hospitalization and care of the patient; b) no hospitalization but care of the patient; c) hospitalization without care of the patient; d) no hospitalization and no care of the patient. These four situations discussed with appropriate examples. The emotional attitude of the psychiatrist in his relationship with the patients who request admission is viewed as the most important factor for a correct decision.

Humans↗
PubMed1978

[Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)].

The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees.

Economics, Hospital↗
PubMed2025

Duration of Hospitalization is Associated with the Gut Microbiome in Patients Undergoing Hematopoietic Stem Cell Transplantation: Early Results from a Randomized Trial of Home Versus Hospital Transplantation.

Home-based hematopoietic stem cell transplantation (HCT) is an innovative care model with growing interest, but its impact on the gut microbiome remains unexplored in a randomized setting. We present interim results from the first randomized controlled trials (RCT) evaluating the effect of HCT location-home versus hospital-on gut microbial diversity and antimicrobial resistance (AMR) gene carriage. We hypothesize that patients randomized to undergo home HCT would have higher gut taxonomic diversity and lower AMR gene abundance compared to those undergoing standard hospital HCT. We analyzed stool samples from the first 28 patients enrolled in ongoing Phase II RCTs comparing home (n = 16) and hospital (n = 12) HCT at Duke University using shotgun metagenomic sequencing to compare taxa and AMR gene composition between groups. We also performed a secondary analysis comparing patients who received transplants at outpatient infusion clinics versus inpatient standard HCT to evaluate the influence of hospitalization duration. In the primary RCT analysis, taxonomic and AMR gene α- and β-diversity were comparable between home and hospital groups, reflecting similar durations of hospitalization despite group allocation. In contrast, secondary analyses demonstrated that patients transplanted in outpatient infusion clinics who experienced significantly reduced hospitalization had higher gut taxonomic α-diversity and differential β-diversity, although AMR gene diversity remained unchanged. In summary, randomization by transplant location did not impact the gut microbiota to the same extent as the duration of hospitalization, although secondary analyses were heavily confounded. Even when taxonomic differences were observed, AMR genes were similar between groups. This RCT represents a novel investigation into how care setting influences the gut microbiome during HCT. Our findings suggest that hospital duration, rather than randomization allocation alone, is the primary driver of microbial disruption. These results underscore the potential for reducing hospital duration to mitigate microbiome injury, thereby informing future interventions to reduce infection risk and improve patient outcomes.

Microbiome↗
PubMed1975

The state mental hospital in transition. Illinois state mental hospitals decentralize.

In this paper, we have looked at mental hospital decentralization as it has developed in the thirteen State of Illinois mental hospitals as of June 30, 1967. The hospitals were looked at from the most centralized to the most decentralized. This was done by relating the hospitals to five descriptive model types, described at greater length elsewhere. Hospital decentralization is portrayed as a complex and highly idiosyncratic process. Attempts to place specific hospitals at point along the decentralization continuum are thus tentative and clear rules for classifying stages of decentralization have yet to be formulated. Complicating the picture still further is that hospitals in transition change rapidly and may at even intervals of a month show dramatic change. It is expected that the trend implied is stable, however, and that ultimately all Illinois state mental hospital with possible exception of ISPI and Illinois Security Hospital, will be located at the decentralized model. This is seen as necessary if they are to survive as viable treatment institutions.

Commitment of Persons with Psychiatric Disorders↗
PubMed1977

Characteristics of hospitalizations and death cases of diabetic patients in a general hospital.

Hospital admissions of diabetic patients were analyzed in relation to total hospital admissions, during a period of 7 years in a general hospital. The prevalence of hospitalization of diabetic patients was 2.5%. The female to male ratio was 1.4:1.0. Admissions of diabetic patients to hospital are mainly in the older age groups. By the age of 40 years, 73.4% of the total hospitalizations occur but only 13.0% of these hospital admissions are diabetics. The age at time of death of admissions ending fatally is similar in both the total and the diabetic admission groups to hospital. When the percentages of hospital admissions which terminated in death are calculated for age groups, an increase is specifically demonstrated in the diabetic group compared to the total admission group. Thus, diabetes is a complicating factor which increases mortality in people over 50 years of age.

Adolescent↗
PubMed1992

Patient satisfaction with hospital services: determinants and level in a hospital in Kuwait.

The present study used a well-tested patient satisfaction measuring instrument to identify the determinants of the level of overall satisfaction with hospital services, and to examine the level of satisfaction with attributes of 7 specific dimensions of hospital services. Using multiple regression analysis, it was found that out of 12 patient characteristics, age was the most important determinant of overall satisfaction, followed by gender. Perceived health status, clinical department, and expectations about the quality of services before admission were also significant but less important determinants of overall satisfaction. Marital status, level of education, nationality, and previous hospitalization in the study hospital, in Kuwait, or in a western country hospital, all had no significant effect on overall satisfaction. Concerning the effect of satisfaction with specific dimensions of hospital services on overall satisfaction, it was found that satisfaction with physicians was the most important determinant of overall satisfaction, followed by satisfaction with housekeeping and with nurses. Satisfaction with hospital environment and facilities and with admission process were also significant but less important determinants of overall satisfaction, while satisfaction with food and radiology services did not affect overall satisfaction. The level of overall satisfaction as well as satisfaction with specific dimensions of hospital services were quite high. Physicians' care was the most favorably rated dimension, followed by admission process and housekeeping, while nursing care was the least favorably rated dimension. Among the attributes of physicians' and nurses' care, technical care and courtesy were the most favorably rated items; while communication, particularly imparting of information, was the least favorably rated aspect. Several attributes of the hospital environment and facilities and of the food services were found to be dissatisfying to patients.

Adult↗