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Discharge against medical advice (DAMA): Causes and predictors

Ashrafi, Ensieh ; Nobakht, Samin ; Safi Keykaleh, Meysam ; [et al.]

Knowledge Kingdom Publishing ; 2017

In: Electronic Physician Vol. 9, No. 6 ( 2017-06-25), p. 4563-4570

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In: Electronic Physician, Knowledge Kingdom Publishing, Vol. 9, No. 6 ( 2017-06-25), p. 4563-4570

Type of Medium: Online Resource

ISSN: 2008-5842

URL: Article

DOI: 10.19082/4563

Language: Unknown

Publisher: Knowledge Kingdom Publishing

Publication Date: 2017

detail.hit.zdb_id: 2524187-4

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Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Haakenstad, Annie ; Irvine, Caleb Mackay Salpeter ; Knight, Megan ; [et al.]

Elsevier BV ; 2022

In: The Lancet Vol. 399, No. 10341 ( 2022-06), p. 2129-2154

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In: The Lancet, Elsevier BV, Vol. 399, No. 10341 ( 2022-06), p. 2129-2154

Type of Medium: Online Resource

ISSN: 0140-6736

URL: Article

DOI: 10.1016/S0140-6736(22)00532-3

RVK:

XA 10000

Language: English

Publisher: Elsevier BV

Publication Date: 2022

detail.hit.zdb_id: 2067452-1

detail.hit.zdb_id: 3306-6

detail.hit.zdb_id: 1476593-7

SSG: 5,21

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Use of ethical predictability in respect for human rights in Iranian hospitals with a 360-degree approach

Malekzadeh, Roya ; Abedi, Ghasem ; Abedini, Ehsan ; [et al.]

Emerald ; 2020

In: International Journal of Human Rights in Healthcare Vol. 13, No. 5 ( 2020-05-15), p. 445-455

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In: International Journal of Human Rights in Healthcare, Emerald, Vol. 13, No. 5 ( 2020-05-15), p. 445-455

Abstract: Respect for human rights is one of the most important criteria for the delivery of medical care in hospitals. Ethical predictability is useful to identify human rights concerns in health-care organizations. The hospital environment and the flow of its processes make the topic of predictability much more sensitive and, at the same time, more difficult than other organizations. The purpose of this paper is to determine and compare the ethical predictive factors in selected hospitals in Mazandaran province. Design/methodology/approach This cross-sectional survey using multilevel sampling (four hospitals, 938 patients, 186 staff) was conducted in the first half of 2017. The measurement instrument was a researcher-made questionnaire consisting of seven areas of service recipients’ rights, patient safety, patient satisfaction, human resources, governance, organizational and financial commitments. The analysis of the collected data was performed through SPSS V. 22 and one-way ANOVA and post hoc Tukey’s tests. Findings Ethical predictability was higher in social security hospitals compared to private and public hospitals, and patient safety and patient rights showed higher magnitudes compared to other dimensions. Financial domain, patient satisfaction, governance and organizational commitment formed the middle priorities in ethical predictability, and human resources had the least average in ethical predictability in the selected hospitals in the province. Originality/value Identifying the factors which influence ethical predictability, in addition to promoting service recipients’ rights and patient satisfaction, is of great help to the managers and health service authorities, so that they can have a better understanding of these factors and, consequently, make appropriate micro and macro-decisions to provide better services.

Type of Medium: Online Resource

ISSN: 2056-4902 , 2056-4902

URL: Article

DOI: 10.1108/IJHRH-10-2019-0083

Language: English

Publisher: Emerald

Publication Date: 2020

detail.hit.zdb_id: 2813769-3

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Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province

Malekzadeh, Roya ; Yaghoubian, Samereh ; Hasanpoor, Edris ; [et al.]

Emerald ; 2021

In: International Journal of Human Rights in Healthcare Vol. 14, No. 2 ( 2021-06-04), p. 133-142

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In: International Journal of Human Rights in Healthcare, Emerald, Vol. 14, No. 2 ( 2021-06-04), p. 133-142

Abstract: Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran. Design/methodology/approach The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section. Findings All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals ( p 〉 0.05). The most crucial responsiveness dimension in hospitals was autonomy. Originality/value In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.

Type of Medium: Online Resource

ISSN: 2056-4902 , 2056-4902

URL: Article

DOI: 10.1108/IJHRH-03-2020-0018

Language: English

Publisher: Emerald

Publication Date: 2021

detail.hit.zdb_id: 2813769-3

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Patients’ and physicians’ perspectives and experiences on the quality of medical consultations: a qualitative study

Bahadori, Mohammadkarim ; Yaghoubi, Maryam ; Haghgoshyie, Elaheh ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2019

In: International Journal of Evidence-Based Healthcare Vol. 18, No. 2 ( 2019-11-09), p. 247-255

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In: International Journal of Evidence-Based Healthcare, Ovid Technologies (Wolters Kluwer Health), Vol. 18, No. 2 ( 2019-11-09), p. 247-255

Abstract: Medical consultation is not only one of the most important steps in disease diagnosis and patient treatment, but also every patient's right. The purpose of this review was to explore patients’ and physicians’ perspectives and experiences of the quality of medical consultations. Methods: A qualitative interview study was carried out in outpatient clinics. A combination of face-to-face and telephone interviews was used due to the geographical spread of the respondents. Interviews were recorded and transcribed verbatim. Thematic descriptive analysis was used to interpret the data. Eligible physicians ( n = 21) and patients ( n = 27) were invited to take part in a semistructured interview to explore the views, perceptions, and experiences of patients on various factors affecting the quality of medical consultations. Results: The consultation quality was categorized into three topics: structure quality, process quality, and outcome quality. Data synthesis identified the following major themes for structure quality of consultations: administrative-organizational quality (with eight subthemes), physical environment quality (with six subthemes), and educational quality (with three subthemes). In addition, process quality was categorized into two major themes: examination quality (with nine subthemes) and interpersonal quality (with 13 subthemes). Outcome quality consisted of three major themes: patient satisfaction (with four subthemes), clinical outcomes (with two subthemes), and organizational outcomes (with three subthemes). Conclusion: Medical consultation plays a central role in the quality and effectiveness of the received health care. Using the indicators of consultation quality improvement can develop physicians’ clinical competence and skills. Furthermore, decision-makers can use them to monitor and evaluate physicians’ performance.

Type of Medium: Online Resource

ISSN: 1744-1609

URL: Article

DOI: 10.1097/XEB.0000000000000210

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2019

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Quality and credibility of clinical practice guidelines recommendations for the management of neonatal hypoglycemia. A protocol for a systematic review and recommendations’ synthesis

Shahid, Shaneela ; Cabra-Bautista, Ginna ; Florez, Ivan D. ; [et al.]

Public Library of Science (PLoS) ; 2023

In: PLOS ONE Vol. 18, No. 1 ( 2023-1-20), p. e0280597-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 1 ( 2023-1-20), p. e0280597-

Abstract: Hypoglycemia is one of the most frequent metabolic conditions in neonates. Clinical practice guidelines (CPGs) influence clinical practice as high-quality CPGs facilitate the use of evidence in practice. This proposed study aims to systematically identify and appraise CPGs and CPG recommendations (CPGRs) for treating neonatal hypoglycemia (NH). Methods and analysis We will conduct searches in MEDLINE, EMBASE, CINAHL, Cochrane Library, LILACS (Latin American & Caribbean Health Sciences Literature), and Epistemonikos. Authors will search CPGs-specific databases and grey literature. Two reviewers will independently perform the titles and abstract screening, full-text review, and data extraction. Two appraisers will assess the quality of the CPGs and their recommendations using AGREE II (Appraisal of Guidelines Research and Evaluation) and AGREE-REX (Appraisal of Guidelines Research and Evaluation–Recommendations Excellence) instruments. Scores of ≥ 60% in the rigour of development domain will be considered for defining high-quality with AGREE II tool. CPGRs with scores 〉 60% in the three domains will be used to determine high quality with the AGREE REX tool. We will perform a synthesis of the CPGRs to identify the consistency among the CPGRs and the methodological quality of primary studies that support them. Ethics and dissemination The results will help us to identify the methodological and quality gaps in the existing CPGs for the treatment of NH. Our findings will be submitted to peer-review journals and presented at academic conferences. Based on the study design, approval from the institutional ethics board is not required for this project. Trial registrations Systematic Review Registration Number (PROSPERO): CRD 42021239921 .

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0280597

DOI: 10.1371/journal.pone.0280597.s001

DOI: 10.1371/journal.pone.0280597.s002

DOI: 10.1371/journal.pone.0280597.s003

DOI: 10.1371/journal.pone.0280597.r001

DOI: 10.1371/journal.pone.0280597.r002

DOI: 10.1371/journal.pone.0280597.r003

DOI: 10.1371/journal.pone.0280597.r004

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2023

detail.hit.zdb_id: 2267670-3

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Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

Rathnayake, Dimuthu ; Clarke, Mike ; Jayasinghe, Viraj ; [et al.]

Public Library of Science (PLoS) ; 2021

In: PLOS ONE Vol. 16, No. 8 ( 2021-8-30), p. e0256578-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 8 ( 2021-8-30), p. e0256578-

Abstract: Concern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems. Methods We searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement. Results The electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty. Conclusions Explicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times.

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0256578

DOI: 10.1371/journal.pone.0256578.g001

DOI: 10.1371/journal.pone.0256578.g002

DOI: 10.1371/journal.pone.0256578.g003

DOI: 10.1371/journal.pone.0256578.g004

DOI: 10.1371/journal.pone.0256578.t001

DOI: 10.1371/journal.pone.0256578.t002

DOI: 10.1371/journal.pone.0256578.s001

DOI: 10.1371/journal.pone.0256578.s002

DOI: 10.1371/journal.pone.0256578.s003

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2021

detail.hit.zdb_id: 2267670-3

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Hospitals early challenges and interventions combatting COVID-19 in the Eastern Mediterranean Region

Ravaghi, Hamid ; Naidoo, Vanessa ; Mataria, Awad ; [et al.]

Public Library of Science (PLoS) ; 2022

In: PLOS ONE Vol. 17, No. 6 ( 2022-6-3), p. e0268386-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-3), p. e0268386-

Abstract: During rapidly evolving outbreaks, health services and essential medical care are interrupted as facilities have become overwhelmed responding to COVID-19. In the Eastern Mediterranean Region (EMR), more than half of countries are affected by emergencies, hospitals face complex challenges as they respond to humanitarian crises, maintain essential services, and fight the pandemic. While hospitals in the EMR have adapted to combat COVID-19, evidence-based and context-specific recommendations are needed to guide policymakers and hospital managers on best practices to strengthen hospitals’ readiness, limit the impact of the pandemic, and create lasting hospital sector improvements towards recovery and resilience. Aim Guided by the WHO/EMR’s “Hospital readiness checklist for COVID-19”, this study presents the experiences of EMR hospitals in combatting COVID-19 across the 22 EMR countries, including their challenges and interventions across the checklist domains, to inform improvements to pandemic preparedness, response, policy, and practice. Methods To collect in-depth and comprehensive information on hospital experiences, qualitative and descriptive quantitative data was collected between May-October 2020. To increase breadth of responses, this comprehensive qualitative study triangulated findings from a regional literature review with the findings of an open-ended online survey (n = 139), and virtual in-depth key informant interviews with 46 policymakers and hospital managers from 18 out of 22 EMR countries. Purposeful sampling supported by snowballing was used and continued until reaching data saturation, measures were taken to increase the trustworthiness of the results. Led by the checklist domains, qualitative data was thematically analyzed using MAXQDA. Findings Hospitals faced continuously changing challenges and needed to adapt to maintain operations and provide essential services. This thematic analysis revealed major themes for the challenges and interventions utilized by hospitals for each of hospital readiness domains: Preparedness, Leadership, Operational support, logistics, supply management, Communications and Information, Human Resources, Continuity of Essential Services and Surge Capacity, Rapid Identification and Diagnosis, Isolation and Case Management, and Infection, Prevention and Control. Conclusion Hospitals are the backbone of COVID-19 response, and their resilience is essential for achieving universal health coverage. Multi-pronged (across each of the hospitals readiness domains) and multi-level policies are required to strengthen hospitals resilience and prepare health systems for future outbreaks and shocks.

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0268386

DOI: 10.1371/journal.pone.0268386.g001

DOI: 10.1371/journal.pone.0268386.g002

DOI: 10.1371/journal.pone.0268386.g003

DOI: 10.1371/journal.pone.0268386.g004

DOI: 10.1371/journal.pone.0268386.g005

DOI: 10.1371/journal.pone.0268386.g006

DOI: 10.1371/journal.pone.0268386.t001

DOI: 10.1371/journal.pone.0268386.s001

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2022

detail.hit.zdb_id: 2267670-3

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Excess cost of care associated with sepsis in cancer patients: Results from a population-based case-control matched cohort

Tew, Michelle ; Dalziel, Kim ; Thursky, Karin ; [et al.]

Public Library of Science (PLoS) ; 2021

In: PLOS ONE Vol. 16, No. 8 ( 2021-8-11), p. e0255107-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 8 ( 2021-8-11), p. e0255107-

Abstract: Cancer patients are at significant risk of developing sepsis due to underlying malignancy and necessary treatments. Little is known about the economic burden of sepsis in this high-risk population. We estimate the short- and long-term healthcare costs of care of cancer patients with and without sepsis using individual-level linked-administrative data. Methods We conducted a population-based matched cohort study of cancer patients aged ≥18, diagnosed between 2010 and 2017. Cases were identified if diagnosed with sepsis during the study period, and were matched 1:1 by age, sex, cancer type and other variables to controls without sepsis. Mean costs (2018 Canadian dollars) for patients with and without sepsis up to 5 years were estimated adjusted using survival probabilities at partitioned intervals. We estimated excess cost associated with sepsis presented as a cost difference between the two cohorts. Haematological and solid cancers were analysed separately. Results 77,483 cancer patients with sepsis were identified and matched. 64.3% of the cohort were aged ≥65, 46.3% female and 17.8% with haematological malignancies. Among solid tumour patients, the excess cost of care among patients who developed sepsis was $29,081 (95%CI, $28,404-$29,757) in the first year, rising to $60,714 (95%CI, $59,729-$61,698) over 5 years. This was higher for haematology patients; $46,154 (95%CI, $45,505-$46,804) in year 1, increasing to $75,931 (95%CI, $74,895-$76,968). Conclusions Sepsis imposes substantial economic burden and can result in a doubling of cancer care costs, particularly during the first year of cancer diagnosis. These estimates are helpful in improving our understanding of burden of sepsis along the cancer pathway and to deploy targeted strategies to alleviate this burden.

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0255107

DOI: 10.1371/journal.pone.0255107.g001

DOI: 10.1371/journal.pone.0255107.g002

DOI: 10.1371/journal.pone.0255107.t001

DOI: 10.1371/journal.pone.0255107.t002

DOI: 10.1371/journal.pone.0255107.s001

DOI: 10.1371/journal.pone.0255107.s002

DOI: 10.1371/journal.pone.0255107.s003

DOI: 10.1371/journal.pone.0255107.s004

DOI: 10.1371/journal.pone.0255107.s005

DOI: 10.1371/journal.pone.0255107.s006

DOI: 10.1371/journal.pone.0255107.s007

DOI: 10.1371/journal.pone.0255107.s008

DOI: 10.1371/journal.pone.0255107.s009

DOI: 10.1371/journal.pone.0255107.s010

DOI: 10.1371/journal.pone.0255107.s011

DOI: 10.1371/journal.pone.0255107.s012

DOI: 10.1371/journal.pone.0255107.r001

DOI: 10.1371/journal.pone.0255107.r002

DOI: 10.1371/journal.pone.0255107.r003

DOI: 10.1371/journal.pone.0255107.r004

DOI: 10.1371/journal.pone.0255107.r005

DOI: 10.1371/journal.pone.0255107.r006

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2021

detail.hit.zdb_id: 2267670-3

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Using the Methodology of Systematic Review of Reviews for Evidence-Based Medicine

Hasanpoor, Edris ; Hallajzadeh, Jamal ; Siraneh, Yibeltal ; [et al.]

African Journals Online (AJOL) ; 1970

In: Ethiopian Journal of Health Sciences Vol. 29, No. 6 ( 1970-01-01)

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In: Ethiopian Journal of Health Sciences, African Journals Online (AJOL), Vol. 29, No. 6 ( 1970-01-01)

Abstract: Systematic Review of Reviews without abstract. Authors' invited you to read the whole review article since it is short.

Type of Medium: Online Resource

ISSN: 1029-1857 , 1029-1857

URL: Article

DOI: 10.4314/ejhs.v29i6.15

Language: Unknown

Publisher: African Journals Online (AJOL)

Publication Date: 1970

detail.hit.zdb_id: 2705970-4

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