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Finnish Hospital (finnish + hospital)
Selected AbstractsSuicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988,2003INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2008Kaisa Karvonen Abstract Objective Elderly people commit suicide more often than people under the age of 65. An elevated risk is also attached to depression and other axis I psychiatric disorders. However, little is known about the preferred suicide method, effect of primary psychiatric diagnosis, and length of time between discharge from psychiatric hospitalization and suicide. The lack of information is most apparent in the oldest old (individuals over 75 years). Methods On the basis of forensic examinations, data on suicide rates were separately examined for the 50,64, 65,74 and over 75 year-olds (Total n,=,564) with regard to suicide method, history of psychiatric hospitalization and primary diagnoses gathered from the Finnish Hospital Discharge Register. Study population consisted of all suicides committed between 1988 and 2003 in the province of Oulu in Northern Finland. Results Of the oldest old, females had more frequent hospitalizations than males in connection with psychiatric disorders (61% vs 23%), of which depression was the most common (39% vs 14%). In this age group, 42% committed suicide within 3 months after being discharged from hospital and 83% used a violent method. Both elderly males and females were less often under the influence of alcohol, but used more often violent methods than middle-aged persons. Conclusions Suicide rates within the first 3 months following discharge from hospital in the 65,74 and the over 75 year olds were substantial and should influence post-hospitalization treatment strategies. To reduce the risk of suicides in elderly patients discharged from hospital, close post-hospitalization supervision combined with proper psychoactive medication and psychotherapy, are possible interventions. Copyright © 2007 John Wiley & Sons, Ltd. [source] The need and total cost of Finnish eyecare services: a simulation model for 2005,2040ACTA OPHTHALMOLOGICA, Issue 8 2009Anja Tuulonen Abstract. Purpose:, The aims of this study were: (i) to create a structural simulation model capable of predicting the future need and cost of eyecare services in Finland; and (ii) to test and rank different policy alternatives for access to care and the required physician workforce. Methods:, Using the system dynamics approach, the number and cost of patients with cataract, glaucoma, diabetic retinopathy and age-related macular degeneration (AMD) were described with causal-loop diagrams and were then translated into a set of mathematical equations to build a computer simulation model. Mathematically, the problem was formulated as a set of differential equations that were solved numerically with specialized software. The validity of the model was tested against prevalence and administrative historical data. The costs covered by the public sector in Finland were obtained from 2003 from the Finnish Hospital Discharge Register (including outpatient care), the Finnish Social Insurance Institution and a survey of hospital price lists. Different levels of access to public care were then simulated in four eye diseases, for which the model estimated the need for services and resources and their costs in the years 2005,2040. Results:, The model forecasted that the adoption of the 2005 national ,access to care' criteria for cataract surgery would shorten waiting lists. If the workload of Finnish ophthalmologists were kept at the 2003 level, the graduation rate of new ophthalmologists would have to increase by 75% from the current level. If all glaucoma patients were followed in the public sector in future, even this increase in training would not meet the demand for physician workforce. The current model indicated that the screening frequency of diabetes can be increased without large sacrifices in terms of costs. AMD therapy has a significant role in the allocation of future resources in eyecare. The modelling study predicted that ageing alone will increase the costs of eyecare during the next four decades in Finland by about 1% per year in real terms (undiscounted and without inflation of unit costs). The increases in total yearly costs were on average 8.6% between 2001 and 2003. Conclusions:, The results of this modelling study indicate that policy initiatives, such as defining criteria for access to care, can have substantial implications on the demand for care and waiting times whereas the effect of ageing alone was relatively small. Measures to control several other factors , such as the adoption and price level of new technologies, treatments and practice patterns , will be at least equally important in order to restrain healthcare costs effectively. [source] Brief report: validity of Finnish registry-based diagnoses of autism with the ADI-RACTA PAEDIATRICA, Issue 9 2010KM Lampi Abstract Aims:, The aim of the study was to explore the validity of registry-based diagnoses of autism in Finland using the Autism Diagnostic Interview , Revised (ADI-R). This study was designed for the Finnish Prenatal Study of Autism and Autism Spectrum Disorders (FIPS-A), an ongoing research project where registry-based diagnoses will be used for epidemiological studies. Methods:, In this small pilot study, a clinical sample of 95 subjects diagnosed with childhood autism or pervasive developmental disorder/pervasive developmental disorder , not otherwise specified (PDD/PDD-NOS) or Asperger,s syndrome according to the Finnish Hospital Discharge Register (FHDR) was gathered nationwide. A small control group consisting of siblings without any registered diagnoses of those being examined was also included in the study. Diagnoses were further re-evaluated by interviewing parents with the ADI-R. Results:, The mean scores of autistic subjects clearly exceeded cut-off limits for autism on all three ADI-R domains and 96% of the subjects with registered diagnosis of childhood autism fulfilled the criteria based on the instrument as well. Conclusion:, These results suggest that the validity of Finnish registry-based diagnoses of childhood autism can be considered good. Our findings lay important groundwork for further population- based studies of the aetiology of autism. [source] Institutional Pressures for Adopting New Cost Accounting Systems in Finnish Hospitals: Two Longitudinal Case StudiesFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2006Janne Järvinen First page of article [source] Burnout among nursing staff in two Finnish hospitalsJOURNAL OF NURSING MANAGEMENT, Issue 3 2000Koivula RN, MNSC Aim To describe burnout and factors affecting it in nursing staff. Background Burnout is a common phenomenon in nursing staff. We need knowledge of phenomena related to burnout in order to be able to properly direct measures decreasing burnout. Methods A questionnaire measuring burnout was answered by 723 nurses. The data were analysed by means of descriptive statistics and anova. Results Half of the staff had scores which indicated they were frustrated or burnt out. Personal resource variables having an influence on staff burnout were age, vocational education and years of practice. Burnout increases with age, and staff with short work experience in nursing practice experience lower levels of burnout. Staff with a secondary level education working on psychiatric wards experience especially high levels of burnout. Continuous professional education is related to lower levels of burnout if it lasts for more than 10 days over a period of 2 years. Conclusions The results of the study can be generalized only to these two Finnish hospitals. The results indicate that education, both vocational basic education and professional further education, are key factors in preventing burnout among nursing staff. [source] The prognostic value of inducible nitric oxide synthase in local prostate cancerBJU INTERNATIONAL, Issue 3 2000S.H. Aaltomaa Objective To compare the clinical and histological data from patients with prostate cancer with the results of the immunohistochemical analysis of inducible nitric oxide synthase (iNOS), and thus determine the prognostic value of iNOS. Patients and methods The study included 82 patients (mean age 64.6 years, sd 6.1) with local prostate cancer treated by radical prostatectomy in two Finnish hospitals. Their mean ( sd) follow-up was 3.3 (2.2) years. An immunohistochemical method was used to detect the expression of iNOS in these specimens, and the expression graded according to staining intensity as none, weak or strong. Results There was weak or strong expression of iNOS in 25 (31%) and 56 (68%) of the patients, respectively, and one specimen was negative for iNOS. Strong expression of iNOS was related to high a preoperative prostate specific antigen (PSA) level (P = 0.006) and high pT classification (P < 0.001), but not to nodal status, grade, seminal vesicle or capsular invasion, surgical margin status, perineural infiltration, tumour infiltrating lymphocytes or proliferation rate of cancer cells. A PSA failure was detected in 29 patients but was not predicted by iNOS expression. A Cox multivariate analysis showed that surgical margin positivity, seminal vesicle involvement and number of tumour infiltrating lymphocytes predicted the PSA failure. Conclusion A high expression of iNOS was related to a high pT classification and the preoperative PSA level but not to other established prognostic factors; iNOS expression was not a predictor of PSA failure in patients with local prostate cancer. 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