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Medical Admissions (medical + admission)

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Medical Sciences	100%

Selected Abstracts

SBIRT Outcomes in Houston: Final Report on InSight, a Hospital District-Based Program for Patients at Risk for Alcohol or Drug Use Problems

ALCOHOLISM, Issue 8 2009
The InSight Project Research Group
Background:, Screening, Brief Intervention, and Referral to Treatment (SBIRT) services have been implemented as the standard of care for patients in the Harris County Hospital District (HCHD). The present analysis addresses alcohol and drug use for patients admitted over a 39-month period from July 1, 2005 through September 30, 2008. Methods:, Patients were screened for alcohol and drug use at medical admission. Those who were positive received further assessment and were transitioned to receive services as appropriate. A sample of consenting patients who were positive and received services was contacted at 6 months for a follow-up interview. Using an intent-to-treat (ITT) protocol, the analysis included all patients who were assigned for follow-up, including those with completed follow-ups as well as those who could not be contacted at follow-up. Patients not contacted at follow-up were assumed to have maintained their baseline drug and alcohol consumption levels. Results:, Of 59,760 patients who were screened by generalists (primarily nurses, physicians, and medical care technicians), 15,241 (26%) were positive and received further assessment and services. The 6-month follow-up interview completion rate was 66%. The ITT sample consisted of all 1,937 patients who were assigned for follow-up. There was an overall reduction in the number of patients reporting any days of heavy drinking from 70% at intake to 37% at 6-month follow-up and a reduction in the mean number of days of heavy drinking from 7.8 days at intake to 4.1 days at follow-up. The number of patients reporting any days of drug use was 82% at intake versus 33% at follow-up, and the mean number of days of drug use declined from 8.3 days at intake to 4.2 days at follow-up. Conclusions:, The results were consistent with but of greater magnitude than most other studies reporting positive outcomes for SBIRT patients. Drug use and heavy alcohol use were found to decrease substantially from admission to follow-up. This finding holds good for all levels of drug or alcohol misuse severity, with the highest severity patients showing the largest decreases. Future studies are needed to control for potential regression to the mean effects and to develop improved understanding of differences in outcomes by race/ethnicity. [source]

The rise in acute medical admissions

INTERNAL MEDICINE JOURNAL, Issue 2 2000
P. Hider
First page of article [source]

Is hospital admission a sufficiently sensitive outcome measure for evaluating medication review services?

INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2007
A descriptive analysis of admissions within a randomised controlled trial
Objective The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist-led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention. Setting Within the context of a RCT of pharmacists providing medication review for 332 elderly patients living at home, taking at least four repeat medicines, carried out in one region of Scotland. Method Hospital data were obtained for all admissions occurring during the 9-month period studied, summarised and evaluated by two independent medical reviewers for the contribution of PCIs to admission. Two pharmacists assessed the extent to which PCIs were preventable by pharmacist intervention. Key findings Approximately two-thirds of the 77 admissions were unplanned, and two-thirds were to medical wards. Only 17 (22%) of all admissions were considered to be related to PCIs and 10 (13%) possibly preventable by pharmacist intervention. Although the majority of surgical admissions were considered to be unrelated to PCIs (26/29), both unplanned and planned medical admissions were related to PCIs. One of these occurred as a direct result of the pharmacist's recommendation. Conclusion The overall numbers of hospital admissions, medical admissions and unplanned admissions may not be sufficiently sensitive outcome measures for evaluating the impact of pharmacist interventions. Consideration could be given to developing categories of admission that are related to medicines or are likely to be preventable as more relevant measures. Including more details of hospital admissions in future studies may be useful. [source]

Hospitalization in Winnipeg, Canada due to occupational disease: A pilot study

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009
Allen G. Kraut MD, FRCPC
Abstract Background The objectives of this study were to identify the extent of occupational exposures to hazardous substances amongst male medical inpatients and to determine the extent to which these exposures may have contributed to the development of medical conditions. Methods A random sample of 297 male who were admitted from outside the hospital to the medical wards to a large tertiary care hospital, were between age 18,75 and could communicate in English completed an occupational history questionnaire. This information was merged with an inpatient database which contained patient demographics, admission diagnoses, and co-morbidity data. A specialist in occupational medicine and internal medicine determined whether the medical conditions the participants had were related to their exposures. Results One individual had a condition causing admission that was related to his work and 12 others (4%) had a condition that was possibly related to their work which had caused symptoms. One additional individual was found to have asymptomatic asbestos related pleural fibrosis. Fourteen of 37 possible harmful occupational exposures were reported by more than 10% of the study participants. On average each participant reported 5.5 exposures. Conclusions Occupational exposures to male medical inpatients are common. For 4.4% (13/297) of male admissions to the general medical wards from the emergency room occupational factors may have played a role in the development of medical conditions which led to admission or to major co-morbidities. Detailed occupational histories will likely lead to more suspected cases of work related medical admissions. Am. J. Ind. Med. 52:372,379, 2009. © 2009 Wiley-Liss, Inc [source]