Healthcare

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8 pages, 493 KiB

Open AccessArticle

Retrospective Analysis of Nosocomial SARS-CoV-2 Infections in Orthopedic and Traumatological Inpatients

by Lukas Dankl, Ulrich Crepaz-Eger, Rohit Arora and Friedemann Schneider

Healthcare 2023, 11(20), 2765; https://doi.org/10.3390/healthcare11202765 - 19 Oct 2023

Viewed by 692

SARS-CoV-2 has had a measurable impact on the field of orthopedic and traumatological surgery. To date, scarce data on intramural SARS-CoV-2 infections in orthopedic and traumatological patients have been reported. Therefore, the aim of our study was to investigate the effect of nosocomial [...] Read more.

SARS-CoV-2 has had a measurable impact on the field of orthopedic and traumatological surgery. To date, scarce data on intramural SARS-CoV-2 infections in orthopedic and traumatological patients have been reported. Therefore, the aim of our study was to investigate the effect of nosocomial SARS-CoV-2 infections in orthopedic and traumatological inpatients regarding symptoms of infection, mortality, duration of hospitalization, and other relevant patient-dependent factors. Patients admitted to hospital for an orthopedic or traumatological indication were screened retrospectively for nosocomial SARS-CoV-2 infections and included in this study. An age-, sex-, and ICD 10-matched control group was assigned and demographic data, clinical symptoms of a SARS-CoV-2 infection as well as mortality, length of hospital stays, time to surgery, pre-existing conditions, LKF-points representing the financial effort, and the Charlson Comorbidity Index were collected. A significantly higher length of stay was observed in the SARS-CoV-2 group (25 days; 4–60; SD 12.5) when compared to the control group (11 days; 2–36; SD 7; p < 0.05). LKF points were significantly higher in the SARS-CoV-2 group (13,939 points vs. 8542 points). No significant difference in mortality could be observed. An infection with SARS-CoV-2 in inpatients significantly increases length of hospital stay and cost of treatment. Although no significant difference in mortality was found, care should be taken to avoid intramural SARS-CoV-2 infections, resulting in prolonged hospitalization, higher costs, and potentially further individual risks. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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15 pages, 742 KiB

Open AccessArticle

Healthcare Service Quality Evaluation in a Community-Oriented Primary Care Center, Italy

by Andrea Ceccarelli, Alice Minotti, Marco Senni, Luca Pellegrini, Giuseppe Benati, Paola Ceccarelli, Andrea Federici, Silvia Mazzini, Chiara Reali, Francesco Sintoni, Davide Gori and Marco Montalti

Healthcare 2023, 11(17), 2396; https://doi.org/10.3390/healthcare11172396 - 25 Aug 2023

Viewed by 778

Abstract

Community-oriented primary care (COPC) is an inclusive healthcare approach that combines individual care with a population-based outlook, striving to offer effective and equitable services. This study concentrates on assessing the perceived quality of a “Casa della Comunità” (CdC) implemented by the Romagna Local [...] Read more.

Community-oriented primary care (COPC) is an inclusive healthcare approach that combines individual care with a population-based outlook, striving to offer effective and equitable services. This study concentrates on assessing the perceived quality of a “Casa della Comunità” (CdC) implemented by the Romagna Local Health Authority, which embraces the COPC model. Through the examination of user experiences, the study aims to comprehend the influence of the CdC’s care delivery model on the community’s perception of service quality. From 13–18 March 2023, paper questionnaires were distributed by trained healthcare professionals and volunteers. The cross-sectional study enrolled participants aged 18 or older, capable of understanding written Italian, and willing to take part voluntarily. A total of 741 questionnaires were collected, resulting in an overall acceptance rate of 85.6%. Among the respondents, 37.9% were female, with an average age of 55.4 ± 16.2 years. While the respondents generally held a positive view of the quality, the results displayed varying levels of satisfaction across the different areas. Multivariate analysis revealed significant associations between factors such as gender, employment status, financial resources, education level, and distance from the healthcare center with the perceived quality of the facility in terms of accessibility, environment, staff, continuity of care, and overall satisfaction. The study yielded valuable insights, identifying strengths and areas for improvement and underscoring the importance of ongoing monitoring studies to enhance patient satisfaction continuously. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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14 pages, 1014 KiB

Open AccessArticle

KIT 1 (Keep in Touch) Project—Televisits for Cancer Patients during Italian Lockdown for COVID-19 Pandemic: The Real-World Experience of Establishing a Telemedicine System

by Calogero Casà, Barbara Corvari, Francesco Cellini, Patrizia Cornacchione, Andrea D’Aviero, Sara Reina, Silvia Di Franco, Alessandra Salvati, Giuseppe Ferdinando Colloca, Alfredo Cesario, Stefano Patarnello, Mario Balducci, Alessio Giuseppe Morganti, Vincenzo Valentini, Maria Antonietta Gambacorta and Luca Tagliaferri

Healthcare 2023, 11(13), 1950; https://doi.org/10.3390/healthcare11131950 - 06 Jul 2023

Cited by 1 | Viewed by 1318

Abstract

To evaluate the adoption of an integrated eHealth platform for televisit/monitoring/consultation during the COVID-19 pandemic. Methods: During the lockdown imposed by the Italian government during the COVID19 pandemic spread, a dedicated multi-professional working group was set up in the Radiation Oncology Department with [...] Read more.

To evaluate the adoption of an integrated eHealth platform for televisit/monitoring/consultation during the COVID-19 pandemic. Methods: During the lockdown imposed by the Italian government during the COVID19 pandemic spread, a dedicated multi-professional working group was set up in the Radiation Oncology Department with the primary aim of reducing patients’ exposure to COVID-19 by adopting de-centralized/remote consultation methodologies. Each patient’s clinical history was screened before the visit to assess if a traditional clinical visit would be recommended or if a remote evaluation was to be preferred. Real world data (RWD) in the form of patient-reported outcomes (PROMs) and patient reported experiences (PREMs) were collected from patients who underwent televisit/teleconsultation through the eHealth platform. Results: During the lockdown period (from 8 March to 4 May 2020) a total of 1956 visits were managed. A total of 983 (50.26%) of these visits were performed via email (to apply for and to upload of documents) and phone call management; 31 visits (1.58%) were performed using the eHealth system. Substantially, all patients found the eHealth platform useful and user-friendly, consistently indicating that this type of service would also be useful after the pandemic. Conclusions: The rapid implementation of an eHealth system was feasible and well-accepted by the patients during the pandemic. However, we believe that further evidence is to be generated to further support large-scale adoption. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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11 pages, 1089 KiB

Open AccessArticle

Resilience of Gynecological and Obstetric Inpatient Care in Central Germany in Times of Repetitive Socioeconomic Shocks—An Epidemiological Study Assessing Standardized Health Services Indicators and Economic Status According to the aG-DRG Catalog

by Sebastian Griewing, Niklas Gremke, Michael Lingenfelder, Uwe Wagner and Corinna Keil

Healthcare 2023, 11(12), 1683; https://doi.org/10.3390/healthcare11121683 - 07 Jun 2023

Cited by 1 | Viewed by 1054

Abstract

Sequential socioeconomic shocks, including the COVID-19 pandemic, economic recession, or energy and refugee crises in the face of violent conflicts, have led to the failure of healthcare systems in Europe. Against this background, the aim of this study was to evaluate the resilience [...] Read more.

Sequential socioeconomic shocks, including the COVID-19 pandemic, economic recession, or energy and refugee crises in the face of violent conflicts, have led to the failure of healthcare systems in Europe. Against this background, the aim of this study was to evaluate the resilience of regional gynecological and obstetric inpatient care using the example of a regional core medical provider in central Germany. Base data were retrieved from Marburg University Hospital and underwent standardized calculation and descriptive statistical assessment pursuant to the aG-DRG catalog. The data illustrate a decline in the average length of patient stays and average case complexity in combination with increasing patient turnover for the six-year observation period of 2017–2022. Core profitability of the departments of gynecology and obstetrics deteriorated in the year of 2022. The results suggest weakened resilience of gynecological and obstetrics inpatient care in the setting of a regional core medical provider in central Germany and indicate how it may have failed in core economic profitability. This is consistent with predictions about the lack of resilience of health systems and the critical economic situation of German hospitals in the face of ongoing socioeconomic shocks that collaterally endanger women’s health care. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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11 pages, 457 KiB

Open AccessArticle

Collective Catering Activities and Official Controls: Dietary Promotion, Sustainability and Future Perspectives

by Vincenzo Marcotrigiano, Giacomo Domenico Stingi, Prudenza Tiziana Nugnes, Sabrina Mancano, Vita Maria Lagreca, Teresa Tarricone, Gerardo Salerno, Pietro Pasquale, Paola Marchet, Giovanni Andrea Sava, Alessandro Citiulo, Monica Tissi, Stefania Oliva, Sandro Cinquetti and Christian Napoli

Healthcare 2023, 11(9), 1347; https://doi.org/10.3390/healthcare11091347 - 07 May 2023

Cited by 2 | Viewed by 1426

Abstract

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where [...] Read more.

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where specific guidelines have been issued, assessing many matters from food weight to single courses and from the use of wholegrain pasta and bread to the rotation of seasonal fruit and vegetables. Overall, 85 menus, edited by freelance professionals and endorsed by the Food Hygiene and Nutrition Service staff of the Local Health Authority, were assessed from 2018 to 2022, highlighting critical issues potentially attributable at a local level to the lack of complete knowledge of the existence of guidelines and official reference documents among nutrition professionals. Since the preliminary outcomes show non-compliance in both sectors investigated, it is essential to continue to strengthen the role of prevention departments entrusted with services dedicated to food and nutritional safety and promote joint official controls performed by healthcare workers and other professionals with different backgrounds in order to ensure safe food for the target population that use collective catering services. In school canteens and healthcare facilities, providing and administering food is an opportunity to promote health through a balanced diet and safe food and offers opportunities for the development of community well-being and the local economy in a sustainable manner, understood in economic, environmental and social terms. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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15 pages, 313 KiB

Open AccessArticle

Exploring Loneliness, Fear and Depression among Older Adults during the COVID-19 Era: A Cross-Sectional Study in Greek Provincial Towns

by Lamprini Moustakopoulou, Theodoula Adamakidou, Sotirios Plakas, Marianna Drakopoulou, Paraskevi Apostolara, Alexandra Mantoudi, Dimos Mastrogiannis, Afroditi Zartaloudi, Stelios Parissopoulos, Alexandra Koreli and Marianna Mantzorou

Healthcare 2023, 11(9), 1234; https://doi.org/10.3390/healthcare11091234 - 26 Apr 2023

Cited by 6 | Viewed by 1631

Abstract

Background: With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression. Objective: To explore the presence and severity of [...] Read more.

Background: With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression. Objective: To explore the presence and severity of depression in older adults in Greek provincial towns during the pandemic and to explore any possible relationships with loneliness and fear. Methods: A convenience sample of 200 participants aged >65, completed a socio-demographic form, the Revised UCLA Loneliness Scale, the Geriatric Depression-15 Scale (GDS-15) and the COVID-19 Fear Scale (FCV-19S). Data were collected from April to May 2022. Results: The average age of participants was 76.6 years and 35.5% of the participants presented depressive symptoms (mean prevalenceof depression 5 ± 3.7). A moderate to low level of loneliness (mean value 39 ± 11.3) and a moderate level of COVID-19 fear (mean value 18.9 ± 6.5) were also experienced. Higher levels of loneliness were found among participants with lower perceived health status and among those participants registered in Primary Health and Social Care (PHSC) services. Loneliness was positively correlated with depression (r = 0.7, p < 0.001), and increased loneliness and depression were associated with an increase in fear of COVID-19 (r = 0.2, p = 0.01 for both). Conclusions: During the pandemic, older adults experienced loneliness, fear of COVID-19 and depression which were positively associated with each other. It is imperative to develop PHSC policies that are aimed at addressing the mental health problems of the older population, which have been caused by the COVID-19 pandemic, through developing their resilience, offering psychological support and promoting social connections. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

19 pages, 945 KiB

Open AccessArticle

Staff Successes and Challenges with Telecommunications-Facilitated Patient Care in Hybrid Hospital-at-Home during the COVID-19 Pandemic

by Stephanie K. Zawada, Jeffrey Sweat, Margaret R. Paulson and Michael J. Maniaci

Healthcare 2023, 11(9), 1223; https://doi.org/10.3390/healthcare11091223 - 25 Apr 2023

Cited by 2 | Viewed by 1636

Abstract

Technology-enhanced hospital-at-home (H@H), commonly referred to as hybrid H@H, became more widely adopted during the COVID-19 pandemic. We conducted focus group interviews with Mayo Clinic staff members (n = 14) delivering hybrid H@H in three separate locations—a rural community health system (Northwest Wisconsin), [...] Read more.

Technology-enhanced hospital-at-home (H@H), commonly referred to as hybrid H@H, became more widely adopted during the COVID-19 pandemic. We conducted focus group interviews with Mayo Clinic staff members (n = 14) delivering hybrid H@H in three separate locations—a rural community health system (Northwest Wisconsin), the nation’s largest city by area (Jacksonville, FL), and a desert metropolitan area (Scottsdale, AZ)—to understand staff experiences with implementing a new care delivery model and using new technology to monitor patients at home during the pandemic. Using a grounded theory lens, transcripts were analyzed to identify themes. Staff reported that hybrid H@H is a complex care coordination and communication initiative, that hybrid H@H faces site-specific challenges modulated by population density and state policies, and that many patients are receiving uniquely high-quality care through hybrid H@H, partly enabled by advances in technology. Participant responses amplify the need for additional qualitative research with hybrid H@H staff to identify areas for improvement in the deployment of new models of care enabled by modern technology. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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9 pages, 621 KiB

Open AccessCommunication

Ensuring Equitable Access to the COVID-19 Vaccine: The Experience of A Local Health Unit in Rome, Italy

by Federica Turatto, Michele Sassano, Mauro Goletti, Santino Severoni, Adriano Grossi and Paolo Parente

Healthcare 2022, 10(11), 2246; https://doi.org/10.3390/healthcare10112246 - 10 Nov 2022

Cited by 2 | Viewed by 1513

Abstract

Growing evidence is emerging on the higher risk of infection and adverse outcomes for the most disadvantaged groups of the population, and COVID-19 vaccination campaigns worldwide are struggling to ensure equitable access to immunization for all. From 21 June 2021 to 15 October [...] Read more.

Growing evidence is emerging on the higher risk of infection and adverse outcomes for the most disadvantaged groups of the population, and COVID-19 vaccination campaigns worldwide are struggling to ensure equitable access to immunization for all. From 21 June 2021 to 15 October 2021, the Local Health Unit ASL Roma 1 adopted a tailored immunization strategy to reach socially vulnerable groups of the population with the primary vaccination course. This strategy was developed with a step-by-step, participatory approach. Through engagement with internal and external stakeholders, target groups were identified, potential barriers analyzed, solutions discussed, and tailored interventions designed. Over nine thousand individuals from among irregular migrants, homeless people and hard-to-reach communities were contacted and vaccinated. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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