Bmc Health Serv Res
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Bmc Health Serv Res · May 2017
Multicenter StudyDescription of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India.
In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India. ⋯ Almost 10% of the women had an inter-institutional referral and still birth or neonatal deaths were doubled in referred women. Conditions associated with referral were often known before onset of labor and delivery. Improvements in maternal and neonatal outcomes will likely require pregnant women with conditions associated with referral to be directly admitted at facilities equipped to care for complicated pregnancies and at risk neonates, as well as prompt detection and transfer those who develop "at risk" conditions during labor and delivery.
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Bmc Health Serv Res · May 2017
Microblogging violent attacks on medical staff in China: a case study of the Longmen County People's Hospital incident.
A violent attack on medical staff in Guangdong Province, in which a female doctor at Longmen County People's Hospital (LCPH) was severely injured by a knife-wielding patient, has drawn significant public attention to the phenomenon of hospital violence and initiated discussions on how to resolve violence in hospitals. Social networking sites, such as Sina Weibo, a Chinese version of Twitter, have played a role in this public debate. The incident at LCPH provides an opportunity to examine how Weibo has been used in the debate about violence against medical staff in China. ⋯ Weibo users played a role in distributing news information about the violent incident at LCPH; however, the legal perspective is inadequately discussed in the debate, and discussion of constructive measures for protecting doctors and preventing hospital violence was rare. Our research suggests that critical challenges for the Chinese health care system will remain or become worse if no effective measures are implemented to prevent hospital violence.
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Bmc Health Serv Res · May 2017
Identified obstacles and prerequisites in telenurses' work environment - a modified Delphi study.
Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses' work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses' work environment. ⋯ Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.
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Bmc Health Serv Res · May 2017
ReviewWhat is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis.
Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient's journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions. ⋯ There is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients.
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Bmc Health Serv Res · May 2017
Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.
Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. ⋯ HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.