Inquiry : a journal of medical care organization, provision and financing
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Reverse transcriptase-polymerase chain reaction (RT-PCR), the reference laboratory method of confirmed SARS-CoV-2 diagnosis, though requiring equipment, is time-consuming. There is a crucial demand for rapid techniques such as antigen detection test during the pandemic. This study assessed whether a rapid antigen detection (RAD) test was an effective and essential method for the early diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 pandemic. The probability of public screening at home and the application of RAD during the novel SARS-CoV-2 outbreak were also topics of interest. ⋯ We concluded that RAD could be a quick and feasible method to identify individuals infected with SARS-CoV-2 from non-contagious individuals during the COVID-19 outbreak. A RAD test was an effective and essential method for the early diagnosis of SARS-CoV-2 during the COVID-19 pandemic.
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Preventing utilization of hospital and emergency department after diagnosis of venous thromboembolism is a complex problem. The objective of this study is to assess the impact of a care transition intervention on hospitalizations and emergency department visits after venous thromboembolism. We randomized adults diagnosed with a new episode of venous thromboembolism to usual care or a multicomponent intervention that included a home pharmacist visit in the week after randomization (typically occurring at time of discharge), illustrated medication instructions distributed during home visit, and a follow-up phone call with an anticoagulation expert scheduled for 8 to 30 days from time of randomization. ⋯ Our patients had a significant number of hospital and emergency department visits after diagnosis. Most visits were not related to recurrent venous thromboembolism or bleeding and of those that were, most were not preventable. Our multicomponent intervention did not decrease hospitalizations and emergency department visits.
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Brazil is in a critical situation due to the COVID-19 pandemic. Healthcare workers that are in the front line face challenges with a shortage of personal protective equipment, high risk of contamination, low adherence to the social distancing measures by the population, low coronavirus testing with underestimation of cases, and also financial concerns due to the economic crisis in a developing country. This study compared the impact of COVID-19 pandemic among three categories of healthcare workers in Brazil: physicians, nurses, and dentists, about workload, income, protection, training, feelings, behavior, and level of concern and anxiety. ⋯ Physicians and nurses were feeling more tired than usual. Most of the healthcare workers in all groups reported difficulties in sleeping during the pandemic. The healthcare workers reported a significant impact of COVID-19 pandemic in their income, workload and anxiety, with differences among physicians, nurses and dentists.
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A novel coronavirus pneumonia broke out and gradually developed into a global public health problem. Health care workers, especially nurses, suffered from great occupational pressure and psychological distress during the outbreak of infectious diseases. We performed a cross-sectional survey to investigate the psychological status and self-efficacy of nurses in public hospital during COVID-19 outbreak between 16th and 25th February 2020. ⋯ The self-efficacy was negatively correlated with anxiety (r = -0.161, P < .05). The psychological status of nurses in public hospital during COVID-19 outbreak needs our attention. Improving nurses' self-efficacy in dealing with emerging infectious diseases may be helpful to their psychology.
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The Affordable Care Act (ACA) required coordination between Marketplaces, Medicaid, and the Children's Health Insurance Program (CHIP) in an effort to streamline application processes and improve enrollment. We use 2013-2018 data from the American Community Survey and difference-in-difference models to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage observed among pre-ACA eligible children after the implementation of the ACA ("welcome mat effects"). Our sample includes non-disabled, citizen children (0-18) at 139-250% FPL who were Medicaid-/CHIP-eligible before (and after) the implementation of the ACA. ⋯ Welcome mat effects were largest in expansion states (for most years) and among children whose parents did not hold employer-sponsored insurance coverage. Ranging from 9 to 13 percentage points, these estimates are larger than those found among other subgroups of children in the welcome mat literature. Although there is evidence of lagged effects for both welcome mat effects and the role of Marketplace policy in non-expansion states, by 2018 we find no differences in these measures by expansion policy.