Risultati per: Passo 10. Intervenire sul singolo paziente in visita: GPG Patient

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Looking to limit unnecessary office visits, more patients began relying on online portals for their medical questions during the COVID-19 pandemic, which has since led to an elevated volume of messages. The influx has created a greater burden for clinicians, often requiring responses outside of regular working hours.

This JAMA Patient Page describes pericarditis signs and symptoms, complications, diagnosis, and treatment.

Objective
There is evidence that those who typically contribute to patient and public involvement (PPI) activities do not reflect the diversity of the population, and individuals from underserved groups are less likely to participate in healthcare research. For some researchers, understanding how to embed diversity into their PPI work can be confusing and challenging. The aim of this communication article is to reflect on our experiences and share the lessons learnt from developing an ethnically diverse PPI group to co-deliver breast cancer research.

Key points
Researchers must be realistic about timelines at both the grant application stage and during the research project, as finding contributors for inclusive and diverse PPI work takes time. Researchers will benefit from utilisation of existing expertise and resources within existing PPI teams at research institutions. It is vitally important to be clear about what researchers need in terms of contributors and what the PPI activities will be at different stages of the research project.

Conclusions
Conducting effective, diverse and meaningful PPI is a research skill that needs to be learnt and practised just like any other. Well-developed inclusive PPI has significant benefits for both researchers and the public.

Background
Understanding the impact of COVID-19 on the unplanned patient flow within hospitals is crucial for future preparedness planning and response strategies. We examined the impact of COVID-19 on the unplanned patient flow in a Danish healthcare region, with particular focus on emergency departments (EDs).

Methods
A descriptive multicentre cohort study was conducted comparing unplanned patient contacts during the first year of the COVID-19 pandemic (1 March 2020–28 February 2021) with the previous year (1 March 2019–29 February 2020). The study examined changes in patient flow and key flow variables—number of contacts, length of stay (LOS), triage, re-contacts, mortality, International Classification of Diseases (ICD)-10 codes, isolations and SARS-CoV-2-positive patients—and compared differences between five EDs in the Central Denmark Region.

Results
The overall number of unplanned patient contacts decreased 3.6% from the previous period (257 657) to the COVID-19 period (248 706). The decrease was lowest in EDs compared with other departments and was primarily detected during lockdowns, which were followed by months of increased ED contacts.
Although overall patient contacts decreased, an increase in proportions was observed in contacts with a LOS

Objective
To examine the association of patient–surgeon racial and ethnic concordance with postoperative outcomes among older adults treated by surgeons with California medical licences.

Design
Retrospective cohort study.

Setting
US acute care and critical access hospitals in 2016–2019.

Participants
100% Medicare fee-for-service beneficiaries aged 65–99 years who underwent one of 14 common surgical procedures (abdominal aortic aneurysm repair, appendectomy, coronary artery bypass grafting, cholecystectomy, colectomy, cystectomy, hip replacement, hysterectomy, knee replacement, laminectomy, liver resection, lung resection, prostatectomy and thyroidectomy), who were operated on by surgeons with self-reported race and ethnicity (21.4% of surgeons) in the Medical Board of California database. We focused our primary analysis on black and Hispanic beneficiaries.

Primary outcomes measure
The outcomes assessed included (1) patient postoperative 30-day mortality, defined as death within 30 days after surgery including during the index hospitalisation, (2) 30-day readmission and (3) length of stay. We adjusted for patient, physician and hospital characteristics.

Results
Among 1858 black and 4146 Hispanic patients treated by 746 unique surgeons (67 black, 98 Hispanic and 590 white surgeons; includes surgeons who selected multiple backgrounds), 977 (16.3%) patients were treated by a racially or ethnically concordant surgeon. Hispanic patients treated by concordant surgeons had lower 30-day readmission (adjusted readmission rate, 4.2% for concordant vs 6.6% for discordant dyad; adjusted risk difference, –2.4 percentage points (pp); 95% CI, –4.3 to –0.5 pp; p=0.014) and length of stay (adjusted length of stay, 4.1 d vs 4.6 days (d); adjusted difference, –0.5 d; 95% CI, –0.8 to –0.2 d; p=0.003) than those treated by discordant surgeons. We found no evidence that patient–surgeon racial and ethnic concordance was associated with surgical outcomes among black patients or mortality among Hispanic patients.

Conclusions
Patient–surgeon racial and ethnic concordance was associated with a lower postoperative readmission rate and length of stay for Hispanic patients. Increasing Hispanic surgeon representation may contribute to narrowing of racial and ethnic disparities in surgical outcomes.

A 41-year-old immunocompromised man presented to the intensive care unit with neutropenic fevers, and after a 1-week stay, developed oral ulcers and tender, diffuse, erythematous pseudovesicular papules, many umbilicated, on the face, trunk, and extremities. What is your diagnosis?

This secondary analysis of the COMET randomized clinical trial examines patient-reported outcomes at baseline and over time in patients with low-risk ductal carcinoma in situ randomized to receive either active monitoring or guideline-concordant care.

This Viewpoint discusses strategies used with driving that can be applied to health care to promote consistent and predictable physician and patient actions.

This cross-sectional study of outpatient dermatology encounters examined the association between dermatology encounter work relative value units and patient age, sex, and race and ethnicity since the 2021 Medicare physician fee schedule update.

This survey study evaluates the measurement properties for acne severity of the Acne Core Outcome Research Network (ACORN) patient global assessment.

This concept elicitation study explores health-related quality-of-life domains from the perspective of patients with cutaneous chronic graft-vs-host disease, defining the domains most important to patients and comparing epidermal vs sclerotic disease manifestation.

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Le 5 ‘best practice’ con ambiente e linguaggio al centro

Da Mazzara del Vallo, ora in cura a Milano