Hospital Patients Research Articles

Calf circumference-albumin index significantly predicts the prognosis of older patients with cancer cachexia: A multicenter cohort study

ObjectivesThe aim of this study was to evaluate the combined prognostic value of calf circumference (CC) and serum albumin on mortality in patients with cancer cachexia aged ≥65 years. MethodsThis multicenter cohort study involved 5322 older patients in hospital with cancer cachexia. The combined indicator of CC and albumin was defined as the calf circumference-albumin (CCA) index. Harrell's C index, a time-dependent receiver operating characteristic curve analysis, was used to assess the prognostic performance of the CCA index and other indices. The optimal thresholds method was used to determine the cutoff values of CC and albumin, and the association between the CCA index and all-cause mortality was assessed using Kaplan-Meier analysis and Cox proportional hazard regression models. ResultsA total of 3875 men and 1447 women with a mean age of 72.0 years (range: 68.0–78.0 years) and a mean follow-up time of 55.0 months (range: 25.0–85.0 months) were included in the study. A total of 1269 patients were classified into the low CCA index group (0 score) by the optimal thresholds method. In the overall population, the CCA index showed better differentiating power at predicting mortality in older patients with cancer cachexia compared with CC or albumin alone (C index = 0.639; 95% CI: 0.612–0.666; P < 0.05). The time-dependent receiver operating characteristic curve showed that the CCA index had the highest prognostic value of all the measures studied (P < 0.05). In the overall population, male and female patients with a high CCA index (2 score) showed better performance than those with a low CCA index (0 or 1 score). ConclusionsThe CCA index could significantly predict the mortality of older patients with cancer cachexia, which might provide renewed assistance for future clinical management.

Comparative Effectiveness of Baricitinib Versus Tocilizumab in Hospitalized Patients With COVID-19: A Retrospective Cohort Study of the National Covid Collaborative.

COVID-19 treatment guidelines recommend baricitinib or tocilizumab for the management of hospitalized patients with COVID-19. We compared the effectiveness of baricitinib vs. tocilizumab on mortality and clinical outcomes among hospitalized patients with COVID-19. Multicenter, retrospective, propensity-weighted cohort study using a target trial emulation approach. The National COVID Cohort Collaborative (N3C), which is the largest electronic health records data on COVID-19 in the United States. The setting included 75 hospitals. Adults who were hospitalized for COVID-19. Newly initiated on baricitinib or tocilizumab. Our primary outcome was 28-day mortality. We used propensity scores with inverse probability of treatment weights (IPTWs) to control bias and confounding while comparing treatments. Among 10,661 individuals included in the study, 6,229 (58.4%) received baricitinib and 4,432 (41.6%) tocilizumab. Overall, the mean age of the cohort was 60.0 ± 15.1 years, 6429 (60.3%) were male, and 19.2% received invasive mechanical ventilation. After IPTW adjustment, baricitinib use was associated with lower 28-day mortality (odds ratio [OR], 0.91; 95% CI, 0.85-0.98) and hospital (OR, 0.88; 95% CI, 0.82-0.94) mortality compared with tocilizumab. Baricitinib was also associated with shorter hospital length of stay (incident rate ratio, 0.92; 95% CI, 0.90-0.94) and lower rates of hospital-acquired infections (OR, 0.86; 95% CI, 0.75-0.99), although no difference in ICU length of stay was noted between the two groups. In this large, diverse cohort of U.S. hospitalized adults with COVID-19, baricitinib was associated with significantly lower 28-day mortality, hospital mortality, shorter hospital length of stay, and less hospital-acquired infections compared with tocilizumab.

Noise within hospital wards: a survey method

Noise pollution is one of the most disturbing environmental factors. It directly affects people's lives, especially vulnerable people such as children, old-age, and hospital patients. Hospitals are complex buildings with manifold spaces and facilities where different users live with different sensitivity to noise. Several studies highlight the discomfort that patients, staff, and visitors experience in hospitals due to inadequate noise levels. All this leads to stress, sleep disorders, interference in communication, aggression, and annoyance. Noise exposure in hospitals is due to several sound sources. Each varies throughout the day, and their detection could be challenging. The present study proposes a clustering technique to analyze long-term sound level meter monitoring in an Italian hospital (Pisa, Tuscany). Equivalent short-term levels obtained with an interval time of 0.1 s are used as the database to exploit the occurrences curves of different chunks of the monitoring. Then, through a validated method, the spectra of different kinds of sound sources are reconstructed via the Gaussian Mixture Model. Results are compared with near-field measurements of single sources.

Isolating and Identification Of Bacteria Causing Urinary Tract Infections From Hospital Patients And Nursing Staff

The current study aimed to isolate and identification the bacteria that cause urinary tract infections from recumbent patients and nursing staff, using traditional and molecular methods. 700 Clinical samples were collected from Azadi Teaching Hospital and Kirkuk Teaching Hospital in Kirkuk city for the period from October 2023 to March 2024 from (500) recumbent patients and 200 nursing staff. 347 (49.6%) of the total samples showed positive results for bacterial growth when cultured on ideal culture media, including mannitol, blood, and MacConkey agars. 353(50.4%) of total samples were appear as negative results for bacterial growth. The findings showed the distribution of bacterial isolates obtained from urine samples of recumbent patients and nursing staff at Azadi Teaching Hospital. Escherichia coli (44.6% and 41.67%) was the most prevalent bacterial species, followed by (13.08% and 13.89%) K. pneumoniae, (11.54% and 11.11%) P. aeruginosa. while, the distribution of bacterial isolates obtained from urine samples of recumbent patients and nursing staff at Kirkuk Teaching Hospital. Escherichia coli (46.9% and 51.85%) was the predominant bacterial species, followed by (16.6% and 14.81%) K. pneumoniae and (9% and 11.11%) P. aeruginosa. for molecular study, 7(50.0%) out of a total of 14 E. coli isolates possessed the gyrA gene. On the other hand, 12(100.0%) isolates out of a total of 14 isolates of K. pneumoniae possess the gyrA gene, while 11(91.7%) isolate out of a total of 12 isolates of P. aeruginosa possesses the gyrA gene. It is concluded that the most common cause of urinary tract infections is Escherichia coli followed by K. pneumoniae and P. aeruginosa, and that one of the most important causes of antibiotic resistance is the presence of the gyrA gene, which causes bacterial resistance to fluoroquinolone.

Evaluating the accuracy and reliability of non-piezo portable ultrasound devices in postpartum care.

The early diagnosis of hemorrhage viapostpartum ultrasound is crucial to initiate therapy and, thus, prevent maternal death. In these critical situations rapid availability and simple transport of ultrasound devices is vital, paving the way for a new generation of portable handheld ultrasound devices (PUD) consisting of transducers and tablets or smart phones. However, evidence to confirm the diagnostic accuracyof these new devices is still scarce. The accuracy and reliability of these new devices in relation to established standard ultrasound devices is analyses in this pilot study by comparing diagnoses and by applying statistical analysis via Bland-Altman plots, intraclass correlation coefficients (ICC), and Pearson correlation coefficients (PCC). One hundred patients of a university hospital were included in this study. In all cases, the same diagnosis was made regardless of the applied ultrasound device, confirming high accuracy. There was a high correlation (PCC 0.951) and excellent agreement (ICC 0.974) in the assessment of the cavum, while the assessment of the diameters of the uterus showed only a good correlation and a goodagreement. Subgroup analysis for maternal weight, mode of delivery and day after deliverywasperformed CONCLUSION: Thesame diagnosis independent ofthe used devices and excellent results of the cavum assessment promote the use of PUDs in a clinical setting. The slightly lower accuracy in the measurement of the uterus may be caused by the PUD's small acoustic window, reflecting one of its weaknesses.Therefore, the patient may benefit from the short time to diagnosis and the unbound location of examination, either in the delivery room, on the ward, or at home.

Value of Pharmacogenetic Testing Assessed with Real-World Drug Utilization and Genotype Data.

Implementation of pharmacogenetic testing in clinical care has been slow and with few exceptions is hindered by the lack of real-world evidence on how to best target testing. In this retrospective register-based study, we analyzed a nationwide cohort of 1,425,000 patients discharged from internal medicine or surgical wards and a cohort of 2,178 university hospital patients for purchases and prescriptions of pharmacogenetically actionable drugs. Pharmacogenetic variants were obtained from whole genome genotype data for a subset (n = 930) of the university hospital patients. We investigated factors associated with receiving pharmacogenetically actionable drugs and developed a literature-based cost-benefit model for pre-emptive pharmacogenetic panel testing. In a 2-year follow-up, 60.4% of the patients in the nationwide cohort purchased at least one pharmacogenetically actionable drug, most commonly ibuprofen (25.0%) and codeine (19.4%). Of the genotyped subset, 98.8% carried at least one actionable pharmacogenetic genotype and 23.3% had at least one actionable gene-drug pair. Patients suffering from musculoskeletal or cardiovascular diseases were more prone to receive pharmacogenetically actionable drugs during inpatient episode. The cost-benefit model included frequently dispensed drugs in the university hospital cohort, comprising ondansetron (19.4%), simvastatin (7.4%), clopidogrel (5.0%), warfarin (5.1%), (es)citalopram (5.3%), and azathioprine (0.5%). For untargeted pre-emptive pharmacogenetic testing of all university hospital patients, the model indicated saving €17.49 in direct healthcare system costs per patient in 2 years without accounting for the cost of the test itself. Therefore, it might be reasonable to target pre-emptive pharmacogenetic testing to patient groups most likely to receive pharmacogenetically actionable drugs.

Study on the Management of Diabetic Foot Ulcer in Diabetic Patients at a Tertiary Care Hospital

AIM: To study the treatment pattern of diabetic foot ulcer and to assess the effect of patient counselling on diabetic foot ulcer patients. OBJECTIVE: 1. To study the various modalities of treatment used for Diabetic Foot Ulcer patients in a tertiary care hospital. 2. To assess the effect of patient counselling on diabetic foot ulcer patients with standard questionaries METHODS: The protocol was reviewed, revised, and approved by the Institutional Review Committee of MVJ Medical College and Research Hospital before commencement of the study. Over the course of six months, a tertiary care hospital conducted prospective research. Following the giving of written informed permission, diabetic patients with foot ulcers of both genders who were visiting the hospital were invited to participate and enrolled. A total of 150 patients participated in the study. The patients were recruited according to the inclusion and exclusion criteria mentioned. The study was attempted to improve the patient’s knowledge and attitude towards the self-management of diabetic foot ulcer. And thus, patient counselling is an essential component of clinical pharmacy practice in hospital. RESULTS: In this study, majority of the study participants belonged to the age group 61-70 years (30.7%) of age. 22% of the study participants were of the age group between 51-60 years of age. Majority (64.7%) of the study participants were males. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling jym oof ff\c b to 44.07+4.70 post counselling which was found to be statistically significant (P&lt;0.001). Thus, a proper foot care education program has been shown to reduce the risk of ulceration. CONCLUSION: The present study was conducted to study the effect of patient counselling on diabetic foot ulcer patients using NAFFC score. Majority in the study belonged to 61-70 years and were males. Most of them had type 2 DM and grade 1 foot ulcer. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling to 44.07+4.70 post counselling which was found to be statistically significant (P&lt;0.001). NAFFC score played an important role in the study to assess the functional outcome among diabetics with foot ulcers. Though there is development of new therapies for the management of diabetic foot ulcers, a high rate of failure ending with amputation still exists. Hence a counselling session to the diabetics with foot ulcers can prevent further complications.

Association of preoperative red blood cell width and postoperative 30-day mortality in patients undergoing non-cardiac surgery: a retrospective cohort study using propensity-score matching

BackgroundIn terms of predicting surgery mortality, it is controversial whether red blood cell width works independently. In non-cardiac surgery patients older than 18 years, we intend to examine the relationship between red blood cell width and postoperative 30-day mortality.MethodsIn this retrospective cohort study, 90,785 Singapore General Hospital patients were matched by propensity score between January 1, 2012 and October 31, 2016. It was determined that red blood cell width at baseline and mortality within 30 days after surgery were the independent and dependent variables. We used a non-parametric multivariate logistic regression to balance the confounders among 7807 patients with high RDW and 7807 patients with non-high RDW in the propensity score matching. We investigated the association between RDW and 30-day mortality after surgery using the doubly robust estimation method.ResultsCohorts matched according to propensity score, the risk of 30-day mortality after surgery increased by 114.6.0% among the high RDW group (OR = 2.146, 95% CI 1.645–2.799, P < 0.00001). In the crude model, there was a significant association between RDW and 30-day mortality after surgery (OR = 1.877, 95% CI 1.476–2.388, P < 0.00001). In the propensity-score adjusted model, the risk of 30-day mortality after surgery in the high RDW group compared to the control group was not as high as in the non-adjusted model (OR = 1.867, 95% CI 1.467–2.376, P < 0.00001). Compared to non-high RDW group, the risk of 30-day mortality after surgery increased by 117.0% and 127.7% among high RDW group in the original cohort (OR 2.170, 95% CI 1.754–2.683, P < 0.00001) and the weighted cohort (OR 2.272, 95% CI 2.009–2.580, P < 0.00001), respectively.ConclusionsAccording to the results of this observational, propensity score-matched cohort study, uncontrolled high RDW before surgery is associated with an increased risk of death within 30 days after surgery, that is to say, patients over the age of 18 with high preoperative RDW who undergo non-cardiac surgery have a worse postoperative prognosis than those with normal RDW.

Disentangling Anemia in Frailty: Exploring the role of Inflammation.

In older patients, frailty and anemia frequently coexist. However, only few studies have been conducted in older patients with multimorbidity and several overlapping causes of anemia, such as inflammation, inadequate nutrition or certain pathologies. This analysis aims to decipher potential factors associated with anemia in older hospital patients with frailty. Patients (n=208, age: 62-98 years) were categorized as pre-frail (n=68) and frail (n=140) using the Fried frailty phenotype. We quantified serum concentrations of markers of iron-metabolism (iron, ferritin, transferrin, soluble transferrin receptor, hepcidin), inflammation (interleukin (IL) 6, IL-10 C-reactive protein) and haematology (hemoglobin). Principal component analysis was conducted to evaluate biomarker patterns and associations with frailty were assessed with logistic regression analysis. Anemia prevalence was higher in patients with frailty (84.3% versus 70.6%, p=0.021). Three principal components (PC1-3) were identified. PC1 was characterized by high factor loadings representing inflammation and factor scores differed between patients with pre-frailty and frailty [-0.04 (IQR:1.45) versus -0.51 (IQR:0.87), p<0.001]. PC2 represents macrocytic anemia and thus vitamin B12 or folate deficiency, whereas PC3 indicates hematological pathologies. Only PC1 was associated with frailty status when controlled for age, sex, number of drugs and comorbidities (OR: 2.018, 95%CI: 1.316; 3.094, p=0.001). PC2 and PC3 were not associated with frailty. Our results suggest that anemia in patients with frailty is driven by inflammation rather than being disease-related or solely the result of micronutrient deficiencies.

Organizational and economic factors of assessing the management of accessibility and quality of medical care in the Republic of Tatarstan

BACKGROUND: Today, when assessing the availability and quality of medical care, objective criteria and indicators prevail, and the factor of patient feedback as end consumers is practically not taken into account, which does not allow us to form a comprehensive view and get closer to solving this problem. AIM: To identify the factors that have the greatest impact on patients' assessment of the availability and quality of medical care, to study the influence degree of organizational and economic problems of medical organizations on this assessment and to develop quantitative indicators for managing this indicator. MATERIAL AND METHODS: The study was conducted using a questionnaire from October to December 2023 based on medical organizations of the Republic of Tatarstan. Two types of questionnaires were compiled. The first questionnaire was for consumers of medical care, covering 2,419 patients of hospitals and clinics from all cities and districts of the Republic of Tatarstan. The second questionnaire was for medical personnel. A total of 20,330 medical workers took part in the survey: 5,206 doctors, 10,841 nurses, 4,283 junior medical personnel from all types of medical organizations, including central republican hospitals, city and district hospitals and clinics of Tatarstan. The results of the questionnaires were processed by means of correlation and regression analysis using the least squares method. RESULTS: It was revealed that for patients of medical organizations the most significant factors in assessing the quality of medical care were: (1) queues and constant waiting (50.5% of respondents); (2) inability to see a specialist (48.9%); (3) unavailability of diagnostic procedures (biochemical blood test, computed tomography and magnetic resonance imaging, ultrasound; 40.7%); (4) inattention, indifference of medical workers (27.5%). Factors in the work of medical institutions and personnel that had the greatest impact on patients' assessments of the indicator of availability and quality of medical care were identified: stress at work, overload and high work pressure, dissatisfaction with salary. The regression coefficients of the identified factors allow them to be used as indicators of management decisions aimed at increasing the importance of availability and quality of medical care. CONCLUSION: Patient assessments obtained by medical organizations as a result of feedback allow not only to bring the level of availability and quality of medical care as close as possible to the expectations and needs of patients, but also to identify areas of management influence to improve it.

Prevalence, Characterization, and Epidemiological Relationships between ESBL and Carbapenemase-Producing Escherichia coli, Klebsiella pneumoniae, and Acinetobacter spp. Isolated from Humans and the Kitchen Environment of Two Greek Hospitals.

Extended-spectrum-β-lactamase (ESBL) and carbapenemase-producing Enterobacterales and Acinetobacter spp. pose significant challenges as nosocomial pathogens, demonstrating resistance against various antimicrobials. Their presence in food suggests that hospital kitchens could serve as antibiotic resistance reservoirs leading to patients' infection. The aim of this study was to assess the prevalence and characteristics of β-lactam-resistant strains of Escherichia coli, Klebsiella pneumoniae, and Acinetobacter spp. isolated from the kitchen environment and from the staff of two Greek hospitals. Strains were recovered after selective isolation with β-lactams and were identified with MALDI-TOF MS. Antimicrobial susceptibility and presence of common β-lactamase genes were evaluated. Protein profiles were examined to analyze potential relationships of the strain with those from hospital patients. E. coli strains were further categorized into phylogenetic groups. The overall prevalence in the kitchen environment was 4.5%, 1.5%, and 15.0% for E. coli, K. pneumoniae, and Acinetobacter spp., respectively, whereas the prevalence of Acinetobacter spp. in human skin was 4.0%. Almost all strains were multidrug-resistant. All E. coli strains were ESBL producers and belonged to phylogroups A and B1. All K. pneumoniae and seven Acinetobacter strains were carbapenemase-producers. A protein profile analysis showed relatedness between chicken and kitchen environment strains, as well as between kitchen environment and patient strains originated either from the same or from different hospitals. The results suggest that hospital kitchens may act as important pathogen hotspots contributing to the circulation of resistant strains in the hospital environment.

B-198 Rapid Molecular Detection of Respiratory Infections in Brazilian Hospitals and Outpatient Units: Insights from the Diagnostic Medicine and Health Network

Abstract Background Diagnosing agents causing respiratory infections remains a global challenge due to the numerous coexisting agents and similar symptoms. This study evaluates the epidemiology of viral and bacterial agents responsible for major respiratory infections through molecular detection in patients across various Brazilian hospital units served by a clinical diagnostic and health laboratory. Understanding the distribution and prevalence of these pathogens is crucial for effective diagnosis, treatment, and prevention strategies in the face of evolving epidemiological landscapes. Methods Utilizing an internal database, we conducted a comprehensive analysis of tests performed on the FilmArray® system. This system employs multiplex PCR technology, capable of simultaneously identifying 21 respiratory agents in a single sample obtained from nasopharyngeal and bronchial lavage specimens collected from diverse geographical regions across Brazil. The data for the examination of patient samples with respect to gender, age group, geographical regions, and the prevalence of various agents between January 2021 and April 2023 were retrieved from the database and analyzed. To ensure privacy, sensitive and individual data from all patients were meticulously preserved throughout the study. Results The analysis encompassed a diverse sample of 477 patients, originating from 26 cities across 11 Brazilian states, including Goiás, Minas Gerais, Mato Grosso, Pará, Paraná, Rio de Janeiro, São Paulo, Tocantins, Amazonas, Bahia, and Distrito Federal. The distribution of patients was nearly split between hospital settings (39.8%) and outpatient units, with hospital patients predominantly from departments such as internal medicine, cardiology, and nephrology. In contrast, outpatient samples were primarily requested by specialists in pulmonology and infectious diseases. The demographic profile revealed an average age of 36 years, with a majority male representation (54%). However, a notable shift occurred in the first four months of 2023, where females constituted 60.8% of the sample. The overall test positivity rate stood at 42.3%, with a significant detection of 71% (15 out of 21) of the surveyed respiratory agents at some point during the study period. The most frequently identified pathogens were Rhinovirus, Enterovirus, and SARS-CoV-2, collectively accounting for 55.1% of the positive findings. Additionally, mixed infections were observed in 29 (6%) of the patients, with combinations such as SARS-CoV-2 and Rhinovirus, SARS-CoV-2 and H3N2, and SARS-CoV-2 and RSV, among others, highlighting the complexity of respiratory infections. Conclusions The findings from this study underscore the critical role of advanced molecular diagnostics in the Brazilian clinical-laboratory landscape. The utilization of multiplex PCR technology has proven to be a pivotal tool in accurately identifying a wide array of respiratory pathogens, thereby enhancing the precision of diagnosis and treatment strategies. The detection of a high prevalence of agents such as Rhinovirus, Enterovirus, and SARS-CoV-2, along with the identification of mixed infections, highlights the complexity of respiratory infections and the necessity for robust diagnostic tools. This study not only contributes to the understanding of the epidemiology of respiratory infections in Brazil but also emphasizes the importance of continuous advancements in molecular diagnostics for better patient care and public health management.

Costs and benefits of routine labs in hospital patients: iatrogenic anaemia and undiagnosed acute kidney injury

ImportanceGuidelines recommend avoiding unnecessary laboratory tests to minimise risks of anaemia in hospitalised patients as well as reduce costs, but there are costs to skipping routine labs including missing acute...

Frailty: A Familiar Challenge or an Unknown Question for Anesthesiologist – Results of an Indian Survey

Abstract Background: Frailty is a public health issue, and with increased life expectancy, more elderly patients are coming for surgical interventions. It is a multidimensional condition, characterized by loss of functional reserve which leads to adverse perioperative outcomes. This novel survey in the Indian scenario not only identifies the knowledge and orientation of the Indian anesthesiologists but also their day-to-day practice of frailty assessment. Methods: This 22-question survey was distributed to mostly Indian anesthesiologists practicing in various cities through electronic media. The first section included the electronic addresses and the informed consent. The second section contains the academic background and demography of the respondents. The third section includes their awareness about frailty and how they perceive it as a clinical entity. The last section focuses on the actual practice of frailty assessment by the participants. Results: We received 306 responses, among them 295 doctors practice anesthesia. Ninety-four percent of respondents agreed that the concept of frailty should be known to all anesthesiologists, 89% of the responses concurred that frailty affects postoperative outcomes. Only 54% respondents were properly trained in this topic during their training days and 45% of all were only confident to diagnose frailty in the preanesthetic check (PAC) clinic. Thirty seven percent of respondents lacked basic knowledge about different frailty tools. Forty-three percent of respondents revealed that they do not report the presence of frailty in patient files during PAC. Only 10% of the respondents have ever used any point-of-care ultrasound for frailty assessment. In 73% of cases, there was no geriatric team available in the hospitals, and 71% said that there is no well-implemented preoperative approach in their hospital for elderly frail patients for elective surgery. Conclusions: Despite the awareness of the importance of frailty in preoperative assessment, there is a huge void in the identification and assessment of frail patients in hospitals. There is an absolute need for a uniform and standardized national guideline.

188 Temporal Impact of Hospice and Palliative Medicine Consults on End-of-Life Outcomes in Emergency Department and Hospitalized Patients

188 Temporal Impact of Hospice and Palliative Medicine Consults on End-of-Life Outcomes in Emergency Department and Hospitalized Patients

Health Care Costs and Utilisation for Diabetes Mellitus among Hospitalised Patients in Ireland: The National Kidney Disease Surveillance System

Health Care Costs and Utilisation for Diabetes Mellitus among Hospitalised Patients in Ireland: The National Kidney Disease Surveillance System

Coexistence of overweight and malnutrition in hospital patients and association with clinical outcomes: A double burden?

Coexistence of overweight and malnutrition in hospital patients and association with clinical outcomes: A double burden?

S2002 A New 3-variable Model Outperforms MELD and King’s College Criteria in Hospitalized Patients With Severe Idiosyncratic DILI

S2002 A New 3-variable Model Outperforms MELD and King’s College Criteria in Hospitalized Patients With Severe Idiosyncratic DILI

S573 Predictive Artificial Intelligence Analysis of Determinants of Health Outcomes in Hospitalized Patients with Eosinophilic Esophagitis

S573 Predictive Artificial Intelligence Analysis of Determinants of Health Outcomes in Hospitalized Patients with Eosinophilic Esophagitis

Knowledge, Attitude and Practice about Ayushman Bharat Digital Mission and Digital Health among hospital patients

ABSTRACT Aim: The Government of India launched the Ayushman Bharat Digital Mission (ABDM) to digitize the national healthcare system. The aim of this study was to estimate the knowledge, attitude and practice regarding the ABDM and benefits of digital health among urban patients, who are likely to be early adopters of digital technologies. Methods: We interviewed 150 outpatients above 18 years of age, in a hospital in urban Bengaluru, India. Our questionnaire captured the knowledge, attitude and practice regarding ABDM and Digital Health, including open-ended questions to evaluate perceptions of the benefits and concerns regarding digital health. Results: Most of the participants belonged to the upper and upper middle socioeconomic classes. Only 8% of participants knew about the ABDM, although their knowledge and practice related to other Government digital services, like National Teleconsultation services (eSanjeevani), Arogya Setu and DigiLocker, were high. Many participants perceived digital health to be beneficial, but there were serious concerns regarding data safety, data privacy and misuse of health data by insurance companies. Conclusion: We established a baseline survey for assessing the knowledge, attitudes and practices of ABDM and digital health among urban patients. The results suggest that implementation agencies of ABDM should increase the Information, Education and Communication (IEC) and devise new strategies to create awareness, disseminate correct information and address the concerns of citizens.