Level Of Patient Satisfaction Research Articles

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

Improvement in pain by using lidocaine combined with esketamine in elderly patients receiving local anaesthesia for percutaneous kyphoplasty: a randomized controlled study

BackgroundElderly patients often experience severe pain during percutaneous kyphoplasty under local anaesthesia. The aim of this work was to evaluate the effect of lidocaine combined with esketamine on pain improvement in elderly patients receiving local anaesthesia via percutaneous kyphoplasty.MethodsThis prospective, randomized comparative trial was conducted on 66 elderly patients, aged 60–80 years, with an American Society of Anaesthesiologists (ASA) grade of I-III, I‒III and a BMI of 18.5–25 kg/m2, who underwent single-level lumbar percutaneous kyphoplasty under local anaesthesia. Patients were divided into two equal groups (33 per group). Group LE received 200 mg of 1% lidocaine and 25 mg of esketamine (total volume of 20 ml), and Group L received 200 mg of 1% lidocaine (total volume of 20 ml). Patient characteristics, surgery, VAS scores, MAP, HR, MOAA/S scores, patient satisfaction and related adverse reactions were compared for the groups. The VAS scores during and after surgery were considered the primary outcome.ResultsThere were statistically significant differences in the VAS score between the two groups at the following time points: channel establishment by the puncture needle, balloon dilation, bone cement injection and postoperative period (P < 0.05). The VAS score decreased in the LE group, but the MAP and HR were more stable, and the difference was statistically significant (P < 0.05). The difference in the MOAA/S score between the two groups was statistically significant (P < 0.05), and the MOAA/S score in the LE group decreased. The patient satisfaction level in the LE group was 100% and 48.48% in the L group (P < 0.05). There were no related complications or adverse reactions in either group.ConclusionThe application of lidocaine combined with esketamine in local episcopal percutaneous vertebral kyphoplasty in elderly patients not only provides an effective analgesic effect but also improves surgical safety and patient comfort, which has important clinical value in promoting the optimization of surgical anaesthesia management in elderly patients.Trial registrationThe study was registered at Chictr.org.cn with the number ChiCTR2400083466 on 06/12/2023.

New protocol for early robot-assisted gait training after spinal surgery

IntroductionEarly rehabilitation post-spinal surgery is vital for patients' recovery. Robot-assisted gait training (RAGT) shows promise but requires further study to establish a specific protocol and gauge its effects on both patients and physical therapists. This study aimed to determine the impact of a newly developed protocol for early RAGT on patients' functional enhancement and satisfaction levels after spinal surgery, as well as on the physical therapists who implemented the therapy.MethodsFirst, we developed the protocol in collaboration with three physiatrists and two physical therapists with extensive experience in musculoskeletal rehabilitation. The protocol was updated three times, each after three rounds of face-to-face meetings. Afterward, we conducted a cross-sectional study involving five physical therapists and 32 post-spinal surgery patients at a tertiary hospital rehabilitation center. The intervention consisted of five sessions of RAGT. Main outcome measures included the Functional Ambulation Category (FAC), the ambulation item of the Modified Barthel Index (MBI ambulation), and satisfaction surveys for both patients and physical therapists.ResultsRAGT typically started 17.91 ± 9.76 days postoperatively and was successfully applied with no remarkable adverse effects. The FAC scores increased from 2.65 ± 1.21 to 3.78 ± 0.71 (p = 0.006), and MBI ambulation increased from 7.69 ± 2.71 to 10.66 ± 2.90 (p &amp;lt; 0.001) between transfer and discharge. Satisfaction with the robot, RAGT, and treatment, assessed using a 5-point Likert scale, were 3.30 ± 0.79, 3.72 ± 0.85, and 3.08 ± 0.84, respectively. Satisfaction was notably the highest for alleviating fear of falling, whereas managing pain and discomfort during position changes scored the lowest. Physical therapists rated RAGT satisfaction, impact on the working environment, and treatment stability at 3.0 ± 0.65, 2.80 ± 0.67, and 3.50 ± 0.61, respectively.ConclusionEarly spinal surgery rehabilitation with RAGT improved patients' functionality and gait satisfaction. While physical therapists considered RAGT safe, its impact on their work environment was limited. Integrating RAGT into post-spinal surgery rehabilitation demands ongoing protocol refinement, custom robot development, and efficacy evaluations.

Роль и место медицинской информационной системы при оказании дерматологической помощи в частной медицинской организации

Dermatological diseases retain statistically significant positions in the structure of modern somatic pathology and are often characterized by severe medical and social consequences. The latter include an unreasonably high number of unsatisfactory treatment results, high level of expenses for diagnostics and treatment, low level of patient satisfaction. Taken together, this allows us to consider the comprehensive quality of dermatological care as a whole insufficient. Medical organizations in the private healthcare segment are no exception in this regard. One of the modern effective directions in improving the quality of a wide variety of types of medical care for the population is the widespread use of the so-called medical information systems (MIS). However, at the level of dermatological organizations in the private healthcare segment, this direction has not been practically worked out to date. Purpose of the study: improving the quality of dermatological care for the population in a private medical organization based on the development and implementation of a medical information system. Materials. The study included 2000 dermatological patients of a private medical organization. The control group (1000 people) consisted of patients in the period before the implementation, the main group (1000 people) – patients in the period after the implementation of the developed system. The duration of the compared periods was 2,5 years. Мethods. To obtain the results, the methods of objective examination, specialized patient questionnaires, simple and extended dermatoscopy, content analysis of medical documentation and databases of the medical organization, pharmacoeconomic analysis were used. The system of integrated assessment of the quality of medical care was applied. The methods of variation statistics were used to analyze the results. The exact level of statistical significance of differences in the results before and after the implementation of the developed MIS was calculated.. Subject. The study is at the intersection of two subject areas: «Organization of dermatological care for the population» and «Medical information systems». Results. As part of this study, a MIS was developed aimed at improving the organization of dermatological care for the population. The system was implemented in a medical organization in the private healthcare segment. The main results of such implementation were: an increase in the number of successful treatment results, the level of patient satisfaction with the quality of dermatological care, the level of its standardization, a decrease in direct economic costs for diagnostics and treatment. The integrated and comprehensive indicators of the quality of dermatological care have been increased.. Conclusion. Improving the quality of dermatological care for the population in a medical organization of the private healthcare segment based on the development and implementation of a medical information system has been achieved. The results obtained have a high level of statistical and medical-social significance.

Utilisation of the minimally invasive chevron akin (mica) osteotomy for severe hallux valgus: a systematic review.

Hallux valgus is the most common forefoot disease that can cause pain and be disabling for the patient. Many surgical procedures have been described to correct this deformity; over the last years, the minimally invasive Chevron and Akin osteotomies (MICA) technique has become very popular. The aim of this review was to assess if MICA technique is a reliable procedure for treating severe hallux valgus. A systematic review was performed according to the Preferred Reporting Items for systematic Reviews and Meta-Analysis (PRISMA) guidelines. The keywords were searched in PubMed Medline and Cochrane library. To minimise the number of missed studies, no filters were applied to the search strategy. To be considered for this review, the articles needed to comply with the following inclusion criteria: Minimally invasive Chevron and Akin osteotomy (MICA) for severe hallux valgus (HVA > 40°, IMA > 16°), patient age over 18years and minimum follow-up of 6months. Following the PRISMA flow chart 7 studies met the inclusion criteria and were taken into consideration in the review. We reached a population of 582 patients for a total of 676 feet. Males and females were 64 and 518, respectively. The mean age was 54.15 ± 8.25. The mean follow-up was 23.74 ± 9.60months. All the studies reported an improvement in clinical results, in terms of function and quality of life. Radiological variables, mostly IMA and HVA, assessed pre- and postoperatively showed significant improvement in all studies included. Despite the limited number of published studies in the literature, the available evidence reveals good clinical outcomes and high levels of patient satisfaction. Percutaneous surgery for severe hallux valgus can achieve great deformity correction with reasonable rates of residual deformity. Patient satisfaction and quality of life following third-generation MICA surgery is very high.

The Microneedle Revolution: Transforming Vitiligo Treatment Landscapes-A Comprehensive Review of the Literature.

Vitiligo is characterized by the emergence of depigmented patches on the skin, posing significant therapeutic challenges. Microneedling, a novel treatment strategy, capitalizes on its potential to invigorate skin regeneration and facilitate melanocyte migration. This review critically evaluates the efficacy, safety, and patient satisfaction associated with microneedling for vitiligo treatment, juxtaposing it with traditional therapies to elucidate its viability as either a standalone or complementary treatment modality. A comprehensive literature review was conducted across major databases, including PubMed and Cochrane Library, using keywords like "microneedling" and "vitiligo," encompassing studies up to January 2024. This review focused on microneedling's effectiveness, safety, and patient satisfaction, including both solo and combined treatments. Data synthesis emphasized repigmentation rates, side effects, and patient feedback. An exhaustive review of studies pertaining to microneedling for vitiligo, especially focusing on outcomes when administered alone or in conjunction with agents such as tacrolimus and 5-fluorouracil, was undertaken. Key evaluation metrics included repigmentation success rates, adverse effects, and patient-reported outcomes. Microneedling demonstrates a favourable safety profile, with mild and manageable side effects such as pain, erythema, and temporary hyperpigmentation. Severe adverse events are rare, further supporting its safety as a treatment option for vitiligo. The evidence amassed suggests that microneedling significantly augments repigmentation rates, particularly in synergy with topical treatments. It is generally well-tolerated, manifests minimal adverse effects, and has garnered high patient satisfaction levels. Nonetheless, the absence of standardized treatment protocols and paucity of long-term efficacy data underscore the imperative for further empirical inquiry. Microneedling emerges as a propitious treatment alternative for vitiligo, demonstrating both safety and efficacy, notably when used in tandem with topical agents. Future investigations should aim at protocol standardization and long-term efficacy evaluation to firmly establish its therapeutic stature within vitiligo management paradigms.

Factors Affecting Satisfaction With the Process of Orthodontic Treatment in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife

Objectives: This study aims to determine the factors contributing to patient satisfaction with orthodontic treatment at Obafemi Awolowo University Teaching Hospital Complex. The specific objectives were to identify factors improving and negatively impacting patient satisfaction, and determine the level of patient satisfaction. Methods: A cross-sectional study design was employed, which involved patients attending the orthodontic clinic at Obafemi Awolowo University Teaching Hospital Complex. A self-administered questionnaire assessed patient demographics, satisfaction levels, and factors influencing satisfaction. Data analysis was performed using descriptive statistics, chi-square tests, and mean scores. Results: Of the 67 respondents, 91% reported satisfaction with their orthodontic treatment. The doctor-patient relationship received the highest mean satisfaction score, while psycho-social improvement received the lowest. Dissatisfied patients were predominantly females in the 21-30 age group. Factors such as dento-facial and dental function improvements significantly affected satisfaction levels. Conclusion: The majority of orthodontic patients at Obafemi Awolowo University Teaching Hospital Complex reported satisfaction with their treatment. Improving patient communication, managing expectations, and addressing dento-facial and dental function improvements can enhance satisfaction levels. Strengthening the doctor-patient relationship and optimizing clinic experiences can improve patient satisfaction.

Real-world usage pattern, effectiveness and safety of oral tramadol/dexketoprofen trometamol fixed-dose combination in moderate-to-severe acute pain in Asia: a prospective, multicentre, observational study

ObjectivesThis study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of...

The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study

Objective: To explore the efficacy of Traditional Chinese Medicine (TCM) acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke. Methods: This is a retrospective study using clinical records of 180 patients with ischemic stroke, hospitalized in the Department of Neurology of the Zhejiang Province Tertiary Class A Hospital, Huzhou, China from July 2022 to June 2023. The patients were divided into two groups on the basis of the nasogastric tube insertion method. We selected 90 patients for each group from the database of records by using a random list method. Patients in the observation group underwent TCM acupuncture-assisted blind insertion of nasointestinal tube and those in the control group underwent the traditional bedside blind insertion of bullet nasointestinal tube. Success rate of tube insertion, average tube insertion time, intragastric insertion time, stomach time to jejunal insertion, patient comfort, and patient satisfaction in both groups were compared. Results: The success rate of nasointestinal tube insertion was significantly higher in the observation group compared to the control group (96.6% and 88.9%, p&lt;0.05). There was no statistically significant difference in the time of nasoenteral tube insertion into the stomach (p&gt;0.05). The insertion time from stomach to jejunum in the observation group was significantly shorter than in the control group (p&lt;0.05). The patient comfort and satisfaction levels were significantly higher in the observation group compared to the control group (p&lt;0.05). Conclusion: TCM acupuncture-assisted blind insertion of bullet nasointestinal tube method improves the success rate of tube insertion, shortens the average catheterization time from the stomach to the jejunum and improves patient’s comfort and satisfaction. doi: https://doi.org/10.12669/pjms.40.10.9936 How to cite this: Zhao H, Chen J, Chen H, Lv X, Lu Z, Sun Y. The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study. Pak J Med Sci. 2024;40(10):2208-2212. doi: https://doi.org/10.12669/pjms.40.10.9936 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Modern Aspects of Closed and Open Rhinoplasty (Literature Review)

Open and closed rhinoplasty are two primary approaches to nasal modification. According to the current literature, there is no consensus among plastic surgeons and otolaryngologists regarding the preferred method in terms of aesthetic outcomes, complications, and patient satisfaction. This review aims to analyze published scientific materials to determine whether open or closed rhinoplasty leads to more favorable patient outcomes. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a literature search across four databases according to our search strategy. The articles were then imported into COVIDENCE, where they underwent primary screening and full-text review. A total of twenty studies were selected for this review after analyzing 243 articles. Among them, there were four case series, twelve retrospective cohort studies, one prospective cohort study, one case-control study, and two outcome studies. The analysis included three cosmetic studies, eight functional studies, and nine studies that addressed both cosmetic and functional components. Sixteen studies used both open and closed rhinoplasty techniques, while four focused exclusively on open rhinoplasty. Both methods demonstrated high satisfaction rates among patients and professionals, with no significant advantage found for either technique. Based on the available studies, we cannot conclude the superiority of either open or closed rhinoplasty in achieving better patient outcomes. Several studies indicated that both open and closed rhinoplasty resulted in comparable levels of patient satisfaction. To enhance the reliability and consistency of outcome reporting, authors should focus on using the Nasal Obstruction Symptom Evaluation (NOSE) scale and other standardized rhinoplasty outcome assessments.

Symptomatology and level of satisfaction in patients using the double‐J ureteral stent

AbstractBackgroundUreteral stents are used as temporary or permanent drainage measures for intrinsic or extrinsic occlusions of the upper urinary tract. Their use can cause complications such as urinary symptoms, which consequently impact the quality of life. Therefore, the aim of this study was to analyze the symptoms and level of satisfaction of patients who used the double‐J ureteral stent.MethodsThis article is a cross‐sectional study involving 40 volunteers who had previously undergone a urological procedure that required the insertion of a double‐J ureteral stent. Subsequently, they consulted the urology outpatient clinic and answered a questionnaire designed by the authors.ResultsAccording to the results, the average age of the patients was 43 years old, 75% were female, and 42.5% reported comorbidities, with hypertension being the most prevalent. The wired double‐J ureteral stent was used in 72.5% of patients, and the average length of stay was 6 days. 95% of the patients had complaints related to the use of the double‐J ureteral stent, with colicky abdominal pain being the most frequent symptom (77.5%) and hematuria being the most common urinary symptom (65%), followed by dysuria (62.5%) and urgency (52.5%). Analysis of the level of satisfaction showed that 55% of patients were satisfied and 22.5% were dissatisfied. No statistical significance was found between the incidence of symptoms related to the double‐J ureteral stent and the groups analyzed.ConclusionThis study was able to highlight important features of the symptomatology of patients using the double‐J ureteral stent and the repercussions on satisfaction with its use. Furthermore, it was possible to concluded that the experience of using the double‐J ureteral stent was satisfactory for 55% of the patients.

Satisfaction Amongst Drug-dependent Population with Methadone Maintenance Treatment Services, A Comparison between Public and Private Clinics: Implications for Private Sector Engagement in the Delivery of Methadone Maintenance Programs Across Vietnam.

In Vietnam, the public sector has largely been responsible for delivering methadone maintenance treatment (MMT) services. However, with foreign aid anticipated to decline in the coming years, the involvement of the private sector in delivering MMT services is critical to ensure the continued sustainability of MMT programs across Vietnam. This study aims to evaluate patient satisfaction and identify correlated factors among Vietnamese drug users undergoing MMT in both public and private methadone clinics. A cross-sectional study was conducted in one private and two public methadone facilities in Nam Dinh, a province in the North of Vietnam. A convenience sampling technique was applied to recruit 395 participants. Data was collected through 20-minute face-to-face interviews using a structured questionnaire. Multivariate Tobit regression was utilized to measure associated factors with patient satisfaction. Results showed that patients were highly satisfied with MMT services in both public and private; however, they expected a higher degree of comprehensive care services. Compared with public facilities, the satisfaction level of patients in private facilities was significantly lower in the following aspects: health administration and professional capacity of health workers. However, there were insignificant differences in regard to infrastructure, equipment, and availability of medical services resources, supporting a promising role of the private sector in supporting the expansion of the MMT programs in Vietnam. Integrating MMT with other physical and mental healthcare services, along with strategies for improving administrative procedures and health workers' capacity in private clinics, are critical implications of this study.

Bridging the Gap: Analyzing Healthcare Access and Inequalityin Ghana

Ghana’s National Health Insurance Scheme (NHIS) has made tremendous progress towards the aimof obtaining universal healthcare coverage. By boosting access to key healthcare services, the NHIS hasplayed a vital role in improving healthcare outcomes across the country. However, despite these advancements, major discrepancies in healthcare access exist, especially among low-income households and rural communities. These inconsistencies show fundamental injustices in the distribution of healthcare services and raise doubts about the NHIS’s potential to effectively serve themost vulnerable parts of society. This research tries to explore the difficulties of healthcare access in Ghana by delving into NHIS membership data. Through an analysis of this data, the study shows patterns of inequality related to both economic status and geographic location. By concentrating on how different economic quintiles connect with the NHIS, the research highlights important hurdles to enrollment and continuing access to healthcare. Additionally, the spatial research indicates considerable inequalities, illustrating how rural residents often experience more severe obstacles in getting healthcare compared to their urbancounterparts. Furthermore, the quality of healthcare services given under the NHIS is severely assessed. Issues such as inconsistent service delivery, poor resource allocation, and different levels of patient satisfaction emerge as important concerns that must be addressed to increase the overall success of the plan. Beyond Ghana’s boundaries, the research encompasses a comparative review of health insurancemodels from Rwanda, South Africa, Mexico, and Kenya—each country presenting a unique approach to healthcare funding and insurance coverage. Rwanda’s community-based health insurance, South Africa’s progressive changes, Mexico’s focus on service quality, and Kenya’s required enrollment offer useful lessons for resolving the inadequacies in Ghana’s NHIS. By drawing on these different models, the study intends to highlight best practices and lessons that could drive policy suggestions customizedto Ghana’s specific social, political, and economic setting. The study offers three critical policy reforms that might strengthen the NHIS and improve healthcare access across the country. Enhancing community participation is regarded as a critical way to enhance NHIS enrollment, particularly among underrepresented populations. Moreover, improving the subsidy mechanisms to better support low-income households is advocated as a manner of eliminating financial obstacles to healthcare. The study also advocates for specific measures to addressthe regional imbalances in healthcare infrastructure, noting the need for increased access in rural areas. Ultimately, these steps are not only meant to eliminate the gaps in coverage but also to secure the long-term sustainability of the NHIS, positioning it to continue offering fair healthcare to all Ghanaians. By tackling these problems and implementing targeted changes, Ghana can make considerable steps toward obtaining true universal healthcare coverage. The NHIS has the potential to become amore inclusive and resilient healthcare system, capable of fulfilling the requirements of the entire population.

The Impact of Healthcare Service Quality on Patient Satisfaction at University Health Center

Patient satisfaction is a critical aspect of healthcare service quality that needs to be periodically evaluated and improved. Understanding various factors, including empathy, assurance, reliability, tangibility, and responsiveness, is necessary to enhance healthcare quality and improve patient satisfaction. This research aims to investigate the level of patient satisfaction and the relationship between patient satisfaction and service quality, using the five SERVQUAL model as a framework. A positivist approach was used to explore the relationship between variables. Data collection was carried out for two weeks using online questionnaires. For this research, 120 UiTM respondents were chosen using convenience sampling. Data was analyzed using SPSS version 29. The findings revealed a significant positive relationship between tangibility, responsiveness, and empathy with patient satisfaction. This study highlights the importance of regularly assessing patient satisfaction and identifying areas for improvement in healthcare service quality. University health centers can enhance patient satisfaction and provide better student healthcare services by focusing on tangibility, responsiveness, and empathy.

Experience of integrating lean technologies into the quality management system of a medical organization providing primary medical and sanitary care

Objective. To evaluate the effectiveness of implementation of lean production methods into the practical activity of primary health care on the example of the State Institution of Health Care «Saratov City Polycli nic № 2». Materials and methods. The study was divided into three stages: data collection through anonymous sociological surveys using phones or tablets, timing and improvement of the process, and a follow-up questioning of participants to assess their satisfaction. 296 residents of Saratov receiving primary health care at the polyclinic took part in the survey. The survey was conducted using a specially developed electronic questionnaire via Google Form. For mathematical processing, the results of the study were initially transferred into an electronic database; the results of the study were analyzed using the descriptive statistics method. Results. According to the survey, the majority of respondents are satisfied with the quality of outpatient medical care. This shows that organization of the medical care is focused on the patients` needs and desire to meet their demands. The organization of the front office and the premises of the polyclinic in accordance with the requirements for the new model of the organization providing primary medical care made it possible to achieve a high evaluation of the information stands and the waiting area. The study showed that ineffective organization of the registry office contributed significantly to the patients` low assessment. In our opinion, in order to solve the problem, it is necessary to optimize the work of the registry office by introducing modern technologies and equal distribution of duties among the employees. Conclusions. In order to improve the quality and accessibility of medical services, it is necessary to make certain changes in the organization of medical care. The level of patient satisfaction with the work of medical institutions may depend on various factors, such as waiting time for a doctor, the timing of medical services provision after the appointment, the availability of necessary diagnostic tests and specialists.

The ‘less is more’ approach: highlighting the benefits of poly-L-lactic acid filler as a treatment option

Advanced nurse practitioner Michelle McLean delves into the benefits of poly-L-lactic acid filler (PLLA) for skin rejuvenation and restoration as patients demand a ‘less is more’ approach to facial aesthetics. A recent surge in patients wanting to restore or preserve a youthful appearance has seen a surge in popularity for collagen stimulators due to their association with high levels of patient satisfaction, long-lasting efficiency, minor adverse events and sound safety profile ( Christen, 2022 ). Patients are increasingly opting for a ‘less is more’ visual aesthetic, hoping to achieve subtle, natural-looking, undetectable results. To meet patient goals, clinicians are utilising combination approaches in facial aesthetics, utilising products with PLLA because of its desirable results. PLLA is a powerful, well-tolerated tool for clinicians to employ for the non-surgical augmentation of the ageing face.

Early ward discharge clinic: facilitating discharges and prompt follow-up for medical inpatients in a district general hospital

Early discharge and follow-up for medical admissions could facilitate reduced length of stay and improve patient satisfaction. However, evidence to confirm this is lacking. Peterborough City Hospital (PCH) designed an...

Prehabilitation for delirium prevention in elderly patients with chronic limb threatening ischemia

Elderly patients with Chronic Limb Threatening Ischemia (CLTI) undergoing revascularization are prone to delirium and prolonged hospitalization. Preoperative prehabilitation may prevent delirium and reduce the length of stay. This study investigates the effect of multimodal prehabilitation on delirium incidence in elderly CLTI patients undergoing revascularization. A comparative observational cohort study conducted in a large teaching hospital (intervention cohort n=101, retrospective control cohort n=207) and a university hospital (prospective control cohort n=48) from 2020 to 2023. Patients aged ≥ 65 years undergoing revascularization were included, with acute treatment or severe cognitive impairment as exclusion criteria. The three-week prehabilitation program included screening of general health and presence of delirium risk factors by a vascular nurse practitioner, screening and provision of personalized, home-based exercises by a physiotherapist, provision of nutritional advice by a dietician, and if indicated comprehensive geriatric assessment by a geriatrician, assessment of self-reliance and home situation by a prearranged homecare nurse, guidance and support for smoking cessation by a quit smoking coach, and anaemia treatment. Primary outcome was 30-day delirium incidence, analysed using regression models adjusting for potential confounders (age, physical impairment, history of delirium, preoperative anaemia and revascularization type). Secondary outcomes were length of stay, postoperative complications, 30-day mortality, and patient experiences. Median age (IQR) was 76 years (71-82). Delirium incidence was lower in the prehabilitation cohort (n=2/101, 2%) compared to controls (n=23/255, 9%; OR=0.21, 95%CI 0.05-0.89, p=.04). Adjusted analysis showed a non-significant delirium reduction (OR=0.28, 95%CI 0.06-1.3, p=.097). The prehabilitation cohort had a significantly shorter length of stay (2 [1-5] vs 4 [2-9] days; p=<.001), and fewer minor complications (14% vs 26%, p=.01). No differences were present in major complications and 30-day mortality. Patients reported high compliance and satisfaction (median score 8/10, IQR 7-9). Prehabilitation among elderly CLTI patients is safe and has the potential to yield multiple beneficial effects on general outcomes following revascularization, while also achieving high levels of patient satisfaction. Further validation and considering implementation in surgical settings is recommended.

Feasibility of outpatient laparoscopic adrenalectomy for primary aldosteronism

ObjectiveLaparoscopic adrenalectomy (LA) has emerged as the gold standard for the management of adrenal diseases. Despite its low complication rate, the utilization of LA in outpatient settings remains limited. This study explored the feasibility of outpatient LA for primary aldosteronism (PA). Design and methodsA retrospective analysis was conducted by reviewing the medical records of consecutive LA procedures performed for PA in our department from 2013 to 2021. A successful outpatient procedure was defined as same-day discharge, less than 12hours after admission, with no readmission within 48hours. A postoperative day one (D1) follow-up call by a nurse assessed complications, pain, and patient satisfaction (Numeric Rating Scale [0–10]). Follow-up visits were scheduled at one, three, and six months. ResultsDuring the study period, 76 LAs were performed for PA, with 60 (78.9%) being outpatient procedures. Sixteen patients (21.9%) were not selected for outpatient procedures. The main reasons for contraindicating outpatient procedures were anesthetic or social issues. The success rate of the outpatient procedures was 95% (57/60), with no reported surgical complications. Prolonged hospitalization occurred due to medical reasons such as pain or vomiting. There were no readmissions within 48hours after discharge. The mean pain and patient satisfaction, evaluated at D1, were 2.1/10 and 9.4/10, respectively. At 6 months, 32 patients (59.2%) were cured without any antihypertensive drugs, and 15 (27.8%) were improved (reduction of their antihypertensive treatment). ConclusionOutpatient LA for PA has demonstrated feasibility with a high success rate, no readmissions, low postoperative pain, and a high level of patient satisfaction. Level of evidence4.

Health Insurance Literacy and Its Impact on Patient Satisfaction with the Quality of Medical Care

Introduction. Health insurance literacy is an important aspect of population health that contributes to the functioning of the healthcare system. The significance of health insurance literacy is underscored by data showing substantial financial resources dedicated to medical care through the compulsory health insurance system (CHI). However, surveys reveal that patients' health insurance literacy is generally lower than their overall medical literacy, leading to several issues.Purpose. The study aims to examine the main aspects of health insurance literacy and its importance for ensuring patient satisfaction with the quality of medical care.Materials and methods. The authors analyzed scientific literature on population literacy in insurance, health insurance, medical care, etc. 80 participants in Moscow and 80 participants in Surgut were asked to fill out a questionnaire on self-assessment of their level of health insurance literacy. A series of semi-struc-tured interviews were also conducted among doctors of the polyclinics visited by study participants.Results. Health insurance literacy is the knowledge and practical use of information about mitigating health risks and covering treatment costs through relevant financial institutions. Health insurance literacy is a structured system of competencies that requires a systematic approach. Improving the health insurance literacy of patients is an important task of any healthcare organization, as it can significantly increase the level of patient satisfaction with the quality of medical care and, consequently, the health of the general population.