Number Of Patient Visits Research Articles

Predicting Alzheimer's Disease Progression Using a Versatile Sequence-Length-Adaptive Encoder-Decoder LSTM Architecture.

Detecting Alzheimer's disease (AD) accurately at an early stage is critical for planning and implementing disease-modifying treatments that can help prevent the progression to severe stages of the disease. In the existing literature, diagnostic test scores and clinical status have been provided for specific time points, and predicting the disease progression poses a significant challenge. However, few studies focus on longitudinal data to build deep-learning models for AD detection. These models are not stable to be relied upon in real medical settings due to a lack of adaptive training and testing. We aim to predict the individual's diagnostic status for the next six years in an adaptive manner where prediction performance improves with the number of patient visits. This study presents a Sequence-Length Adaptive Encoder-Decoder Long Short-Term Memory (SLA-ED LSTM) deep-learning model on longitudinal data obtained from the Alzheimer's Disease Neuroimaging Initiative archive. In the suggested approach, decoder LSTM dynamically adjusts to accommodate variations in training sequence length and inference length rather than being constrained to a fixed length. We evaluated the model performance for various sequence lengths and found that for inference length one, sequence length nine gives the highest average test accuracy and area under the receiver operating characteristic curves of 0.920 and 0.982, respectively. This insight suggests that data from nine visits effectively captures meaningful cognitive status changes and is adequate for accurate model training. We conducted a comparative analysis of the proposed model against state-of-the-art methods, revealing a significant improvement in disease progression prediction over the previous methods.

Enhancing Chronic Disease Management: Personalized Medicine Insights from Rural and Urban General Practitioner Practices.

Health policies worldwide emphasize managing chronic conditions like diabetes and hypertension through medication and lifestyle modifications. However, translating guidelines into practical application remains challenging, leading to suboptimal care and poor health outcomes, particularly in low-resource settings. This study aims to reveal significant differences between rural and urban patients requiring personalized approaches to chronic disease management based on geographical location and demographic data, considering the impact of emergencies such as the COVID-19 pandemic. Data were collected from rural and urban general practitioner (GP) practices in Poland, covering four years from 2018 to the first quarter of 2021, focusing on diabetes and hypertension epidemiology, risk factors, comorbidities, resource consumption, and disease burden. The findings revealed significant differences between rural and urban patients regarding age, number of patient visits, gender distribution, and types of diagnoses and visit modalities. Rural patients tended to be older, had a higher median number of visits, and exhibited different patterns of diagnoses and visit types compared to urban patients. The study also investigated the impact of the COVID-19 pandemic on chronic disease treatment, finding that while age at visits increased during the pandemic, there were no significant changes in gender distribution, but a noticeable shift in diagnoses and visit modalities with an increase in remote visits and changes in the prevalence of specific diagnoses. These disparities highlight the need for tailored approaches to chronic disease management based on geographic location and patient demographics. The study underscores the importance of understanding the unique challenges and opportunities in managing chronic diseases across different settings and during public health crises like the COVID-19 pandemic, aiding healthcare providers and policymakers in developing targeted interventions to improve chronic disease prevention and management, ultimately leading to better health outcomes for individuals and communities. Further research is needed to explore the long-term effects of the pandemic on chronic disease treatment and assess the effectiveness of interventions to mitigate its impact.

Telemedicine in orthopaedics during the COVID-19 pandemic: a comparative landscape.

The purpose of this study was to provide a comprehensive analysis on observed trends regarding the impact of the COVID-19 pandemic on telemedicine application in orthopaedics compared to other procedural, non-emergent specialties. This was a retrospective review of all telemedicine and in-person visits at a large single institution from January to December 2020. The number of patient visits, visit type, location, and provider specifics were collected. Comparisons were made between subspecialties (orthopaedic surgery, oncology, family medicine, rheumatology) for analyses. All specialties included were not conducting virtual visits at the beginning of 2020. By April 2020, orthopaedic virtual visits spiked to an all-time high of 33.5% of all patient visits as compared to oncology at 25.5%, rheumatology at 92.9%, and family medicine at 94%. By the end of the study period, orthopaedic virtual visits decreased back down to 6.5% of patient visits compared to oncology at 7.0%, and family medicine (17.4%) and rheumatology (26.2%). Orthopaedic providers practicing greater than 20years had the highest average virtual visit rates. Although the COVID-19 pandemic has posed unique challenges for healthcare providers, there was a great advancement in the rollout and application of telemedicine. To mitigate the spread of infection from coronavirus and given the recent adjustments to reimbursement policies and HIPAA regulations, orthopaedics saw a dramatic expansion of telemedicine since April 2020. The pandemic may have served as a catalyst to adopt telehealth into clinical practice. However, telehealth saw a downtrend trend by December 2020, particularly in procedure-based fields like orthopaedics and oncology.

The Influence of Marketing Mix on Patient Decision-Making in Choosing Nur'aini General Hospital South Labuhan Batu

Analysis of consumer behavior in health services is crucial in securing a company's sustainability. Amid intense competition, consumer perceptions about the quality of service at hospitals greatly influence their visiting decisions. This research focuses on the case study of Nur'aini General Hospital, which experienced a decline in patient visits from 2013 to 2016. The research method used a survey with 79 respondents from inpatients. The results show that the majority of respondents are adults, have secondary education, and most are women. Data is described in various variables such as service products, rates, service places, promotions, people involved, service processes, and physical facilities. The results of this research can help RSU Nur'aini improve marketing and service strategies to overcome the decline in the number of patient visits.

Can the electronic medical record provide reliable indicators of primary care behavioral health fidelity? Comparison of accessibility and productivity indicators assessed through observational coding.

The primary care behavioral health (PCBH) model is one of the most widely implemented integrated care approaches. However, research on the model has been limited by inconsistent measurement and reporting of model fidelity. One way of making measurement of PCBH model fidelity more routine is to incorporate fidelity indicators into the electronic medical record (EMR), though research regarding the accuracy of EMR data is mixed. In this study, we aimed to assess the reliability of EMR data as a PCBH fidelity measurement tool by comparing key EMR indicators of PCBH fidelity to those recorded by an observational coder. Over an 8-month period (October 2021-May 2022), 12 behavioral health consultants (BHCs; 92% White, 75% female) across five primary care clinics recorded indicators of PCBH fidelity in the EMR as part of their routine charting of behavioral health visits. During that same period, one observational coder completed seven 4-hr visits per clinic to obtain multiple samples of data from each over time and recorded the same variables (i.e., percentage of visits prompted by warm handoffs, number of warm handoffs, and number of patient visits). We used bivariate correlations to test the associations between the EMR variables and the observer-coded variables. Correlations between EMR and observer-coded variables were moderate to strong, ranging from r = .46 to r = .97. Leveraging EMR data appears to be a fairly reliable approach to capturing indicators of PCBH model fidelity in the key domains of accessibility and high productivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of a double catastrophe, war and COVID-19, on health service utilization of a tertiary care hospital in Tigray: an interrupted time-series study

BackgroundIn developing nations with fragile healthcare systems, the effect of war is likely to be much worse than it would be in more developed countries. The presence of COVID-19 will also likely exacerbate the war’s impact. This study set out to determine the effect of armed conflict and the COVID-19 pandemic on health service utilization at Ayder Comprehensive Specialized Hospital, in the Tigray region of Ethiopia.MethodsAn interrupted time-series study design was used to analyze patient visits over forty-eight consecutive months (from July 2017 to June 2021) at inpatient, outpatient, and emergency departments. Data were analyzed using segmented regression analysis with a defined outcome of level and trend changes in the number of patient visits. In addition, negative binomial regression analysis was also used to estimate the impact of both COVID-19 and the war on patient flow.ResultsThere were 59,935 admissions, 876,533 outpatient visits, and 127,872 emergency room visits. The effect of COVID-19 was seen as soon as the Tigray regional government imposed comprehensive restrictions. Immediately after COVID-19 appeared, all the service areas exhibited a significant monthly drop in visits; [-35.6% (95% CI: -48.2%, -23.1%)] for inpatient, [-60.6% (95% CI: -71.6%, -49.5%)] for outpatient, and [-44.1% (95% CI: -59.5%, -28.7%)] for emergency department visits. The impact of the war became apparent after a lag time of one month. Controlling the effects of time and COVID-19, the war led to a significant fall in inpatient visits [-44.3% (95% CI: -67.2%, -21.5%)], outpatients [-52.1% (95% CI: -82.7%, -21.5%)], and emergency-room attendances [-45.0% (95% CI: -74.8%, -15.2%)]. An upward trend in outpatient flow was observed after the war [1,219.4 (95% CI: 326.1, 2,112.8)].ConclusionsThe present study has clearly indicated that the war and COVID-19 have led to a large reduction in admissions, outpatient attendance, and emergency department visits. The evidence from this study suggests that due to this double catastrophe, thousands of patients could not gain access to healthcare, with probable negative consequences. Governments and organizations should implement measures to buttress the healthcare system to maintain pre-war status of service.

The Profile of Oncologic Orthopedic Surgery in 2 Years of COVID-19 Pandemic: A Single-Centered Study in Orthopedic Hospital

Background: COVID-19 pandemic has led to a difficult condition for healthcare providers to maintain their service without risking their safety. Generally, patients were canceling their hospital visits as they feared COVID-19 transmission. This has led to a general decline in the number of patient visits, attending doctors, and elective surgeries. However, this may not be the same for oncologic orthopedic cases which are allowed to continue elective surgeries, and the patients still perceive their condition as urgently in need of treatment. This article aimed to compare the number of oncologic orthopedic surgeries before and during the COVID-19 pandemic and describe the profile of oncologic orthopedic surgery two years of the pandemic.Methods: This was a retrospective study comparing the total number of oncologic orthopedic patients undergoing elective surgery in a single center, Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia, from March 2019 to February 2022. The number of surgeries per month before the pandemic, in the first and second years of the COVID-19 pandemic, was described and compared with one-way ANOVA. The surgical procedures performed in these three years were also described.Results: The total of oncologic orthopedic surgeries before the COVID-19 pandemic was 390 cases in comparison to 374 cases in the first year and 355 cases in the second year of the pandemic. The average number of cases per month was 32.5 ± 6.4 before the pandemic compared to 31.2 ± 7.8 in the first year and 29.5 ± 6.4 cases per month in the second year of the pandemic. There was no significant difference (p = 0.59, Confidence Interval 95%). Sophisticated reconstruction surgery such as arthroplasty and megaprosthesis still took place during the pandemic. Conclusions: The trend in the number of oncologic orthopedic surgeries did not decline significantly during the COVID-19 pandemic.

Factor analysis of the role of physicians and its associated factors for encompassing patients with suspected tuberculosis in Surabaya City

Background: Indonesia remains the highest tuberculosis morbidity rate, 9.6 million globally. Limited detection and surveillance of suspected tuberculosis need to be enhanced. Objective: This study aims to investigate the factors that influence the role of Physicians in screening for suspected tuberculosis. Materials and Methods: a case-control study with secondary datasets of 132 physicians. The analysis used is simple logistic regression and multiple logistic regressions. Results: out of 132, only 34 physicians (25.7%) have an active role; meanwhile, 98 physicians (74.3%) did not participate in assisting suspected tuberculosis. Almost 73% of physicians have not received additional training in tuberculosis management. The physicians contributed 19.1% to the total discovery of tuberculosis suspected in Surabaya. Age, years of working, and the number of patient visits were associated with the role of physicians in tuberculosis screening (OR of 3.809, 1.112, and 3.057). Conclusions: based on 5 variables that qualify for multivariate analysis, three factors greatly influence the physicians’ role in screening tuberculosis suspected, including age, number of patient visits, and years of working.

Abstract P3-03-18: M1 registration: Signaling patients who develop metachronous metastases after primary breast cancer

Abstract Background At the moment, over 180,000 breast cancer survivors are living in the Netherlands and survival after a breast cancer diagnosis and treatment is still increasing. Therefore, the number of survivors is rising, and these patients are at risk of metachronous metastases. Data at a national level on the development of metachronous metastases are limited, as this is not registered in the Netherlands Cancer Registry on a regular basis. Due to the vast amount of survivors, it is not feasible to actively monitor all patients to signal and register metachronous metastases. Applying machine learning may be an option to overcome this issue. The aim of our study is to develop a M1 detection algorithm based on hospital data to signal patients who developed metachronous metastases after their primary breast cancer treatment. Methods The Netherlands Cancer Registry (NCR) collects data on all individuals newly diagnosed with cancer in one of the 76 hospitals in the Netherlands since 1989. Dutch Hospital Data (DHD) collects and processes data from hospitals, including data on diagnosis and treatment. DHD data from 2019-2020 were linked to the NCR using a probabilistic matching method. We matched on date of birth, gender, diagnosis, postal code, hospital and patient ID. Column values that matched were weighted inversely proportional to the respective column’s probability distribution, where a match on a rare column value (e.g. postal codes with a relatively small population) increased the probability that the match was correct. Scores for each column were combined and patients with high matching scores were included in the algorithm development, validation and deployment. Actively signaled and manually registered data on metastases were available for subgroups of breast cancer patients included in previous studies (‘the golden standard’). First, 80% of these data was used to train the model, 20% was used to validate the model. Second, a pilot study was performed in which patients files were checked for 928 patients, sampled with variance in prediction probability, to evaluate a diverse range of cases. Results We included 4,395 patients. Variables that were included to predict metastases were i.e. specific medication for metastatic disease (palbociblib), counselling for metastatic breast cancer, Carcinoembryonic Antigen test, a confirmed diagnosis of metastases, and number of patient visits. The first validation step (including 20% of known data) showed that the model had a precision of 0.91 to predict metachronous metastases, 0.93 to predict free of metastases. The pilot study confirmed that a higher prediction probability of >0.8 correlated with a higher chance that a patient has metachronous metastases. However, false positive predictions did occur. Conclusion We developed a M1 detection algorithm to signal patients with metachronous metastases after breast cancer treatment on a national level. With this algorithm we are one step closer to identify all patients with metachronous metastases and to reach a complete registration of all breast cancer metastases reusing existing data sources. After review of patients with a high prediction probability, the model will be re-trained using these data and updated data from DHD. Citation Format: Linda de Munck, Daan Knoors, Harm Buisman, Koen Scholman, Janneke Verloop, Sabine Siesling. M1 registration: Signaling patients who develop metachronous metastases after primary breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-18.

Cost of care for asylum seekers and refugees entering the United States: The case of volunteer medical providers in El Paso, Texas.

Between October 2018, and February 2020, the United States saw an unprecedented increase in the number of asylum seekers and refugees arriving unexpectedly at international crossings along the US-Mexico Border. Many of these migrants needed proper medical attention, and consequently created significant pressure on local health systems. In El Paso, Texas, volunteer clinicians, collaborating closely with religious organizations and non-governmental organizations, provided outpatient medical care for the new arrivals; the county hospital provided in-patient care at local tax payers' expense. The objective of this study was to estimate costs of healthcare services offered by these volunteers in order to formulate sustainable and appropriate healthcare policies to address the needs of refugees and asylum seekers in the United States. A mixed methods approach was used including personal interviews with stakeholders, and follow up surveys with volunteer clinicians. The cost analysis was done from the payer perspective using Medicaid reimbursement rates. Total costs of care provided to asylum seekers and refugees varied between $1.9MM to $4.4MM during the study period. The number of patient visits was estimated at 15,736 to 19,236, and cost per patient ranged between $99 and $281. Most common conditions treated by volunteer providers were abdominal pain, dermatological conditions, headaches, dehydration and hypertension. This is the first study looking at the cost of healthcare for refugees and asylum seekers provided by volunteer clinicians, in a binational context. The resources invested by volunteer providers were significant, and essential to meet medical needs of migrant populations. Without appropriate financial support, a strategy relying on volunteer and local community resources will prove unsustainable in the long term. Findings from this study will help formulate federal and local policies to support local health systems along the US-Mexico Border in providing care to future migrations into the United States.

PROFIL PERESEPAN OBAT HIPERTENSI PADA PASIEN RAWAT JALAN DI PUSKESMAS BETOAMBARI PERIODE JANUARI – JUNI TAHUN 2020 DI KOTA BAUBAU

Hypertension or high blood pressure is a condition in which blood vessels have persistently elevated pressure. This research method is done by collecting data in the form of secondary data. Secondary data was obtained from the Pharmacy section to find out the data on the number of patient visits. The data taken in the form of age group, gender, type of drug, drug class and drug combination. The results showed that the number of prescriptions obtained from January to June was 174 prescriptions and the highest percentage of drug use in hypertension patients based on gender was 115 prescriptions (66.91%) women, namely in the age group 50 years, 96 prescriptions were used. (83.47%), the use of drugs based on Hypertension drugs that was most widely prescribed was Amlodipine with 144 prescriptions (78.68%), the most prescribed group of Hypertension drugs was Calcium Antagonists with 144 (83.75%) prescriptions The most combined drugs were Amlodipine + Captopril with 18 prescriptions (58.06%)

Advanced Telemedicine Training and Clinical Outcomes in Type II Diabetes: A Pilot Study.

Background: COVID-19 caused a dramatic increase in the scope and utilization of telemedicine. However, the sustainability of the permanent integration of telemedicine in the management of chronic disease beyond the pandemic is still enigmatic. The purpose of this retrospective chart review was to analyze the effect of advanced training in telemedicine on clinical outcomes in type II diabetes mellitus (T2DM) in the United States.Methods: A retrospective chart review was conducted in 104 deidentified patients with diabetes from 28 specialized telemedicine agency physicians who had received specialized telemedicine training. After establishing exclusion criteria, the charts of 59 T2DM patients were evaluated. Glycated hemoglobin (HbA1c) percentage and body mass index (BMI) were used as quantitative endpoints. Visit consistency, mediation data, and compliance data were also studied.Results: The mean change in HbA1c for the 42 patients who met the inclusion criteria for evaluating HbA1c (n = 42) was −0.429%. The largest decrease in HbA1c was 5.4%, and the most significant increase was 3.9%. The mean change in BMI for the 16 patients who met the inclusion criteria for evaluating BMI (n = 16) was −2.175 kg/m2. The largest decrease in BMI was 9.5 kg/m2 and the largest increase was +0.7 kg/m2. The average number of visits for patients with a decrease in HbA1c was 3.45. The average number of visits for patients with an increase in HbA1c was 2.62.Conclusions: Outcomes of telemedicine providers with training are comparable with the standard of care. Advanced telemedicine training and its effect on clinical outcomes in the management of chronic disease warrant further investigation. For telemedicine to become a mainstay in U.S. medicine, a standard of best practices should be evaluated and available for providers who wish to continue telehealth care delivery.

PATIENT SATISFACTION ANALYSIS BASED ON SERVICE QUALITY ASSESSMENT AND TRUST IN HEALTH FACILITIES

Health centers have an important role to provide the best service to the community. One of the problems in the outpatient installation of the Tambelangan Health Center is the decrease in the number of patient visits. It is necessary to evaluate the quality of service so that patients put their trust and then reuse the service until they feel satisfied. The purpose of this study was to analyze the effect of service quality and trust on patient satisfaction. This research is included in the type of analytic observational using a cross-sectional approach. The sample size is 100 patients who seek treatment at the outpatient installation of the Tambelangan Health Center. The sampling technique was carried out by systematic random sampling. Data were obtained directly through the perception of the patient's assessment of the perceived service quality, their trust in the facilities and services received and including the satisfaction that the patient felt through the questionnaire instrument. The data obtained were then analyzed using binary logistic regression. The results showed that all patients (86%) stated that the overall dimensions of service quality were good, and almost all patients (81%) stated that they had believed and almost all respondents (84%) stated that they were satisfied with the service at the Outpatient Installation of the Tambelangan Health Center. Furthermore, service quality has a significant effect on patient satisfaction (p-value = 0.022) and trust has a significant effect on patient satisfaction (p-value = 0.006). The conclusion of the study shows that service quality and trust can affect patient satisfaction.

Preparations of Dutch emergency departments for the COVID-19 pandemic: A questionnaire-based study.

The onset of the COVID-19 pandemic was characterized by rapid increases in Emergency department (ED) patient visits. EDs required an appropriate transformation. The main challenges were: adapting capacity to respond to surges in the number of patient visits, protection of high risk (frontline) staff and the segregation of suspect-COVID-19 patients. To date, only a few studies have assessed the nation-wide response of EDs to the COVID-19 pandemic. This study was designed to review the preparations of Dutch EDs during the initial phase of this public health crisis. The study was designed as a nation-wide, cross-sectional, questionnaire-based study of Dutch hospital organizations having one or more EDs. One respondent completed the questionnaire for each hospital. The questionnaire was conducted between the first and the second COVID-19 wave in the Netherlands. It contained close-ended and open-ended questions on changes in ED infrastructure, ED workforce adaptions and the role of emergency physicians (EPs) in each hospital crisis management team. The questionnaire was completed by 58 respondents. This represented 80% of the total number of EDs. All respondents had made preparations in anticipation of a COVID-19 patient surge. Treatment capacity was expanded in 70% of EDs, with a median increase of 49% (IQR 33-73%). Suspect-COVID-19 was segregated from non-COVID-19 patients in 89% of EDs. Alternative locations (such as outpatient departments) were more often used to assess non-COVID-19 patients, than for suspect-COVID-19 patients. Staff was expanded in 82% of EDs. This largely concerned nursing staff. A formal role for Emergency Physicians (EPs) in the hospital's crisis management team was reported by 94% of hospital organizations employing EPs. All Dutch EDs responded to the COVID-19 pandemic in a very short time span despite much uncertainty. Preparations predominantly concerned expansion of treatment capacity and segregation of COVID-19 ED care. EPs played a prominent role, both in direct COVID-19 care and in the hospital crises management team. It is vital for EDs to adapt to community needs swiftly. The ability of EDs to respond to the pandemic varied considerably.

ANALISIS DAMPAK KEBIJAKAN PROGRAM RUJUKAN ONLINE BERJENJANG BPJS TERHADAP PELAYANAN RAWAT JALAN DI POLI PENYAKIT DALAM RSUD DELI SERDANG

The era of National Health Security (NHS) enacted tiered referral system start in first level health services, then the hospital type D, type C, type B and type A. Community complaints and a significant decrease in the number of patients in type B hospital especially in outpatient services, the occurrence of patient accumulation and long queues in hospital type C, this indicates that the implementation of this tiered referral system policy program has not run well. The purpose of this study was to look at the impact of the implementation of this tiered referral program policy on outpatient care in poly Internal medicine at the Regional General hospital Deli Serdang Lubuk Pakam. This research is a qualitative research with a prosfective case study approach and uses a fixed case design. This study triangulation to obtain in-depth information on document from SIMRS data, in-depth interviews, Focus Group Discussion (FGD), direct observation in the field without intervention. This reseach was carried out at the Regional General Hospital Deli Serdang Lubuk Pakam , start from January until April 2019. The result of the study show that the implementation of the program has been carried out in accordance with the regulation of Director of Health Service No. 4 of 2014 regarding the referral system for health services carried out in stages. But there were several impacts from the implemention of the program, namely there was a decrease in the number of patient visits, patients cannot get the doctor’s service they want, patients service time is long because the patient must go through several referral procedur first. Recommendation for BPJS as The National Health Insurance Organizing Body to evaluate and improve existing regulations. If it is necessary to make new regulations so that people do not feel like they are being complicated to get services. Recommendation for the hospital to provide better facilities, both facilities and infrastructure, more competent medical personnel and paramedics.

The Relationship between the Number of Emergency Room Patient Visits with Triage Accuracy and Emergency Nurse Response Time in the Covid 19 Pandemic Season

Handling emergency cases must not only be carried out quickly but also must be precise. Standard Operating Procedures (SOP) is one of the instruments to measure the quality of service. the number of patient visits that can affect the quality of service. Triage is a way of sorting patients based on therapy needs and available resources. Therapy is based on ABC conditions (Airway, with cervical spine control, Breathing, and Circulation with bleeding control). On the other hand, the COVID-19 pandemic greatly affects the response time, impacting the number of patient visits. Response time is the time between the beginning of a request being responded to in other words it can be called response time. A good response time for patients is 5 minutes. The purpose of this study was to identify the relationship between the number of patient visits and the accuracy of triage implementation and response time. The electronic database used is PubMed, Springer, and Google Scholar with a search strategy using the PICO (patient, intervention, comparison, and outcome) method.

Relationship of Quality Health Service Towards Loyalty of Patient at Bhayangkara Hospital Kendari

Based on the Profile of the Bhayangkara Kendari Hospital, the number of patient visits to the inpatient unit from 2017-2018 experienced an increase in the number of patient visits. The purpose of this study was to determine the relationship between the quality of health services and the loyalty of inpatients at the Bhayangkara Hospital, Kendari City. This study used a cross-sectional study design with a population of 358 people and a sample of 78 people who were determined by taking the sample using the accidental sampling method. Data analyze using chi square test. The results showed that there was relationship between physical evidence (X2count=4,197; φ=0,264), reliability (X2count=5,816; φ=0,305), and empathy (X2count=9,442; φ=0,378) with inpatient loyalty. The conclusion is there was a weak relationship between physical evidence, reliability, and empathy with inpatient loyalty at the Bhayangkara Hospital Kendari City. The hospital should pay more attention to the comfort of the patient's room and improve skills in serving patients so that it can improve the quality of service to patients and encourages patients to come back for treatment at Bhayangkara Hospital Kendari City.

Minimizing Nonessential Follow-up for Hip Fracture Patients.

Introduction:Hip fractures pose a significant burden to patients and care providers. The optimal protocol for postoperative care across all surgically treated hip fracture patients is unknown. The purpose of this study was to investigate the effect that routine follow-up had on changing the clinical course.Methods:This was a retrospective review of all low-energy hip fractures (ie, femoral neck fractures, pertrochanteric hip fractures, and subtrochanteric fractures) treated surgically from January 2018 through December 2019. Charts were reviewed for demographic information; the procedure performed; the number of postoperative follow-up visits each patient had with the orthopaedic surgery team; the number of sets of postoperative radiographic images obtained; and postoperative complications.Results:Eight hundred eleven patients with 835 hip fractures were included in the study. The overall number of patient visits was 1,788, and the number of radiograph sets was 1,537. The median number of follow-up visits was two visits/fracture (interquartile range: 1 to 3 visits, maximum = 9 visits), with the median follow-up length of 54 days (interquartile range: 33 to 97 days) with the treating orthopaedic surgeons. Sixty-two (7.6%) patients had 81 (4.5%) postoperative visits and 26 (1.7%) sets of images that led to treatment changes. Among them, 48 (77.4%) patients had concerns that were initiated by the patients and/or care provider. Fourteen standard patient visits led to treatment changes that were not initiated as concerns by the patient and/or care provider.Discussion:Most clinic visits and radiographs did not lead to a change in the care plan. We recommend that emphasis be placed on comprehensive orthogeriatric care of these patients, and we believe that these data provide the impetus to work toward improving the care pathways for elderly patients with hip fractures.

Airborne pollens in Wuhan urban area and its correlation with hospital visits of allergic rhinitis patients from 2017 to 2018

Objective: To investigate the species and concentrations of airborne pollens in Wuhan urban area and their correlation with the number of visits of allergic rhinitis patients. Methods: Retrospective analysis of pollen dispersal characteristics and the number of patients with allergic rhinitis presenting to Tongji Hospital of Huazhong University of Science and Technology in Wuhan city from October 2017 to September 2018, as well as pollen allergen testing results of patients with allergic rhinitis presenting to the Department of Allergy during the same period. Pollen data was collected by a 1-year air sampling conducted in Wuhan City during the same period using the volumetric method. The samples were examined microscopically to identify airborne pollen species and counted, and the concentrations of various pollens were calculated. Information on patients with allergic rhinitis who came to the hospital during the same period was collected, and the correlation between pollen concentration and the number of patient visits was statistically analyzed using Pearson correlation analysis. Results: A total of 35 types of airborne pollen were collected from October 2017 to September 2018. The dominant pollens in spring were Moraceae (68.46%, 1 042/1 522), Pendula (12.22%, 186/1 522) and Cupressaceae (2.30%, 35/1 522); in summer and autumn, the dominant pollens were Artemisia (3.81%, 58/1 522), Humulus (4.01%, 61/1 522) and Ambrosia (0.59%, 9/1 522). The peak number of visits for allergic rhinitis patients occurred in March-April and July-September, both exceeding 2 200 visits and reaching a maximum of 2 545 visits. There was a very weak correlation between the number of visits and the total pollen concentration (r=0.17, P=0.001). The average monthly pollen skin prick test positive rate of patients with allergic rhinitis was highest in March-May, exceeding 40% with a maximum of 45.73%, and there was a significant correlation between the positive pollen skin prick test positive rate and the average monthly pollen concentration (r=0.62, P=0.031). Conclusions: Pollen species and concentrations fluctuated continuously with time in Wuhan urban area, with peak pollen dispersal in spring from March to April and in autumn from August to September. The number of visits to patients with allergic rhinitis and the positive pollen skin prick test positive rate increased accordingly during the peak pollen concentration periods.

Occlusal Outcome of Orthodontic Treatment for Patients With Complete Cleft Lip and Palate.

To assess occlusal outcomes of orthodontic treatment for patients with complete cleft lip and palate. Retrospective assessment using the Peer Assessment Rating (PAR) index. Consecutive patients treated by one consultant orthodontist at a tertiary care cleft center. One hundred twenty-seven patients with either complete unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) consecutively treated with fixed appliances. Fixed orthodontic appliance treatment and orthognathic surgery when required. The PAR index assessment was carried out by a calibrated-independent assessor. Treatment duration, the number of patient visits, and data on dental anomalies were drawn from patient records and radiographs. One hundred two patients' study models were assessed after exclusions. Mean start PAR score for UCLP (n = 71) was 43.9 (95% CI, 41.2-46.6, SD 11.5), with a mean score reduction of 84.3% (95% CI, 81.9-86.7, SD 10.1). The UCLP mean treatment time was 23.7 months with 20.1 appointments. Mean start PAR score for BCLP (n = 31) was 43.4 (95% CI, 39.2-47.6, SD 11.4), with a mean score reduction of 80.9% (95% CI, 76.3-85.5, SD 12.5). The BCLP mean treatment time was 27.8 months with 20.5 appointments. These results compare well with other outcome reports, including those for patients without a cleft, and reflect the standard of care provided by an experienced cleft orthodontist. As with high-volume surgeons, orthodontic treatment for this high need group is favorable when provided by a high-volume orthodontist. These findings may be used for comparative audit with similar units providing cleft care.