المؤلفون: McCabe, Ruth, Schmit, Nora, Christen, Paula, D’Aeth, Josh C., Løchen, Alessandra, Rizmie, Dheeya, Nayagam, Shevanthi, Miraldo, Marisa, Aylin, Paul^{Aff3, Aff4}, Bottle, Alex, Perez-Guzman, Pablo N., Ghani, Azra C., Ferguson, Neil M.^{Aff1, Aff5}, White, Peter J.^{Aff1, Aff6}, Hauck, Katharina^{Aff1, Aff5}

المصدر: BMC Medicine. 18(1)

المؤلفون: Marisa Miraldo, Nora Schmit, Alessandra Løchen, Katharina Hauck, Ruth McCabe, Peter J White, Dheeya Rizmie, Paula Christen, Pablo N Perez-Guzman, Josh C. D’Aeth, Alex Bottle, Azra C. Ghani, Paul Aylin, Shevanthi Nayagam, Neil M. Ferguson

المساهمون: Medical Research Council (MRC), National Institute for Health Research, Abdul Latif Jameel Foundation

المصدر: BMC Medicine
BMC Medicine, Vol 18, Iss 1, Pp 1-12 (2020)

مصطلحات موضوعية: Adult, Coronavirus disease 2019 (COVID-19), Critical Care, Pneumonia, Viral, Psychological intervention, lcsh:Medicine, Emergency treatment, State Medicine, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, General & Internal Medicine, Pandemic, Medicine, Humans, 030212 general & internal medicine, Elective surgery, Pandemics, 11 Medical and Health Sciences, Interventions, General & acute, Surge Capacity, business.industry, SARS-CoV-2, lcsh:R, Hospital capacity, COVID-19, General Medicine, medicine.disease, Hospital care, Hospitals, 3. Good health, Hospitalization, England, Elective Surgical Procedures, Needs assessment, Medical emergency, business, Coronavirus Infections, 030217 neurology & neurosurgery, Needs Assessment, Research Article

الوصف: Background To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients. Methods We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators. Results NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors. All elective surgery can be conducted at normal pre-pandemic levels provided the other interventions are sustained, but only if the daily number of COVID-19 patients occupying CC beds is not greater than 1550 in the whole of England. If the other interventions are not maintained, then elective surgery can only be conducted if the number of COVID-19 patients occupying CC beds is not greater than 320. However, there is greater national capacity to treat G&A patients: without interventions, it takes almost 10,000 G&A COVID-19 patients before any G&A elective patients would be unable to be accommodated. Conclusions Unless COVID-19 hospitalisations drop to low levels, there is a continued need to enhance critical care capacity in England with field hospitals, use of private hospitals or deployment of former and newly qualified medical staff to allow some or all elective surgery to take place.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0988f26160fbd2781c9b51b753755685
http://europepmc.org/articles/PMC7565725

المؤلفون: Elizabeth Cecil, Alex Bottle, Richard Ma, Dougal S. Hargreaves, Ingrid Wolfe, Arch G. Mainous, Sonia Saxena

المصدر: Cecil, E, Bottle, A, Ma, R, Hargreaves, D S, Wolfe, I, Mainous, A G & Saxena, S 2018, ' Impact of preventive primary care on children's unplanned hospital admissions : A population-based birth cohort study of UK children 2000-2013 ', BMC Medicine, vol. 16, no. 1, 151 . https://doi.org/10.1186/s12916-018-1142-3
BMC Medicine, Vol 16, Iss 1, Pp 1-11 (2018)

مصطلحات موضوعية: Child health, Male, Primary Health Care, lcsh:R, lcsh:Medicine, Ambulatory care sensitive conditions, Infant, Hospitals, Pediatric, United Kingdom, Cohort Studies, Hospitalization, Primary Prevention, Universal Health Insurance, Preventive primary care, Universal health coverage, Child, Preschool, Humans, Female, Child, Unplanned hospital admissions

الوصف: Background: Universal health coverage (UHC) aims to improve child health through preventive primary care and vaccine coverage. Yet, in many developed countries with UHC, unplanned and ambulatory care sensitive (ACS) hospital admissions in childhood continue to rise. We investigated the relation between preventive primary care and risk of unplanned and ACS admission in children in a high-income country with UHC. Methods: We followed 319,780 children registered from birth with 363 English practices in Clinical Practice Research Datalink linked to Hospital Episodes Statistics, born between January 2000 and March 2013. We used Cox regression estimating adjusted hazard ratios (HR) to examine subsequent risk of unplanned and ACS hospital admissions in children who received preventive primary care (development checks and vaccinations), compared with those who did not. Results: Overall, 98% of children had complete vaccinations and 87% had development checks. Unplanned admission rates were 259, 105 and 42 per 1000 child-years in infants (aged < 1 year), preschool (1-4 years) and primary school (5-9 years) children, respectively. Lack of preventive care was associated with more unplanned admissions. Infants with incomplete vaccination had increased risk for all unplanned admissions (HR 1.89, 1.79-2.00) and vaccine-preventable admissions (HR 4.41, 2.59-7.49). Infants lacking development checks had higher risk for unplanned admission (HR 4.63, 4.55-4.71). These associations persisted across childhood. Children who had higher consulting rates with primary care providers also had higher risk of unplanned admission (preschool children: HR 1.17, 1.17-1.17). One third of all unplanned admissions (62,154/183,530) were for ACS infectious illness. Children with chronic ACS conditions, asthma, diabetes or epilepsy had increased risk of unplanned admission (HR 1.90, 1.77-2.04, HR 11.43, 8.48-15.39, and HR 4.82, 3.93-5.91, respectively). These associations were modified in children who consulted more in primary care. Conclusions: A high uptake of preventive primary care from birth is associated with fewer unplanned and ACS admissions in children. However, the clustering of poor health, a lack of preventive care uptake, and social deprivation puts some children with comorbid conditions at very high risk of admission. Strengthening immunisation coverage and preventive primary care in countries with poor UHC could potentially significantly reduce the health burden from hospital admission in children.

وصف الملف: application/pdf

URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::c0295ad4888a34698ddd631c35a27e02
https://pubmed.ncbi.nlm.nih.gov/30220255

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المؤلفون: Ruth McCabe, Nora Schmit, Paula Christen, Josh C. D’Aeth, Alessandra Løchen, Dheeya Rizmie, Shevanthi Nayagam, Marisa Miraldo, Paul Aylin, Alex Bottle, Pablo N. Perez-Guzman, Azra C. Ghani, Neil M. Ferguson, Peter J. White, Katharina Hauck

المصدر: BMC Medicine, Vol 18, Iss 1, Pp 1-12 (2020)

مصطلحات موضوعية: Hospital capacity, Interventions, General & acute, Critical care, Elective surgery, COVID-19, Medicine

الوصف: Abstract Background To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients. Methods We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators. Results NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors. All elective surgery can be conducted at normal pre-pandemic levels provided the other interventions are sustained, but only if the daily number of COVID-19 patients occupying CC beds is not greater than 1550 in the whole of England. If the other interventions are not maintained, then elective surgery can only be conducted if the number of COVID-19 patients occupying CC beds is not greater than 320. However, there is greater national capacity to treat G&A patients: without interventions, it takes almost 10,000 G&A COVID-19 patients before any G&A elective patients would be unable to be accommodated. Conclusions Unless COVID-19 hospitalisations drop to low levels, there is a continued need to enhance critical care capacity in England with field hospitals, use of private hospitals or deployment of former and newly qualified medical staff to allow some or all elective surgery to take place.

وصف الملف: electronic resource

Relation: http://link.springer.com/article/10.1186/s12916-020-01781-w; https://doaj.org/toc/1741-7015

URL الوصول: https://doaj.org/article/fc3a0b33d4414f9184bbb65ae37f4707