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Background
Heart failure (HF) readmissions are a longstanding national healthcare issue for both hospitals and patients. Our purpose was to evaluate the efficacy of a structured, educational intervention targeted towards un- and under-insured emergency department (ED) HF patients.Methods
HF patients presenting to the ED for care were enrolled between July and December 2015 as part of an open label, interventional study, using a parallel observational control group. Eligible patients provided informed consent, had an established HF diagnosis, and were hemodynamically stable. Intervention patients received a standardized educational intervention in the ED waiting room before seeing the emergency physician, and a 30-day telephone follow-up. Primary and secondary endpoints were 30- and 90-day ED and hospital readmission rates, as well as days alive and out of hospital (DAOH) respectively.Results
Of the 94 patients enrolled, median age was 58.4?years; 40.4% were female, and 54.3% were African American. Intervention patients (n?=?45) experienced a 47.8% and 45.3% decrease in ED revisits (P?=?0.02 & P?<?0.001), and 60.0% and 47.4% decrease in hospital readmissions (P?=?0.049 & P?=?0.007) in the 30 and 90?days pre- versus post-intervention respectively. Control patients (n?=?49) had no change in hospital readmissions or 30-day ED revisits, but experienced a 36.6% increase in 90-day ED revisits (P?=?0.03). Intervention patients also saw a 59.2% improvement in DAOH versus control patients (P?=?0.03).Conclusion
An ED educational intervention markedly decreases ED and hospital readmissions in un- and under-insured HF patients. 相似文献Material and methods: In this prospective observational study, 75 patients of reproductive age (20–35 years) undergoing bariatric surgery for morbid obesity were followed up after six months to determine the changes in weight, Body Mass Index (BMI), menstrual pattern and serum AMH. The results were further studied on basis of pre operative classification of patients in polycystic ovary syndrome (PCOS) and non-PCOS group.
Result: The serum AMH levels were statistically higher in patients of PCOS group pre operatively and at the end of six months in comparison to non-PCOS patients. The AMH values reduced post operatively in both groups significantly so much in the values though not significant statistically. Non-PCOS patients had lower AMH values pre operatively and showed a trend towards reducing ovarian reserve after six months. The overall change in AMH values in both groups was statistically significant as was the normalization of menstrual irregularity.
Conclusion: Morbidly obese patients with PCOS appear to benefit from bariatric surgery both in terms of regularization of menstrual function and normalization of serum AMH values. 相似文献