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71.
Michael C. Kontos Kristin L. Schmidt Michael McCue Louis F. Rossiter Michael Jurgensen Christopher S. Nicholson Robert L. Jesse Joseph P. Ornato James L. Tatum 《Journal of nuclear cardiology》2003,10(3):284-290
BACKGROUND: Our objective was to determine the cost-effectiveness of a comprehensive, risk-based triage system, composed of multiple critical pathways, with the use of early myocardial perfusion imaging (MPI) in low-risk patients. We found previously that a chest pain evaluation system that uses MPI in low-risk patients was safe and effective, but the cost-effectiveness of this approach was not studied. METHODS AND RESULTS: We compared two groups. The Acute Cardiac Team (ACT) group (n = 874) was assigned prospectively to 1 of 4 risk levels by emergency department (ED) physicians. Level 1, 2, and 3 patients were admitted; level 4 patients were evaluated in the ED. Level 3 and 4 patients underwent ED MPI. The control group (n = 713) represented consecutive patients evaluated in the prior year according to standard care and assigned retrospectively to an ACT level based on the presenting electrocardiographic and clinical data. Record and hospital administrative data were assessed for clinical variables, outcomes, lengths of stay, and all expenses incurred within 30 days of the index visit. The baseline characteristics of the two groups were similar, including age, sex, myocardial infarction prevalence, and 30-day revascularization rates within each level or between the two groups. Mean costs per encounter were reduced for the ACT patients for each level, which was significant when all patients were compared ($5,030 +/- $7,081 vs $6,044 +/- $10,432, P =.02). Use of MPI in the low-risk patients was associated with reduced costs (level 3, $4,958 +/- $4,948 vs $5,051 +/- $7,036; level 4, $1,529 +/- $2,664 vs $1,794 +/- $6,854) and was associated with a significantly lower angiography rate and shorter length of stay. CONCLUSIONS: Implementation of a comprehensive strategy for chest pain evaluation and triage reduced overall costs for patients with chest pain on presentation. Acute MPI in the ED setting did not increase net cost. 相似文献
72.
对173例支气管哮喘特异性脱敏治疗的疗效及影响疗效的因素进行了分析。结果表明:显效为30.6%(53/173).有效为56.1%(97/173),无效为13.3%(23/173)。影响疗效的因素与病情的程度有关,而与年龄、病程、皮试阳性反应强弱及脱敏治疗前4个疗程内是否应用曲安缩松等无关。并对特异性脱敏治疗支气管哮喘的优缺点进行讨论。 相似文献
73.
74.
Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity
Toshihiko Nagata Hiroshi Ishida Hiroyuki Shinohara Seiji Nishikawa Shinji Kasahara Yoichi Wakano Shusaku Daigen Emanuel S. Troullos 《Journal of clinical periodontology》1994,21(3):217-221
Abstract The effectiveness of a 5% potassium nitrate dentifrice as a daily home treatment for dentinal hypersensitivity was evaluated in a double-blind study in 36 Japanese subjects who complained of cold and/or tactile hypersensitivity. The subjects were divided into 2 groups, with 18 being given a 5% potassium nitrate dentifrice (treated group) and the other 18 a vehicle paste (control group). Both groups were instructed to brush their teeth 2 × a day. The hypersensitivity levels of the affected teeth were assessed by 2 stimuli, one tactile and the other cold air, and by the perception of pain. The results of all 3 assessment methods indicated that the potassium nitrate dentifrice significantly decreased the level of hypersensitivity at weeks 4, 8, and 12. In the treated group, a rapid decrease of positive scores for both the cold air stimulus and the subjective symptoms appeared from week 2. Although a significant decrease of the assessment score was also observed in the control group, the reduction rate of the score was much greater in the treated group by ail 3 assessment methods at weeks 4, 8, and 12. Complete relief of subjective symptoms throughout the 12 weeks’examination was noted in 67% of the subjects in the treated group, but in only 6% in the control group. These results suggest the usefulness of a 5% potassium nitrate dentifrice in Japanese patients with dentinal hypersensitivity. 相似文献
75.
同济医科大学控烟活动及效果评价 总被引:1,自引:0,他引:1
我校自1993年开展控烟工作,1995年9月开始创办无吸烟大学校园,采取了卫生宣教和行政干预等综合措施,并进行了效果评价。高强度干预措施实施前期(1995年3月)和中期(1996年10月)相比,男医学生和男女学生平均吸烟率分别从16.3%和11.4%下降到9.6%和5.94%;男教工和男女教工平均吸烟率分别从28.6%和13.8%下降到13.9%和8.86%。 相似文献
76.
77.
西文介绍了综合效益评价中指标的逐步筛选及其假设检验方法,用该法选出的指标具有独立性强、代表性好的优点。同是分析处理了全国34家县级医院的投入指标,从中筛选出5个指标参与评价。 相似文献
78.
天津市煎炸油卫生状况评价 总被引:2,自引:0,他引:2
通过连续8小时的煎炸实验和对市,郊29个煎炸点的现场卫生学调查及采用羰基值(COV),极性组分(PC)对所采样品的分析表明,天津煎炸油的总体的卫生质量基本符合国家卫生标准,参考极性组分的ADI值并依据本次调查结果,估计天津大部分居民的煎炸食品摄入量安全水平,但对于偏爱煎炸食品者其安全系数明显下降。 相似文献
79.
80.
根据《妇幼保健机构等级评审标准》(下称《标准》)要求,对全省20个妇幼保健机构现状进行了调查。结果显示:我省妇幼卫生工作基础薄弱,离《标准》要求差距较大;各机构间的发展极不平衡;县(市)级机构整体水平偏低,业务用房、人员、设备、床位等建设滞后;服务项目单一,二级专业分科不完善等矛盾较为突出。据此提出,在创等达标工作中,要依靠各级政府,努力争取各方面的支持,抓住机遇,迎接挑战,重点抓好软件建设,加强在职培训,积极引进人才,拓宽服务范围,规范自我,依法服务。 相似文献