Objective: Our aim was to assess the feasibility and preliminary results of implementing a telehealth system, Alice Agora, as a tool for optimizing health delivery in a new primary care-based health system.
Results: We had 4193 consultations over the last 6 months (February and August 2021). Preliminary results show patients high level of satisfaction (Consumer satisfaction score of 4.92). The chief complaints were related to upper respiratory tract (n = 1542; 28.5%), gastrointestinal (n = 781; 14.43%), musculoskeletal (n = 607; 11.22%), and other (n = 643; 11.88%). We found that 20.1% (842) of the cases were solved digitally, that is, by a chat only with a nurse, through the use of health protocols, and 43.9% were solved by nurses with medical assistance. Only 6.6% (277) of the cases had to be referred to the emergency room (ER). This means that 64% of the cases were completely resolved by our nurses-driven system. Forty-eight hours readmission rates were higher for the uncoordinated ER cases compared with the coordinated cases (14.81% vs. 5.87%; p = 0.016). The same pattern was observed for the 72-h readmission rates (16.67 vs. 7.26%; p = 0.02).
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http://dx.doi.org/10.1186/s13104-022-06197-8 | DOI Listing |
Surg Endosc
January 2025
Department of Surgery, Duke University, 2301 Erwin Road, HAFS Building 7th floor 7665A, Durham, NC, 27710, USA.
Background: Previous studies have demonstrated Black-vs-White disparities in postoperative outcomes following primary metabolic and bariatric surgery (MBS). With the rising prevalence of MBS, it is important to examine racial disparities using quality indicators in primary and revisional procedures. This study explores Black-vs-White disparities in postoperative outcomes following primary and revisional MBS.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY, USA, 10010. Electronic address:
Background: Despite advances in surgical techniques and postoperative prophylactic protocols, venous thromboembolism (VTE) events remain an important source of morbidity following total hip arthroplasty (THA). Prior research in cardiology and other surgical fields has suggested that statin medications may have a protective effect against VTE. Our study aimed to: 1) Assess if preoperative statin use was associated with decreased rates of VTE following THA, and 2) conduct a subgroup analysis of statin intensity and VTE events.
View Article and Find Full Text PDFStroke
February 2025
Division of Interventional Neuroradiology, Department of Radiology (H.C., S.M., D.G.), University of Maryland Medical Center, Baltimore.
Background: Sex-specific differences in stroke risk factors, clinical presentation, and outcomes are well documented. However, little is known about real-world differences in transient ischemic attack (TIA) hospitalizations and outcomes between men and women.
Methods: This was a retrospective cohort study of the 2016 to 2021 Nationwide Readmissions Database in the United States.
Int J Qual Health Care
January 2025
Department of Medicine, Johns Hopkins University, 1830 E. Monument Street, Baltimore, MD 21287, USA.
Background: Hospitals face mounting pressure to reduce unplanned utilization amid rising healthcare demands from an aging population. The Case management for At-Risk patients in the Emergency Department (CARED) program is among the first ED transitional care strategies to focus on both frail older adults and emergency department (ED) re-attenders to reduce acute hospital utilization. This study aims to evaluate the effectiveness of the CARED program in reducing hospital (re)admissions and ED re-attendances within 30- and 60 days post-discharge.
View Article and Find Full Text PDFJAMA
January 2025
Worcestershire Royal Hospital, Worcester, United Kingdom.
Importance: Patients undergoing unplanned abdominal surgical procedures are at increased risk of surgical site infection (SSI). It is not known if incisional negative pressure wound therapy (iNPWT) can reduce SSI rates in this setting.
Objective: To evaluate the effectiveness of iNPWT in reducing the rate of SSI in adults undergoing emergency laparotomy with primary skin closure.
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