Peristomal skin complications (PSCs) have a significant impact on quality of life and ostomy treatment costs. This study aimed to assess the healthcare resource use for patients with an ileostomy and PSCs symptoms. Two surveys were developed and, after validation by healthcare professionals and patients, data were collected on healthcare resource use while not experiencing any PSCs symptoms and while experiencing complications of various severities, as defined by the modified Ostomy Skin Tool. Costs applied to resource use were assigned from relevant United Kingdom sources. Additional healthcare resource use associated with PSCs, relative to no complications, was estimated to result in a total cost per instance of £258, £383, and £505 for mild, moderate, or severe PSC, respectively. The average estimated total cost per complication instance, weighted across mild, moderate, and severe PSCs, was £349. Severe-level PSCs were associated with the highest cost, because of the treatment-level required and the longer duration of symptoms. There is potential for clinical benefits and economising in stoma care if interventions are implemented that reduce the incidence and/or severity of PSCs.
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http://dx.doi.org/10.1111/iwj.14118 | DOI Listing |
The 2024 European Society of Intensive Care Medicine clinical practice guideline provide clinicians with evidence-based recommendations on intravenous fluid in critically ill adults across a range of common conditions. These guidelines aim to improve the practices of fluid therapy by adopting a global perspective that considers both clinical efficacy and resource utilization in diverse healthcare settings. The guidelines address three key questions: (1) albumin versus crystalloids, (2) balanced crystalloids versus isotonic saline, and (3) small-volume hypertonic solutions versus isotonic crystalloids.
View Article and Find Full Text PDFJ Dent Sci
January 2025
School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.
Background/purpose: Domiciliary dental care (DDC) is essential for maintaining oral health in disabled and homebound patients who face barriers to accessing dental services. With Taiwan nearing super-aged society status, the demand for DDC is rising. However, comprehensive data on DDC availability and distribution across Taiwan are lacking.
View Article and Find Full Text PDFInt J Gen Med
January 2025
Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Background: Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening condition characterized by the formation of a blood clot in the dural venous sinuses or cerebral veins. CVT presents a diverse array of clinical symptoms, making its diagnosis challenging. Understanding regional variations and specific risk factors associated with CVT is crucial, especially in low-resource settings like Somalia, where epidemiological data is limited and healthcare resources are scarce.
View Article and Find Full Text PDFFront Radiol
January 2025
Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, United States.
In neuro-oncology, MR imaging is crucial for obtaining detailed brain images to identify neoplasms, plan treatment, guide surgical intervention, and monitor the tumor's response. Recent AI advances in neuroimaging have promising applications in neuro-oncology, including guiding clinical decisions and improving patient management. However, the lack of clarity on how AI arrives at predictions has hindered its clinical translation.
View Article and Find Full Text PDFJAC Antimicrob Resist
February 2025
Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa.
Background: Research on the contextual drivers of antimicrobial stewardship (AMS) programme interventions in neonatal units is limited.
Methods: As part of a prospective mixed-methods multidisciplinary neonatal AMS (NeoAMS) interventional study in 14 South African hospitals, we applied a three-phased process to assess implementation barriers and contextual drivers experienced by participating health professionals. The study included: (Phase one; P1) a survey of pre-intervention barriers and enablers; (P2) written feedback during the study intervention phase; and (P3) semi-structured exit interviews.
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