Irish journal of medical science
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Observational Study
Trends in private maternity care in Ireland's capital during and after the Great Economic Recession 2009-2017.
Maternity care in hospitals in the Republic of Ireland is funded by a hybrid of public finance and private health insurance. ⋯ Ireland's recent economic recession was accompanied by an overall decrease in the number of women choosing private maternity care after 2009. Furthermore, economic recovery with increasing female employment after 2012 was not associated with a recovery in demand for private care. These findings have important implications for healthcare policies and for the future organisation and funding of our maternity services.
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This study highlights the multiple sources of delay along a hip fracture clinical pathway. The national recommendation is that 'patients with a hip fracture should be admitted within 4 hours of arrival at the Emergency Department to which they first presented'. ⋯ We identified numerous sources of delay, occurring at every point along the pathway, emphasising the complexity of providing acute integrated care. There was no single stage that persistently contributed to the delay in the patient pathway. The focus is now to achieve marginal gains in each area. Increased staff and resources to the front line are a clear solution but this is complex to achieve.
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Despite the important role of some haematological parameters in tendency to thrombosis is known, their relationship with long-term stent thrombosis (ST) remains unclear. ⋯ We found that higher MPV/PC ratios were associated with long-term ST and mortality. The MPV/PC ratio may constitute both a rapid and an easily obtainable parameter for identifying reliably high-risk patients who have undergone pPCI.
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Headache is the most common reason for referral to neurology outpatient clinics in Ireland and represents approximately 30% of all new appointments. ⋯ Most patients referred to a neurology outpatient clinic with headache have a primary headache disorder. Alternate pathways should be considered to reduce the burden on Ireland's limited neurology resources without compromising patient safety.