Swiss medical weekly
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Swiss medical weekly · Jan 2012
Comparative StudyPrevalence of multimorbidity in medical inpatients.
To validate the estimates of the prevalence of multimorbidity based on administrative hospital discharge data, with medical records and chart reviews as benchmarks. ⋯ Estimates of the prevalence of multimorbidity in medical inpatients based on administrative data, chart reviews and medical records were very high and congruent for the different definitions of multimorbidity. Agreement for rating multimorbidity based on the different data sources was moderate to good. Administrative hospital discharge data are a valid source for exploring the burden of multimorbidity in hospital settings.
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Swiss medical weekly · Jan 2012
Perception of non-invasive ventilation in adult Swiss intensive care units.
The real utilisation scenario of non-invasive ventilation (NIV) in Swiss ICUs has never been reported. Using a survey methodology, we developed a questionnaire sent to the directors of the 79 adult ICUs to identify the perceived pattern of NIV utilisation. We obtained a response rate of 62%. ⋯ The perceived use of NIV is generally high in Switzerland, but regional variations are remarkable. The indications of NIV use are in accordance with international guidelines. A high percentage of units consider selected do-not-intubate conditions as an important additional indication.
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Swiss medical weekly · Jan 2012
Why do walk-in patients prefer a busy urban emergency department during office hours? A pilot survey of 200 consecutive patients from Switzerland.
In Switzerland, more and more patients go directly to the emergency department, bypassing general practitioners. However, a mixture of non-urgent walk-in patients and acute emergencies in the same emergency department can inevitably make it more difficult to provide genuine emergencies with rapid treatment, leading to deterioration in the quality of emergency services, and tending to increase on-floor mortality and morbidity, together with higher overall costs. ⋯ Our study is another small piece of the puzzle to help us to understand why people in "minor" medical emergencies prefer to consult a hospital than their own GP. Our study supported the evidence in current literature that there is a demand for hospital-based ambulatory emergency medicine. Only a future large study on the drivers and barriers to emergency care in Switzerland can provide additional answers.
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Swiss medical weekly · Jan 2012
The Acute Physiology and Chronic Health Evaluation II score is helpful in predicting the need of relaparotomies in patients with secondary peritonitis of colorectal origin.
Secondary peritonitis of colorectal origin has considerable morbidity and mortality. Relaparotomies are frequently necessary in the course of the disease. The objective of this study was to evaluate several scores in terms of their predictive value, i.e. whether Mannheim Peritonitis Index (MPI), Acute Physiology And Chronic Health Evaluation (APACHE) II, or Colorectal Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (CR-POSSUM) scores can predict relaparotomies. ⋯ The Acute Physiology And Chronic Health Evaluation II score might be helpful in predicting the need for relaparotomies in patients with secondary peritonitis of colorectal origin.
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Swiss medical weekly · Jan 2012
Fracture clinic redesign: improving standards in patient care and interprofessional education.
Current fracture clinic models, especially with the advent of reductions in junior doctors' hours, may limit outpatient trainee education and patient care. We have designed a new fracture clinic model, involving an initial consultant-led case review focused on patient management and trainee education. ⋯ Our model of fracture-clinic redesign has significantly enhanced consultant input into patient care without additional funding. In addition, we have demonstrated increased service efficiency and significant improvements in staff support, morale and education. In the face of current economic and training challenges, we recommend this new model as a tool that will enhance patient and trainee experience.