Swiss medical weekly
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Swiss medical weekly · Mar 2021
Randomized Controlled Trial Multicenter StudyContinuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial.
Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multicentre randomised controlled trial that assessed the relationship of cEEG versus repeated rEEG with outcome. ⋯ In a Swiss Diagnosis Related Groups billing system applied to critically ill adults, reimbursement largely depends on duration of acute hospital stay, whereas cEEG and lack of seizure/ status epilepticus detection also contribute to the bill. This differs from the USA, where charges are directly increased by cEEG.
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Swiss medical weekly · Feb 2021
Iatrogenic events contributing to paediatric intensive care unit admission.
To identify the incidence of iatrogenic events leading to paediatric intensive care unit (PICU) admission and to analyse these patients regarding demographic, illness severity and outcome parameters. ⋯ In our setting, the number of PICU admissions associated with iatrogenic events is significant and comparable to adult data on admission to ICU caused by iatrogenic events. The categories with most potential for improvement are nosocomial infections and the wrong management decisions / delayed diagnoses. Focused measures on these iatrogenic events may have a major impact on patient outcome, availability of PICU resources and healthcare costs.
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Swiss medical weekly · Dec 2020
Observational StudyImpact of the COVID-19 pandemic on acute coronary syndromes.
To assess the impact of the first wave of the COVID-19 pandemic on acute coronary syndromes and on the delay from symptom onset to first medical contact among patients presenting with ST-segment elevation myocardial infarction (STEMI), as well as to investigate whether there were patient-related reasons related to COVID-19 for delaying first medical contact. ⋯ We observed prolonged delays from symptom onset to first medical contact and a decline in overall ACS incidence during the first wave of the COVID-19 pandemic, with a higher threshold to call for help among ACS patients.
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Swiss medical weekly · Dec 2020
Observational StudyEarly experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs.
Hydroxychloroquine and lopinavir/ritonavir have been used as experimental therapies to treat COVID-19 during the first wave of the pandemic. Randomised controlled trials have recently shown that there are no meaningful benefits of these two therapies in hospitalised patients. Uncertainty remains regarding the potential harmful impact of these therapies as very early treatments and their burden to the health care system. The present study investigated the length of hospital stay (LOS), mortality, and costs of hydroxychloroquine, lopinavir/ritonavir or their combination in comparison with standard of care among patients hospitalised for coronavirus disease 2019 (COVID-19). ⋯ Prescribing experimental therapies for COVID-19 was not associated with a reduced LOS and might have increased the pressure put on healthcare systems.