Articles: hospitals.
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Observational Study
The Potential for Providing Treatment on an Outpatient Rather Than Inpatient Basis: A Nationwide Analysis of Hospital Discharge Data in Germany for the Year 2022.
In an expert analysis by the IGES Institute, it was examined which inpatient hospital treatments could also be carried out on an outpatient basis. A method of determining the feasibility of performing any particular treatment in the outpatient setting based on routine documentation was proposed in the report. A new version of the German catalogue of operations that can be performed on an outpatient basis and other outpatient procedures (the AOP catalogue) was issued accordingly. In addition, sector-blind (hybrid DRG) reimbursement of selected treatments was introduced, i.e., the amount of the reimbursement is now the same regardless of whether the treatment is provided on an inpatient or outpatient basis. ⋯ Both the IGES model and the AOP catalogue identified a relevant potential for providing treatment on an outpatient rather than inpatient basis. However, the overlap between the two approaches is small. Further development of the AOP catalogue appears necessary for the more accurate identification of treatment cases that can be provided in the outpatient setting. The extent to which the new AOP catalogue and hybrid DRG remuneration can promote the provision of outpatient rather than inpatient care will need to be determined in future analyses.
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An increasing number of older people are being treated in German hospitals. In 2022, more than 35.7 million hospitalized patients in Germany were of age 65 or older. Comprehensive geriatric assessment (CGA) can help to structure and improve the diagnosis and treatment of these patients, many of whom suffer from multimorbidity. ⋯ The German clinical practice guideline on CGA can serve as a guide to personalized geriatric medicine in the hospital. Further complex interventional studies are needed to evaluate the efficacy of CGA in other settings.
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Extracorporeal cardiopulmonary resuscitation (CPR) for refractory in-hospital cardiac arrest has been associated with improved survival compared with conventional CPR. Perioperative patients represent a unique cohort of the inpatient population. This study aims to describe and analyze the characteristics and outcomes of patients who received extracorporeal CPR for perioperative cardiac arrest. ⋯ The use of extracorporeal CPR for adults with perioperative cardiac arrest can be associated with excellent survival with neurologically favorable outcomes in carefully selected patients. Longer CPR time, higher lactate levels, and lower pH were associated with increased mortality. Given the small sample size, no other prognostic factors were identified, although certain trends were detected between survival groups.
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To determine the association between postdischarge mental health care and odds of readmission after emergency general surgery (EGS) hospitalization for patients with serious mental illness (SMI). ⋯ Postdischarge MHV after EGS hospitalization was associated with decreased odds of readmission for patients with SMI managed operatively and nonoperatively. In older EGS patients with SMI, coordination of MHVs may be a mechanism to reduce readmission disparities.
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To compare access, quality, and clinical outcomes between Latino and non-Latino White Californians with colon cancer. ⋯ Latino patients with colon cancer experienced delays, segregation, and lower receipt of recommended care. Hospital-level colectomy volume appears to be strongly associated with access, quality, and survival-especially for patients who identify as Latino-suggesting that directing at-risk patients with cancer to high-volume hospitals may improve health equity.