Articles: hospitals.
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Multicenter Study Comparative Study
Effect of practice variation on resource utilization in infants hospitalized for viral lower respiratory illness.
Hospital care for children with viral lower respiratory illness (VLRI) is highly variable, and its relationship to severity and impact on outcome is unclear. Using the Pediatric Comprehensive Severity Index, we analyzed the correlation of institutional practice variation with severity and resource utilization in 10 children's medical centers. ⋯ Institutional differences in care practices for children with VLRI were not explained by differences in patient severity and did not affect the children's recovery but correlated significantly with hospital costs and LOS.
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Revista de saúde pública · Oct 2001
Multicenter Study[Assessment of the promotion of breastfeeding in public and private maternities of São Paulo city, Brazil].
The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) carried out a study to compare and evaluate the practices of protecting, promoting and supporting breastfeeding in public and private hospitals using the "ten steps" of the Hospital Initiative (BFHI) as a reference parameter. ⋯ The present study shows that practices considered detrimental to the onset and progressing of breastfeeding - unnecessary separation of the mother and her newborn, restrictions regarding the length of time and frequency of breastfeeding, use of pre-lacteal foods and supplements - are still quite frequently observed in public and private hospitals within the city of São Paulo. Given the benefits of breastfeeding for both the mother's and their children's health, and the important role maternities play for an early and successful onset of breastfeeding, it is paramount that the BFHI patterns be adopted by hospitals within the municipality of São Paulo.
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Multicenter Study
Influence of trauma system implementation on process of care delivered to seriously injured patients in rural trauma centers.
Statewide trauma systems are implemented by health care policy makers whose intent is to improve the process of care delivered to seriously injured patients. In Oregon, Advanced Trauma Life Support (ATLS) training was mandated for all physicians employed in the emergency department of trauma centers. The purpose of this study was to test the hypothesis that mandatory ATLS training favorably influenced processes of care. ⋯ Process of care for seriously injured patients improved after categorization of rural trauma centers in Oregon. Evidence shows improved process of care may have benefitted patients with serious but survivable injuries. Measurement of process of care is an alternative to mortality analysis as an indication of the quality of care.
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Am J Infect Control · Jun 2001
Multicenter StudyNosocomial infection rates in US children's hospitals' neonatal and pediatric intensive care units.
Few data are available on nosocomial infections (NIs) in US children's hospitals' neonatal or pediatric intensive care units. The Pediatric Prevention Network (PPN) was established to improve characterization of NIs in pediatric patients and to develop and test interventions to decrease NI. ⋯ The number of months that NICU or PICU NI surveillance was conducted varied among hospitals. Reported NICU and PICU NI rates varied by hospital; some reported overall NI rates, and others focused on one or more particular sites of infection (eg, BSI or pneumonia). Many did not provide NICU device-associated rates stratified by birth-weight group. Denominators used to calculate device-associated infection rates also varied, with hospitals reporting either patient-days or device-days. These findings suggest the need to determine reasons for variations and to identify optimal NI surveillance methods at children's hospitals so that valid interhospital NI rate comparisons can be made.
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Intensive care medicine · Jan 2001
Multicenter StudyA cost-effectiveness analysis of stays in intensive care units.
To evaluate patient outcome and the efficiency of stays in intensive care units (ICUs). ⋯ This work provides medical and economic information on ICU stays in teaching hospitals and enables comparisons with other health-care options.