Search results for "appropriateness"
showing 10 items of 22 documents
Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation
2018
Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients …
Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study
2017
Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants. Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model. Results Forty-five cases (…
Effect of partner–agent model practice on microinsurance client value: Insight from microfinance institutions in Tanzania
2018
In absence of formal microinsurance to protect low-income people against natural and man-made disasters, the partnership between insurance companies and microfinance institutions (MFIs), also known as the Partner–Agent Model (PAM), is gaining global recognition from governments, practitioners, and donors for its potential role to deliver microinsurance. Although the model is still nascent in Tanzania, it has significantly increased microinsurance outreach. However, while the microinsurance landscape has been extensively studied, the effect of PAM practice on mandatory microinsurance client value has not received much attention. Therefore, this study examines how the PAM practice affects mic…
Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily
2015
Over the past twenty years, important changes in the Italian National Health System have been made in order to obtain significant improvements in the efficiency, appropriateness and quality of health care delivery, while reducing health expenditure. In this paper we proposed a multidimensional approach to assess the impact of organization inappropriateness on the efficiency evaluation of hospitals in Sicily for the year 2009. This study was based on cross-sectional data for 116 (out of 129) short-term, acute-care hospitals. The analysis considered beds, physicians, nurses and other personnel as inputs, ordinary discharges and day-hospital admissions as desirable outputs and inappropriate di…
Deliveries by caesarean sections on request of women: legal-medical evidence
2014
Introduction: In Italy the use of caesarean delivery has a rising trend moving away from European standards appeared on Euro-Peristat on maternal and child health, presenting the highest percentage of use of this procedure with significant regional differences. This study have analyzed the most recent data of a Sicilian reality about normal delivery and caesarean sections carried out in a hospital situated in Messina (Italy). Materials and methods: A total number of 1,573 medical records from 1st January 2011 to 31st December 2013 were analyzed and data gathered were statistically examined to describe general and specific parameters of the sample making use of Epi Info 7.1.4 software (CDC A…
Proceedings of the Closed Round Table and Italian Consensus on the Medication-Related Osteonecrosis of Jaws (MRONJ) at the Symposium of Italian Socie…
2019
On 20 October 2018 a Closed Round Table brought together a wide range of stakeholders from several medical disciplines, including academic experts, dentists, oncologists, maxillo-facial surgeons, oral surgeons, radiologists, under the technical and scientific coordination of Giuseppina Campisi (for SIPMO) and Giacomo Oteri (for Italian Society of Oral Surgery- SIdCO)
APPROPRIATENESS OF CESAREAN SECTION IN A HOSPITAL OF SICILY (ITALY): STATISTIC EVIDENCES AND MEDIC LEGAL CONSIDERATIONS
2014
ntroduction: Authors have carried out a survey to evaluate the appropriateness of the caesarean deliveries performed in a hospital of Sicily (Italy) during 2013. The choices of these surgeries have been compared with italian and sicilian guidelines. Materials: EpiInfo 7.1.4 software (CDC - Atlanta - USA) was used to perform the statistical data analysis (chi-square test). Results: We analyzed a total of 818 medical records related to 50.61% of spontaneous deliveries, :06% induced labor, and 46.33% of cesarean deliveries. Medical records showed that in 32.7% the caesarean section were justified by emergency conditions, whereas in 15.89% the choice was not quite justified according to guideli…
Between a rock and a hard place : middle managers' ethical decision making and behaviour in the organisational context
2018
This study increases knowledge and understanding of middle managers’ ethical decision-making and behaviour within the context of Finnish higher education. The aim of the research is to develop a new framework for ethical decision-making and behaviour by combining prior theories and empirical knowledge. This dissertation consists of an introductory essay and three articles. The main argument of this research is that through organisations’ socialisation processes, middle managers adopt socially defined managerial roles, which affect their ethical decision-making and ethical conduct. We can say that especially the ethical organisational culture is significant for middle managers’ understanding…
Inappropriateness in laboratory medicine: an elephant in the room?
2017
Appropriateness of diagnostic testing can be conventionally described as prescription of the right test, using the right method, at the right time, to the right patient, with the right costs and for producing the right outcome. There is ongoing debate about the real burden of inappropriateness in laboratory diagnostics. The media coverage of this issue has also recently led to either over- or under-emphasizing the clinical, organizational and economic consequences. This is quite problematic, inasmuch as some reliable data are available in the current scientific literature, showing that inappropriateness of laboratory testing can be as high as 70%. This is especially evident for, though not …
Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients
2021
Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinica…