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1.
Stud Health Technol Inform ; 317: 2-10, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39234701

RESUMEN

INTRODUCTION: Increase in health IT adoption is often driven by financial support through the state. In 2020, the German Hospital Future Law passed Parliament with a schedule to see potential effects in 2023. The research question of the present study thus was if there were differences between 2017 and 2023 in selected application areas eligible for funding by the law. METHODS: Availability and percentage of use in clinical units was measured in a panel of 172 hospitals for these areas. A linear mixed model with repeated measures yielded a significant increase in "medication management" and "discharge management". RESULTS AND DISCUSSION: In "medication management", hospitals in a group as compared to single hospitals tripled the percentage of clinical units using IT systems for this purpose. Not-for-profit hospitals doubled their IT systems for "discharge management" when compared to for-profit hospitals. CONCLUSION: Whether these changes can be attributed to the Hospital Future Law is debatable due to severe delays in various fields, particularly in making funding available. There is room for speeding up particularly the administrative funding process and finally demonstrating results that are proportional to the government money invested.


Asunto(s)
Sistemas de Información en Hospital , Alemania , Humanos , Difusión de Innovaciones
2.
Stud Health Technol Inform ; 317: 201-209, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39234723

RESUMEN

INTRODUCTION: The secondary use of data in clinical environments offers significant opportunities to enhance medical research and practices. However, extracting data from generic data structures, particularly the Entity-Attribute-Value (EAV) model, remains challenging. This study addresses these challenges by developing a methodological approach to convert EAV-based data into a format more suitable for analysis. BACKGROUND: The EAV model is widely used in clinical information systems due to its adaptability, but it often complicates data retrieval for research purposes due to its vertical data structure and dynamic schema. OBJECTIVE: The objective of this study is to develop a methodological approach to address the handling of these generic data structures, Methods: We introduce a five-step methodological approach: 1) understanding the specific clinical processes to determine data collection points and involved roles; 2) analysing the data source to understand the data structure and metadata; 3) reversing a use-case-specific data structure to map the front-end data input to its storage format; 4) analysing the content to identify medical information and establish connections; and 5) managing schema changes to maintain data integrity. RESULTS: Applying this method to the hospital information system has shown that EAV-based data can be converted into a structured format, suitable for research. This conversion reduced data sparsity and improved the manageability of schema changes without affecting other classes of data. CONCLUSION: The developed approach provides a systematic method for handling complex data relationships and maintaining data integrity in clinical systems using EAV models. This approach facilitates the secondary use of clinical data, enhancing its utility for medical research and practice.


Asunto(s)
Almacenamiento y Recuperación de la Información , Almacenamiento y Recuperación de la Información/métodos , Humanos , Sistemas de Información en Hospital , Registros Electrónicos de Salud
3.
Stud Health Technol Inform ; 317: 146-151, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39234717

RESUMEN

INTRODUCTION: The reuse of clinical data from clinical routine is a topic of research within the field of medical informatics under the term secondary use. In order to ensure the correct use and interpretation of data, there is a need for context information of data collection and a general understanding of the data. The use of metadata as an effective method of defining and maintaining context is well-established, particularly in the field of clinical trials. The objectives of this paper is to examine a method for integrating routine clinical data using metadata. METHODS: To this end, clinical forms extracted from a hospital information system will be converted into the FHIR format. A particular focus is placed on the consistent use of a metadata repository (MDR). RESULTS: A metadata-based approach using an MDR system was developed to simplify data integration and mapping of structured forms into FHIR resources, while offering many advantages in terms of flexibility and data quality. This facilitated the management and configuration of logic and definitions in one place, enabling the reusability and secondary use of data. DISCUSSION: This work allows the transfer of data elements without loss of detail and simplifies integration with target formats. The approach is adaptable for other ETL processes and eliminates the need for formatting concerns in the target profile.


Asunto(s)
Metadatos , Proyectos Piloto , Reino Unido , Registros Electrónicos de Salud , Humanos , Sistemas de Información en Hospital , Integración de Sistemas
4.
Dtsch Med Wochenschr ; 149(18): 1094-1104, 2024 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-39208862

RESUMEN

Clinics are, by definition, part of a country's critical infrastructure. In recent years, hospitals have increasingly become the target of cyber attacks, resulting in disruptions to their functionality lasting weeks to even months. According to the "National Strategy for the Protection of Critical Infrastructures (CRITIS Strategy)", clinics are legally obligated to take preventive measures against such incidents. This involves evaluating, defining, and developing failure concepts for IT-dependent processes within a clinic to be prepared for a cyber attack. Specifically tailored emergency plans for computer system failures should be created and maintained in all IT-dependent areas of a clinic.Additionally, paper-based alternative solutions, such as request forms for diagnostic or consultation services, department-specific emergency documents, and patient documentation charts, should be kept in a readily accessible location known to staff in the respective areas. The complete restoration of a clinic's network after a cyber attack often requires extensive recovery of numerous IT systems, which may take weeks to months in some cases.If the hospital has robust plans for cyber emergency preparedness, including regular scans and real-time backups, stabilization and a quicker resumption of operations may be possible.


Asunto(s)
Seguridad Computacional , Humanos , Alemania , Sistemas de Información en Hospital , Planificación en Desastres/organización & administración
5.
Stud Health Technol Inform ; 316: 1135-1139, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39176581

RESUMEN

A key barrier to the use of health information technology on hospital wards is an insufficient number of computers to support clinical information system access. This paper reports on the development and pilot testing of a novel approach, based on work-sampling principles, for assessing adequate availability of computers.


Asunto(s)
Sistemas de Información en Hospital , Humanos , Computadores
6.
Stud Health Technol Inform ; 316: 683-684, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39176834

RESUMEN

Monitoring of artificial intelligence (AI)-based algorithms is necessary for safe implementation and will be required in upcoming regulations. This study investigates the potential for monitoring of AI in hospitals. First, by reviewing regulatory requirements and state of the art of monitoring. Then, by conducting a gap analysis of ISO42001, containing industry agnostic requirements harmonized with the EU AI Act. The analysis illustrates the need for comprehensive monitoring capable of capturing deviations in input, performance drifts and unintended interactions. However, hospitals often suffer from a technical debt, and the gap analysis provides qualitative indications on implementation challenges, including data quality, infrastructure and limitations in continuous improvement.


Asunto(s)
Inteligencia Artificial , Algoritmos , Humanos , Hospitales , Sistemas de Información en Hospital
7.
Rev Esc Enferm USP ; 58: e20240039, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-39190875

RESUMEN

OBJECTIVE: To analyze public management actions regarding organ, cell, and tissue transplant procedures and their financial investments in Brazil. METHOD: Mixed (time and place) ecological study, carried out based on data from the Hospital Information System of the Brazilian Public Health System (SUS) Information Technology Department and the National Transplant System, from 2001 to 2023. Temporal trend analyses, descriptive and inferential statistics were performed. RESULTS: Organ, cell, and tissue transplants are concentrated in the Southeast region of the country, with increased costs there. The Northeast and South regions of Brazil have the longest waiting list, with an increasing trend (R2 = 0.96), associated with a decreasing trend in the number of transplants (R2 = 0.97). CONCLUSION: The difference in the total number of transplants and procedures performed among the Brazilian regions represents the need for organization and investments with strategies aimed at training professionals and raising awareness among the population.


Asunto(s)
Listas de Espera , Brasil , Humanos , Inversiones en Salud , Trasplante de Órganos/estadística & datos numéricos , Programas Nacionales de Salud/organización & administración , Sistemas de Información en Hospital , Factores de Tiempo
8.
Epidemiol Serv Saude ; 33: e20231172, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-39194080

RESUMEN

OBJECTIVE: To analyze bed demand and occupancy within the Brazilian National Health System (Sistema Único de Saúde - SUS) for the main types of cancer in Brazil, from 2018 to 2021. METHODS: This was a descriptive cross-sectional study, using data from the Hospital Information System. Queuing theory model was used for calculating average admission rate, average hospitalization rate, probability of overload, and average number of people in the queue. RESULTS: The Southeast and South regions showed the highest average hospitalization rates, while the North region showed the lowest rates. The Southeast region presented a high probability of surgical bed overload, especially in the states of São Paulo (99.0%), Minas Gerais (97.0%) and Rio de Janeiro (97.0%). São Paulo state showed an overload above 95.0% in all types of beds analyzed. CONCLUSION: There was a high probability of oncology bed occupancy within the Brazilian National Health System, especially surgical and medical beds, and regional disparities in bed overload. MAIN RESULTS: The study found a high demand for hospital admissions to oncological bed in the Southeast region and a high probability of system overload in the states of the Southeast and Northeast regions of Brazil, thus highlighting the inequities in access to healthcare services in the country. IMPLICATIONS FOR SERVICES: This study presents a methodology for the improved allocation of resources and management of surgical and medical bed flows in areas with the highest bed overload and regions with low service availability. PERSPECTIVES: It is necessary to promote public policies that ensure the equitable supply of beds for oncological treatment within the SUS, especially in states with bed overload and healthcare service gaps.


Asunto(s)
Ocupación de Camas , Sistemas de Información en Hospital , Hospitalización , Programas Nacionales de Salud , Neoplasias , Estudios Transversales , Humanos , Brasil , Neoplasias/terapia , Neoplasias/epidemiología , Programas Nacionales de Salud/estadística & datos numéricos , Programas Nacionales de Salud/organización & administración , Ocupación de Camas/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Sistemas de Información en Hospital/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos
9.
BMJ Open ; 14(8): e082547, 2024 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-39182935

RESUMEN

OBJECTIVES: This study aims to address the significant knowledge gap in the literature on the implementation of Casemix system in total hospital information systems (THIS). The research focuses on validating a quantitative instrument to assess medical doctors' acceptance of the Casemix system in Ministry of Health (MOH) Malaysia facilities using THIS. DESIGNS: A sequential explanatory mixed-methods study was conducted, starting with a cross-sectional quantitative phase using a self-administered online questionnaire that adapted previous instruments to the current setting based on Human, Organisation, Technology-Fit and Technology Acceptance Model frameworks, followed by a qualitative phase using in-depth interviews. However, this article explicitly emphasises the quantitative phase. SETTING: The study was conducted in five MOH hospitals with THIS technology from five zones. PARTICIPANTS: Prior to the quantitative field study, rigorous procedures including content, criterion and face validation, translation, pilot testing and exploratory factor analysis (EFA) were undertaken, resulting in a refined questionnaire consisting of 41 items. Confirmatory factor analysis (CFA) was then performed on data collected from 343 respondents selected via stratified random sampling to validate the measurement model. RESULTS: The study found satisfactory Kaiser-Meyer-Olkin model levels, significant Bartlett's test of sphericity, satisfactory factor loadings (>0.6) and high internal reliability for each item. One item was eliminated during EFA, and organisational characteristics construct was refined into two components. The study confirms unidimensionality, construct validity, convergent validity, discriminant validity and composite reliability through CFA. After the instrument's validity, reliability and normality have been established, the questionnaire is validated and deemed operational. CONCLUSION: By elucidating critical success factor and acceptance of Casemix, this research informs strategies for enhancing its implementation within the THIS environment. Moving forward, the validated instrument will serve as a valuable tool in future research endeavours aimed at evaluating the adoption of the Casemix system within THIS, addressing a notable gap in current literature.


Asunto(s)
Sistemas de Información en Hospital , Humanos , Malasia , Encuestas y Cuestionarios/normas , Estudios Transversales , Masculino , Sistemas de Información en Hospital/normas , Femenino , Actitud del Personal de Salud , Adulto , Análisis Factorial , Reproducibilidad de los Resultados , Persona de Mediana Edad
10.
Cien Saude Colet ; 29(8): e03892023, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39140529

RESUMEN

This article aims to examine the effects of weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in Brazil. Information from the Hospital Information System of the Unified Health System (SIH/SUS) of urgently admitted patients diagnosed with acute myocardial infarction (AMI) between 2008 and 2018 was used, made available through the Hospital Admission Authorization (AIH). Multivariable logistic regression models, controlling for observable patient characteristics, hospital characteristics and year and hospital-fixed effects, were used. The results were consistent with the existence of the weekend effect. For the model adjusted with the inclusion of all controls, the chance of death observed for individuals hospitalized on the weekend is 14% higher. Our results indicated that there is probably an important variation in the quality of hospital care depending on the day the patient is hospitalized. Weekend admissions were associated with in-hospital AMI mortality in Brazil. Future research should analyze the possible channels behind the weekend effect to support public policies that can effectively make healthcare equitable.


Asunto(s)
Mortalidad Hospitalaria , Hospitalización , Infarto del Miocardio , Brasil/epidemiología , Humanos , Infarto del Miocardio/mortalidad , Infarto del Miocardio/epidemiología , Masculino , Factores de Tiempo , Femenino , Persona de Mediana Edad , Hospitalización/estadística & datos numéricos , Anciano , Calidad de la Atención de Salud , Programas Nacionales de Salud/organización & administración , Admisión del Paciente/estadística & datos numéricos , Modelos Logísticos , Sistemas de Información en Hospital , Anciano de 80 o más Años
11.
Int J Equity Health ; 23(1): 143, 2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39026324

RESUMEN

BACKGROUND: Race and ethnicity are important drivers of health inequalities worldwide. However, the recording of race/ethnicity in data systems is frequently insufficient, particularly in low- and middle-income countries. The aim of this study is to descriptively analyse trends in data completeness in race/color records in hospital admissions and the rates of hospitalizations by various causes for Blacks and Whites individuals. METHODS: We conducted a longitudinal analysis, examining hospital admission data from Brazil's Hospital Information System (SIH) between 2010 and 2022, and analysed trends in reporting completeness and racial inequalities. These hospitalization records were examined based on year, quarter, cause of admission (using International Classification of Diseases (ICD-10) codes), and race/color (categorized as Black, White, or missing). We examined the patterns in hospitalization rates and the prevalence of missing data over a period of time. RESULTS: Over the study period, there was a notable improvement in data completeness regarding race/color in hospital admissions in Brazil. The proportion of missing values on race decreased from 34.7% in 2010 to 21.2% in 2020. As data completeness improved, racial inequalities in hospitalization rates became more evident - across several causes, including assaults, tuberculosis, hypertensive diseases, at-risk hospitalizations during pregnancy and motorcycle accidents. CONCLUSIONS: The study highlights the critical role of data quality in identifying and addressing racial health inequalities. Improved data completeness has revealed previously hidden inequalities in health records, emphasizing the need for comprehensive data collection to inform equitable health policies and interventions. Policymakers working in areas where socioeconomic data reporting (including on race and ethnicity) is suboptimal, should address data completeness to fully understand the scale of health inequalities.


Asunto(s)
Sistemas de Información en Salud , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Sistemas de Información en Hospital , Femenino , Humanos , Masculino , Brasil , Sistemas de Información en Salud/normas , Disparidades en Atención de Salud/estadística & datos numéricos , Sistemas de Información en Hospital/normas , Hospitalización/estadística & datos numéricos , Estudios Longitudinales , Grupos Raciales/estadística & datos numéricos , Factores Socioeconómicos , Población Blanca/estadística & datos numéricos , Población Negra/estadística & datos numéricos
12.
Stud Health Technol Inform ; 315: 573-574, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39049328

RESUMEN

Hospitals improve safety and workflow efficiency by implementing systems for identification of items and patients. Little is known about the implementation of these systems across entire hospitals. The aim of this study is to identify challenges and enablers of adoption of such systems at scale, within a hospital organisation and across the English NHS. The focus is on the experience of the Scan4Safety project at Leeds Teaching Hospital NHS Trust (UK). Study methods are qualitative and include interviews with staff and review of documents. This poster paper presents preliminary findings of research in progress.


Asunto(s)
Seguridad del Paciente , Medicina Estatal , Humanos , Inglaterra , Sistemas de Información en Hospital , Administración de la Seguridad
13.
Epidemiol Serv Saude ; 33: e20231252, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-39082584

RESUMEN

OBJECTIVE: To validate the Brazilian National Health System Hospital Information System (SIH/SUS) for maternal morbidity surveillance. METHODS: This was a cross-sectional study conducted in 2021/2022, taking as its reference a national study on maternal morbidity (MMG) conducted in 50 public and 28 private hospitals; we compared SIH/SUS and MMG data for hospitalization frequency, reason and type of discharge and calculated sensitivity, specificity, positive and negative likelihood ratios for seven diagnoses and four procedures. RESULTS: Hospitalizations identified on SIH/SUS (32,212) corresponded to 95.1% of hospitalizations assessed by MMG (33,867), with lower recording on SIH/SUS (85.5%) for private hospitals [10,036 (SIH/SUS)]; 11,742 (MMG)]; compared to MMG, SIH/SUS had a lower proportion of hospitalizations due to "complications during pregnancy" (9.7% versus 16.5%) as well as under-recording of all diagnoses and procedures assessed, except "ectopic pregnancy". CONCLUSION: Better recording of diagnoses and procedures on SIH/SUS is essential for its use in maternal morbidity surveillance.


Asunto(s)
Sistemas de Información en Hospital , Hospitalización , Complicaciones del Embarazo , Humanos , Brasil/epidemiología , Femenino , Estudios Transversales , Embarazo , Hospitalización/estadística & datos numéricos , Complicaciones del Embarazo/epidemiología , Hospitales Privados/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Sensibilidad y Especificidad , Programas Nacionales de Salud , Morbilidad/tendencias , Vigilancia de la Población/métodos
14.
Epidemiol Serv Saude ; 33: e20231110, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38985064

RESUMEN

OBJECTIVE: To assess the epidemiological profile and trend in hospitalizations for mental and behavioral disorders due to alcohol and other psychoactive substance use among Brazilian adolescents, between 2017 and 2022. METHODS: This was a time-series study using data from the Hospital Information System of the Brazilian National Health System; the trend analysis was performed by estimating the annual percentage change (APC) of hospitalization rates per 100,000 inhabitants and respective confidence intervals (95%CI), using the Prais-Winsten method. RESULTS: A total of 29,991 hospitalizations were recorded in the study period, with a decreasing trend observed, from 16.18/100,000 inhabitants in 2017 to 13.72/100,000 inhab. in 2022 (percent change of -2.65%; 95%CI -4.47;-0.80), a greater decline was found in males (-3.48%; 95%CI -5.20;-1.72), in the age group of 15 to 19 years (-2.79%; 95%CI -4.49;-1.06), in the South (-3.29%; 95%CI -5.37;-1.16) and Midwest (-3.64%; 95%CI -5.75;-1.49) regions of the country. CONCLUSION: Hospitalizations showed a decreasing trend in the study period, with sociodemographic disparities.


Asunto(s)
Hospitalización , Trastornos Mentales , Trastornos Relacionados con Sustancias , Humanos , Brasil/epidemiología , Adolescente , Masculino , Hospitalización/estadística & datos numéricos , Femenino , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Mentales/epidemiología , Adulto Joven , Sistemas de Información en Hospital , Distribución por Sexo , Alcoholismo/epidemiología
15.
BMC Health Serv Res ; 24(1): 806, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38997698

RESUMEN

BACKGROUND: During the prolonged COVID-19 pandemic, hospitals became focal points for normalised prevention and control. In this study, we investigated the feasibility of an inpatient bed reservation system for cancer patients that was developed in the department?s public WeChat account. We also explored its role in improving operational efficiency and nursing quality management, as well as in optimising nursing workforce deployment. METHODS: We utilised WeChat to facilitate communication between cancer patients and health care professionals. Furthermore, we collected data on admissions, discharges, average number of hospitalisation days, bed utilisation rate, and the number of bed days occupied by hospitalised patients through the hospital information system and nurses? working hours and competency levels through the nurse scheduling system. The average nursing hours per patient per day were calculated. Through the inpatient bed reservation system, the number of accepted admissions, denied admissions, and cancelled admissions from the reservation system were collected. The impact of the bed reservation system on the department?s operational efficiency was analysed by comparing the number of hospitalisation discharges before and after reservations, as well as the average hospitalisation and bed utilisation rates. By comparing nurses? working hours per month and average nursing hours per patient per day, the system?s impact on nurses? working hours and nursing quality indicators was analysed. RESULTS: The average hospitalisation length, bed utilisation rate, and nurses? working hours were significantly lower, and the average number of nursing hours per patient per day was significantly higher after the implementation of the reservation system. The full-cycle bed information management model for cancer patients did not affect the number of discharged patients. CONCLUSION: Patients? ability to reserve bed types from home in advance using the department?s official WeChat-based inpatient bed reservation system allowed nurses to prepare for their work ahead of time. This in turn improved the operational efficiency of the department and nursing quality, and it optimised the deployment of the nursing workforce.


Asunto(s)
COVID-19 , Neoplasias , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Neoplasias/terapia , Hospitalización/estadística & datos numéricos , SARS-CoV-2 , Ocupación de Camas , Pandemias/prevención & control , Masculino , Femenino , Sistemas de Información en Hospital , Pacientes Internos
16.
ABCS health sci ; 49: e024205, 11 jun. 2024. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1555509

RESUMEN

INTRODUCTION: The growing older population increases proportionately the demand for hospital care due to the increase in health problems. OBJECTIVE: To estimate the prevalence and incidence of hospitalizations, and to investigate associated factors in older adults from the Zona da Mata of Minas Gerais, Brazil, between 2016-2018. Secondly, to provide a more comprehensive epidemiological overview of hospitalizations, the following were estimated: monthly hospitalization rate; hospital mortality rate; frequency of hospitalizations according to diagnosis, hospitalizations for conditions sensitive to primary care and in-hospital death; and hospital costs. METHODS: This is an ecological and descriptive-analytic study. Data were obtained from the Brazilian Hospital Information System (SIH/SUS). RESULTS: The prevalence of hospitalizations was 35.1% (31.2% in women and 39.7% in men). The monthly rate of hospitalizations was higher in older men when compared with older women (Rate-Ratio=1.35 [95% CI=1.27-1.43]) and adult men between 40­59 years (Rate Ratio=2.42 [95% CI=2.26-2.58]). The cumulative incidence of hospitalization was 144/1,000 older persons (125/1,000 women and 169/1,000 men). Factors significantly associated with hospitalizations were: male sex (PR=1.52 [95% CI=1.11-2.08]); hospitalization in surgical bed (PR=1.93 [95% CI=1.05-3.56]); absence of death (PR=1.94 [95% CI=1.03-3.65]); and hospital stay ≥15 days (PR=0.71 [95% CI=0.54 0.95]). The cost of hospitalizations was R$ 220,8 million (mean of R$ 201,700/day). CONCLUSÃO: The findings strengthen the need for preventive healthcare for the older population living in the Zona da Mata of Minas Gerais and alert managers to the substantial socioeconomic impact of hospitalizations.


INTRODUÇÃO: O crescente aumento da população idosa faz aumentar proporcionalmente a demanda por cuidados hospitalares devido ao aumento dos problemas de saúde. OBJETIVO: Estimar a prevalência e incidência de hospitalizações, e investigar fatores associados, em idosos da Zona da Mata Mineira, Brasil, entre 2016-2018. Secundariamente, com intuito de fornecer um panorama epidemiológico mais abrangente acerca das hospitalizações, foram estimadas: taxa mensal de hospitalização; taxa de mortalidade hospitalar; frequência de hospitalizações conforme o diagnóstico, internações por condições sensíveis à atenção primária (ICSAP) e óbito hospitalar; e custos hospitalares. MÉTODO: Trata-se de um estudo ecológico e descritivo-analítico. Os dados foram obtidos do Sistema de Informação Hospitalar brasileiro (SIH/SUS). RESULTADOS: A prevalência de hospitalizações em idosos foi de 35,1% (31,2% em mulheres e 39,7% em homens). A taxa mensal de hospitalização foi maior em homens idosos quando comparados com mulheres idosas (Razão-de-Taxas=1,35 [IC 95%=1,27-1,43]) e homens adultos entre 40­59 anos (Razão-de-Taxas=2,42 [IC 95%=2,26-2,58]). A incidência acumulada de hospitalização foi de 144/1.000 idosos (125/1.000 mulheres e 169/1.000 homens). Os fatores significativamente associados com as hospitalizações foram: sexo masculino (RP=1,52 [IC 95%=1,11­2,08]), internação em leito cirúrgico (RP=1,93 [IC 95%=1,05­3,56]), ausência de óbito (RP=1,94 [IC 95%=1,03-3,65]) e permanência hospitalizado ≥15 dias (RP=0,71 [IC 95%=0,54-0,95]). O custo das hospitalizações foi de R$ 220,8 milhões (média de R$ 201,7 mil/dia). CONCLUSÃO: Os resultados reforçam a necessidade de cuidados preventivos à saúde da população idosa da Zona da Mata Mineira e alertam gestores para o substancial impacto socioeconômico gerado pelas hospitalizações.


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Incidencia , Prevalencia , Hospitalización/estadística & datos numéricos , Epidemiología Descriptiva , Sistemas de Información en Hospital , Costos de Hospital , Estudios Ecológicos
17.
J Am Med Inform Assoc ; 31(7): 1608-1621, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38781289

RESUMEN

OBJECTIVES: Healthcare providers employ heuristic and analytical decision-making to navigate the high-stakes environment of the emergency department (ED). Despite the increasing integration of information systems (ISs), research on their efficacy is conflicting. Drawing on related fields, we investigate how timing and mode of delivery influence IS effectiveness. Our objective is to reconcile previous contradictory findings, shedding light on optimal IS design in the ED. MATERIALS AND METHODS: We conducted a systematic review following PRISMA across PubMed, Scopus, and Web of Science. We coded the ISs' timing as heuristic or analytical, their mode of delivery as active for automatic alerts and passive when requiring user-initiated information retrieval, and their effect on process, economic, and clinical outcomes. RESULTS: Our analysis included 83 studies. During early heuristic decision-making, most active interventions were ineffective, while passive interventions generally improved outcomes. In the analytical phase, the effects were reversed. Passive interventions that facilitate information extraction consistently improved outcomes. DISCUSSION: Our findings suggest that the effectiveness of active interventions negatively correlates with the amount of information received during delivery. During early heuristic decision-making, when information overload is high, physicians are unresponsive to alerts and proactively consult passive resources. In the later analytical phases, physicians show increased receptivity to alerts due to decreased diagnostic uncertainty and information quantity. Interventions that limit information lead to positive outcomes, supporting our interpretation. CONCLUSION: We synthesize our findings into an integrated model that reveals the underlying reasons for conflicting findings from previous reviews and can guide practitioners in designing ISs in the ED.


Asunto(s)
Servicio de Urgencia en Hospital , Humanos , Heurística , Sistemas de Apoyo a Decisiones Clínicas , Sistemas de Información en Hospital , Toma de Decisiones Clínicas
18.
Comput Inform Nurs ; 42(8): 557-566, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38787735

RESUMEN

Operations management of a hospital unit is a shared activity involving nursing and medical professionals, characterized by suddenly changing situations, constant interruptions, and ad hoc decision-making. Previous studies have explored the informational needs affecting decision-making, but only limited information has been collected regarding factors affecting information management related to the daily operations of hospital units. The aim of this study was to describe the experiences of nursing and medical professionals of information management in the daily operations of hospital units. This qualitative study consists of interviews following the critical incidence technique. Twenty-six nurses and eight physicians working in operational leadership roles in hospital units were interviewed, and the data were subjected to thematic analysis. The data analysis showed that strengths of current systems were organizational operational procedures, general instruments supporting information management, and a digital operations dashboard, whereas opportunities for improvement included the information architecture, quality of information, and technology use. The study findings highlight that despite several decades of efforts to provide solutions to support information management in hospital daily operations, further measures need to be taken in developing and implementing information systems with user-centered strategies and systematic approaches to better support healthcare professionals.


Asunto(s)
Investigación Cualitativa , Humanos , Personal de Enfermería en Hospital/psicología , Gestión de la Información , Unidades Hospitalarias/organización & administración , Femenino , Médicos/psicología , Adulto , Masculino , Cuerpo Médico de Hospitales/psicología , Sistemas de Información en Hospital , Entrevistas como Asunto
19.
Artículo en Alemán | MEDLINE | ID: mdl-38759686

RESUMEN

Clinics are, by definition, part of a country's critical infrastructure. In recent years, hospitals have increasingly become the target of cyber attacks, resulting in disruptions to their functionality lasting weeks to even months. According to the "National Strategy for the Protection of Critical Infrastructures (CRITIS Strategy)", clinics are legally obligated to take preventive measures against such incidents. This involves evaluating, defining, and developing failure concepts for IT-dependent processes within a clinic to be prepared for a cyber attack. Specifically tailored emergency plans for computer system failures should be created and maintained in all IT-dependent areas of a clinic.Additionally, paper-based alternative solutions, such as request forms for diagnostic or consultation services, department-specific emergency documents, and patient documentation charts, should be kept in a readily accessible location known to staff in the respective areas. The complete restoration of a clinic's network after a cyber attack often requires extensive recovery of numerous IT systems, which may take weeks to months in some cases.If the hospital has robust plans for cyber emergency preparedness, including regular scans and real-time backups, stabilization and a quicker resumption of operations may be possible.


Asunto(s)
Seguridad Computacional , Alemania , Sistemas de Información en Hospital/organización & administración , Humanos , Hospitales
20.
Rev. Ciênc. Plur ; 10 (1) 2024;10(1): 31414, 2024 abr. 30. ilus, tab
Artículo en Portugués | LILACS, BBO | ID: biblio-1553430

RESUMEN

Introdução: As doenças do sistema respiratório se mostram como uma das causas mais preocupantes de internações hospitalares no país. Nessa perspectiva, o perfil das internações por doenças respiratórias em crianças permite observar os parâmetros desta problemática, fornecendo um conhecimento amplo acerca do processo saúde e doença nessa população. Objetivo: Analisar o perfil epidemiológico das internações hospitalares por causas do aparelho respiratório em crianças de 0 a 9 anos no Brasil e regiões, entre os anos de 2013 e 2022. Metodologia: Trata-se de um estudo ecológico, realizado no Brasil, a partir de dados secundários do Sistema de Informações Hospitalares. A população escolhida para este estudo foram crianças de 0 a 9 anos deidade. Os dados foram coletados em 26 de novembro de 2022. As variáveis dependentes do estudo são as internações de crianças de 0 a 9 anos por doenças do aparelho respiratório no Brasil e suas regiões. Já, como variáveis independentes, tem-se o tempo, do período de janeiro de 2013 a setembro de 2022, regiões e faixa etária. Resultados: Há uma tendência de queda das internações por causa respiratória até o ano de 2016, seguido de um crescimento gradativo até 2019. Entretanto, em 2020, a taxa de hospitalização reduziu drasticamente em todas as localidades. As regiões Sul, Norte e Centro-Oeste permaneceram com taxas maiores que o Brasil em todo o período estudado. A internação em menores de 1 ano representa o maior quantitativo de internações sendo a pneumonia a causa mais prevalente. Conclusões: As taxas de internação infantil por doenças respiratórias representam importante preocupação para saúde pública. Assim, destaca-se a relevância da efetividade da Atenção Primária à Saúde, que possui grande impacto no desfecho dos adoecimentos em crianças, especialmente das doenças respiratórias (AU).


Introduction: Respiratory system diseases are one of the most worrying causes of hospital admissions in the country. From this perspective, the profile of hospitalizations for respiratory diseases in children allows us to notice the parameters of this problem, providing a broad understanding of the health and disease process in this population.Objective: To analyze the epidemiological profile of hospital admissions due to respiratory causes in children aged 0 to 9 in Brazil and its regions between 2013 and 2022. Methodology: This is an ecological study held in Brazil using secondary data from the Hospital Information System. The population chosen for this study consisted of children aged 0 to 9. Data were collected on November 26, 2022. The dependent variables of this study are hospitalizations of children aged 0 to 9 due to respiratory diseases in Brazil and its regions. The independent variables are time, from January 2013 to September 2022, regions, and age group.Results: There was a downward trend in hospitalizations due to respiratory causes until 2016, followed by a gradual increase until 2019. Nonetheless, in 2020, the hospitalization rate fell dramatically in all locations. The South, North and Mid-West regions remained with higher rates than Brazil throughout the studied period. Hospitalization of children under 1 year old represents the largest number of admissions, with pneumonia being Revista Ciência Plural. 2024; 10(1): e31414 3the most prevalent cause.Conclusions: Hospitalization rates during childhood due to respiratory diseases represent a major public health concern. Thus, one can highlight the importance of the effectiveness of Primary Health Care, which has a major impact on the outcome of illnesses in children, especially respiratory diseases (AU).


Introducción: Las enfermedades del sistema respiratorio son una de lascausas más preocupantes de hospitalizaciones en el país. Desde esta perspectiva, el perfil de hospitalizaciones por enfermedades respiratorias en niños permite observar los parámetros de este problema, proporcionando una amplia comprensión del proceso de salud y enfermedad en esta población.Objetivo: Analizar el perfil epidemiológico de las internaciones por causas respiratorias en niños de 0 a 9 años en Brasil y sus regiones entre 2013 y 2022. Metodología: Se trata de un estudio ecológico conducido en Brasil a partir de datos secundarios del Sistema de Información Hospitalaria. La población elegida para este estudio fueron los niños de 0 a 9 años. Los datos se recogieron el 26 de noviembre de 2022. Las variables dependientes del estudio son las hospitalizaciones de niños de 0 a 9 años por enfermedades respiratorias en Brasil y sus regiones. Las variables independientes son el tiempo, de enero de 2013 a septiembre de 2022, las regiones y la franja etaria.Resultados: Se nota una tendencia a la baja de las hospitalizaciones por causas respiratorias hasta 2016, seguida de un aumento gradual hasta 2019. Sin embargo, en 2020, la tasa de hospitalización cayó drásticamente en todas las localidades. Las regiones Sur, Norte y Medio Oeste se mantuvieron con tasas másaltas que Brasil durante todo el período estudiado. Las hospitalizaciones en niños menores de 1 año representan el mayor número de internaciones, siendo la neumonía la causa más prevalente.Conclusiones: Las tasas de hospitalización infantil por enfermedades respiratorias representan un importante problema de salud pública. Así, se subraya la importancia de la eficacia de la Atención Primaria de Salud, que tiene un gran impacto en el resultado de las enfermedades en los niños, especialmente las respiratorias (AU).


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Enfermedades Respiratorias/patología , Perfil de Salud , Salud Infantil , Morbilidad , Atención Primaria de Salud , Sistemas de Información en Hospital , Estudios Ecológicos , Hospitalización
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