The Impact of Adding a 2-Way Video Monitoring System on Falls and Costs for High-Risk Inpatients.

OBJECTIVES: We aimed to investigate the value of adding a video monitoring (VM) system with falls and costs for patients at high risk. METHODS: We conducted a retrospective, historically controlled study of adults (≥18 y old) at high risk of fall admitted at the University of Miami Hospital and Clinics from January 1 to November 30, 2020 (pre-VM) and January 1 to November 30, 2021 (post-VM); in-person sitters were available in both periods. Fall risk assessment was conducted on admission and at every nursing shift; we defined patients as high risk if their Morse Fall Scale was ≥60. We conducted a multivariable logistic regression model to evaluate the association of period (pre- versus post-VM) with falls and performed a cost analysis. RESULTS: Our primary cohort consisted of 9,034 patients at high risk of falls, 4,207 (46.6%) in the pre-VM and 4,827 (53.4%) in the post-VM period. Fall rates were higher in the pre- than the post-VM periods (3.5% versus 2.7%, P = 0.043). After adjustment, being admitted during the post-VM period was associated with a lower odds of fall (odds ratio [95% confidence interval], 0.49 [0.37-0.64], P < 0.001). The median adjusted hospital cost (in 2020 dollars) was $1,969 more for patients who fell than for patients who did not (interquartile range, $880-$2,273). Considering start-up and ongoing costs, we estimate VM implementation to partly replace in-person monitoring has potential annual cost savings of >$800,000 for a hospital similar to ours. CONCLUSIONS: Video monitoring to augment in-person sitters is an effective fall prevention initiative for patients at high risk of falls, which is likely also cost-effective.

Factores asociados a la baja adherencia al tratamiento de la diabetes tipo 2: un estudio de corte transversal / Factors associated with low adherence to diabetes type 2 treatment: a cross-sectional study

La diabetes mellitus (DM) es una enfermedad crónica que se define por la hiperglucemia prolongada en el tiempo, que trae como consecuencia daño a nivel microangiopático - macrovascular y representa uno de los mayores problemas de salud pública a nivel mundial. Actualmente, no se ha podido definir en la población chilena los diferentes factores que influyen en la adherencia al tratamiento de los pacientes con DM2. Objetivo: Analizar la asociación entre la baja adherencia terapéutica en personas adultas con DM2 que se atienden en el CESFAM Jean et Marie Thierry y las variables propias del paciente como sexo, edad, presencia de otras enfermedades crónicas y polifarmacia. Materiales y métodos: Se realizó un estudio observacional y analítico de corte transversal, en pacientes con DM2 pertenecientes al CESFAM Jean et Marie Thierry en el año 2019 y 2020. Se recolectaron datos desde la cartola del programa cardiovascular, parte de la ficha clínica, correspondiente a cada paciente con DM2 del CESFAM. Resultados: Se obtuvieron datos de 253 participantes del CESFAM. En total, un 43,87% de los pacientes no fueron adherentes y un 56,13% fue adherente al tratamiento. El promedio de edad fue de 67,3 años y la adherencia en pacientes con enfermedades crónicas concomitantes 44,1%. Conclusión: No hubo una asociación significativa entre las variables estudiadas y la adherencia terapéutica. A pesar de esto, es importante continuar el estudio debido al gran número de pacientes diabéticos no adherentes a su tratamiento.

Diabetes mellitus (DM) is a chronic disease defined as hyperglycemia over a prolonged period leading to damage at the microangiopathic and macrovascular level and is one of the largest public health problems worldwide. Currently, it has not been possible to define the different factors influencing treatment adherence in DM2 patients in the Chilean population. Objectives: Analyze the association between adherence to treatment in adults with DM2 attending CESFAM Jean et Marie Thierry and the patients' variables such as gender, age, concomitant chronic disease and polypharmacy. Material and Methods: In 2019 and 2020 an observational and analytical study was done in a cross section of DM2 patients from CESFAM Jean y Marie Thierry. Data from each of the CESFAM's DM2 patients was collected from the cardiovascular program register in the clinical file. Results: Data was obtained from 253 participants. In total, 43.87% did not adhere to treatment and 56.13% adhered to treatment. The average age was 67.3 years and the adherence in patients with concomitant chronic disease was 44.1%. Conclusion: There was no significant association between the variables studied and adherence to treatment. Despite this, it is important to continue the study because of the large number of diabetics not adhering to treatment.