Class of 2009 Abstract / OBJECTIVES: The purpose of the study was to determine the rate of Clostridium difficile infections (CDI) in hospitalized patients and the various factors that were associated with the risk of developing CDI by examining patient discharge data for hospitals in 37 states in the United States using Healthcare Cost and Utilization Project (HCUP). METHODS: Patient discharge information for all patients obtained using HCUP census for the years 2002-2005, either for primary or secondary (all-listed) occurrences of CDI using the ICD-9-CM code (008.45) specific for intestinal infections due to C. difficile, were included in the study. Regression analysis, either Generalized Linear Model log-link or power-link, or a logistic regression was employed to control for the multiple independent variables. RESULTS: The incidence rate for CDI was 9.4% for the years 2002-2005. Among the concomitant diagnoses and procedures, essential hypertension, volume depletion, congestive heart failure, urinary tract infection and venous catheterization were the top 5. The length of stay (LOS) for CDI was associated with being Black, Hispanic or Other race category, number of diagnoses and procedures, primary expected payer of Medicaid, private insurance and other (including worker’s compensation, CHAMPUS,CHAMPVA etc), and all groups classified based on median household income category for patient’s zip code. Predictors of CDI related to inpatient total hospital charges were being female, race (other than black), number of diagnoses and procedures, Death, LOS, patient location and with self-pay and no charge categories as primary expected payer. Predictors of higher CDI related inpatient hospital deaths were age, female sex, Hispanic race, number of diagnoses and procedures, LOS and having Medicaid, self-pay or other as primary expected payer. CONCLUSIONS: LOS, inpatient total hospital charges, and inpatient mortality were dependent on several patient and other characteristics.

Class of 2009 / OBJECTIVES: To determine and characterize the relative impact of patient demographics on hospital inpatient charges, length of stay, and inpatient mortality in patients with ovarian cancer from 2002-2005. METHODS: A retrospective database analysis of AHRQ’s Health Care Cost and Utilization Project (HCUP) Nationwide Inpatient Sample databases was conducted spanning from January 1, 2002, to December 31, 2005.Data were collected regarding age, race, payer status, median household income, location of hospital (urban/rural), comorbidities, procedures, total charges, length of stay, and inpatient mortality. Multivariate and gamma regression methods were utilized to examine incremental risks associated with length of stay, total charges, and inpatient mortality, after controlling for all other variables. RESULTS: Overall, data from 246,012 hospital admissions were obtained. The average length of stay of patients was 6.58 days (SD = 7.22), the average number of diagnoses was 7.18 (SD = 3.36), the average number of procedures performed was 2.71 (SD = 2.66). A total of 14,485 (5.9%) patients died during hospitalization. The average total charge was $29,698 (SD = $42,951). The IRR was 0.886 (95%CI, -0.105 to -0.04) for patients who were Hispanic, and 1.089 (95%CI, 0.017–0.153) for patients who were Black compared to patients who were white. When compared to patients who lived in large, metropolitan areas, the IRR was 0.88 (95%CI, -0.146 to - 0.109) for patients located in smaller, metropolitan areas, and the IRR was 0.74 (95%CI, -0.335 to -0.268) for patients located in non- urban areas. CONCLUSIONS: Patient demographics were found to have associations, both directly and indirectly, with length o

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第23118号 / 社医博第114号 / 新制||社医||11(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 佐藤 俊哉, 教授 森田 智視, 教授 黒田 知宏 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

No description available.

No description available.

SUMMARY A surgery ward is one of the crucial departments in the České Budějovice Hospital. It provides a highly specialized care not only to patients from the district of České Budějovice, but also to people from the whole South-Bohemian region. Nearly 4,000 patients are treated in this ward every year. In my work I focused on a group of people who are able to work, but at the time of hospitalization they had no job and were registered in the employment agency and they came to the surgical ward for optional surgeries. The reasons why they did so could be as follows: they either neglected the care of their health due to a large amount of tasks at work, or they postponed the surgery since they were worried that they could lose their job due to a long sick leave. The objective of the work was to identify the influence of employment on decisions of clients to undergo surgeries. Questionnaires were used to gather data; they were distributed to patients hospitalized in the surgical ward of Nemocnice České Budějovice a.s. (the České Budějovice Hospital). The hypothesis which assumed that people registered in the employment agency for a short time have more surgeries than people registered in the employment agency for a long time was confirmed in the degree work. The second hypothesis assuming that people registered in the employment agency have more optional surgeries than employed people was confirmed as well. The third hypothesis where I assumed that the fees charged for hospital stays would influence the length of hospitalization of unemployed people was not confirmed since political changes resulted in the conclusion of a donation agreement between Nemocnice České Budějovice, a.s. and the South-Bohemian region; the agreement enables people to take advantage of the South-Bohemian region{\crq}s donation to cover the hospital fees starting from 1 February 2009. The results of my work could be used as arguments in solving the unemployment policy.