Suchergebnisse

Background: Under-coding of dementia during hospitalisation results in an inability to identify all patients with dementia using hospital administrative data. Clinical coding can be viewed as a proxy for management; therefore, under-coding indicates dementia was not considered in the patient's management. While under-coding of dementia is well established, there is sparse evidence on whether dementia is coded in subsequent hospitalisations among patients with a known diagnosis. Objective: (a) To describe patterns of dementia coding over 5 years after a first-coded (i.e. index) admission for dementia; (b) to identify factors associated with clinical coding of dementia; and (c) to identify patient subgroups at risk of not being coded to inform future interventions to improve hospital identification and management of dementia. Method: Retrospective study of longitudinal hospital data from 1 July 2006 to 30 June 2015 for 7919 patients hospitalised during the 5 years' post-index admission for dementia in a regional local health district of New South Wales, Australia. Results: Dementia was coded in 63.9% of admissions in the 12 months following index admission for dementia; this decreased to 53.7% after 5 years. Patients were 20% more likely to have dementia actively managed when it co-occurred with delirium. Under-coding varied across conditions, with dementia more likely to be coded in admissions for falls and pneumonitis, and less likely for heart failure, pneumonia and urinary tract infection (UTI). Conclusion: The frequency with which dementia was not coded highlights opportunities to improve identification and management of dementia through dementia-specific care, enhanced clinical protocols, and interventions focused around heart failure, pneumonia and UTI admissions.

No processo de compra existem diversos aspectos que influenciam o consumidor, desde racionais até emocionais. Um destes aspectos é a valorização dada à obtenção de posses, que caracteriza o materialismo. A religião e a religiosidade estão também relacionadas ao bem estar psicológico, social e emocional do indivíduo. Considerando que a maior parte da população brasileira se declara pertencente à religião católica, o presente artigo tem como objetivo analisar o impacto da religião no materialismo entre os fiéis católicos residentes em Santa Catarina. Para a realização do estudo foram coletados 272 questionários aplicados via online e que continham duas escalas: a Escala Brasileira de Valores Materiais e a Escala de Religiosidade de Duke. Encontrou-se que não houve correlação significativa entre gênero, idade e renda com materialismo; porém, os católicos que possuem alta religiosidade intrínseca - aquelas ligadas a fatores psicológicos e convicções pessoais - possuem um menor grau de materialismo do que aquelas que possuem baixa religiosidade intrínseca. Conclui-se, portanto, que o grau materialismo pode ser influenciado pelas crenças pessoais quando vividas de forma intrínseca, porém os dados não podem ser generalizados. Sugere-se ainda pesquisas que contenham respondentes com baixa religiosidade ou sem religião para comparar ao grupo do estudo.

BACKGROUND: There is good evidence of both community support for sharing public sector administrative health data in the public interest and concern about data security, misuse and loss of control over health information, particularly if private sector organizations are the data recipients. To date, there is little research describing the perspectives of informed community members on private sector use of public health data and, particularly, on the conditions under which that use might be justified. METHODS: Two citizens' juries were held in February 2020 in two locations close to Sydney, Australia. Jurors considered the charge: 'Under what circumstances is it permissible for governments to share health data with private industry for research and development?' RESULTS: All jurors, bar one, in principle supported sharing government administrative health data with private industry for research and development. The support was conditional and the juries' recommendations specifying these conditions related closely to the concerns they identified in deliberation. CONCLUSION: The outcomes of the deliberative processes suggest that informed Australian citizens are willing to accept sharing their administrative health data, including with private industry, providing the intended purpose is clearly of public benefit, sharing occurs responsibly in a framework of accountability, and the data are securely held. PATIENT AND PUBLIC CONTRIBUTION: The design of the jury was guided by an Advisory Group including representatives from a health consumer organization. The jurors themselves were selected to be descriptively representative of their communities and with independent facilitation wrote the recommendations.