Abstract:
BACKGROUND:Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes. The study reports on the incidence of HC adverse events, the magnitude of the events, the types of events that occur, and the consequences experienced by HC clients in the province of Ontario. METHODS:A retrospective cohort design was used, utilizing comprehensive secondary databases available for Ontario HC clients from the years 2008 and 2009. The data were derived from the Canadian Home Care Reporting System, the Hospital Discharge Abstract Database, the National Ambulatory Care Reporting System, the Ontario Mental Health Reporting System, and the Continuing Care Reporting System. Descriptive analysis was used to identify the type and frequency of the adverse events recorded and the consequences of the events. Logistic regression analysis was used to examine the association between the events and their consequences. RESULTS:The study found that the incident rate for adverse events for the HC clients included in the cohort was 13%. The most frequent adverse events identified in the databases were injurious falls, injuries from other than a fall, and medication-related incidents. With respect to outcomes, we determined that an injurious fall was associated with a significant increase in the odds of a client requiring long-term-care facility admission and of client death. We further determined that three types of events, delirium, sepsis, and medication-related incidents were associated directly with an increase in the odds of client death. CONCLUSIONS:Our study concludes that 13% of clients in homecare experience an adverse event annually. We also determined that an injurious fall was the most frequent of the adverse events and was associated with increased admission to long-term care or death. We recommend the use of tools that are presently available in Canada, such as the Resident Assessment Instrument and its Clinical Assessment Protocols, for assessing and mitigating the risk of an adverse event occurring.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Doran DM,Hirdes JP,Blais R,Baker GR,Poss JW,Li X,Dill D,Gruneir A,Heckman G,Lacroix H,Mitchell L,O'Beirne M,White N,Droppo L,Foebel AD,Qian G,Nahm SM,Yim O,McIsaac C,Jantzi Mdoi
10.1186/1472-6963-13-227subject
Has Abstractpub_date
2013-06-22 00:00:00pages
227issn
1472-6963pii
1472-6963-13-227journal_volume
13pub_type
杂志文章abstract:BACKGROUND:General practitioners (GPs) adopt clinical practice guidelines to varying degrees. Several factors have been found to influence application of guidelines in practice and the GP is apparently the key actor. Studies are needed to increase our understanding of how GPs' attitudes influence their use of guideline...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-218
更新日期:2008-10-22 00:00:00
abstract:BACKGROUND:Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers' views and practices regarding the use of health systems evidence in health p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-200
更新日期:2012-07-16 00:00:00
abstract:BACKGROUND:The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation pro...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-2862-y
更新日期:2018-01-31 00:00:00
abstract:BACKGROUND:Crowding in hospital Emergency Departments (EDs) is a problem in several countries. We evaluated the number and characteristics of patients who make repeated visits to the EDs in Naples, Italy. METHODS:All patients (> or = 16 years) who presented to the EDs of three randomly selected non-academic acute care...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-97
更新日期:2008-05-02 00:00:00
abstract:BACKGROUND:In 2011, South Africa improved its ability to test for rifampicin-resistant TB (RR-TB) by introducing GeneXpert MTB/RIF. At the same time, the South African National TB program adopted a policy decentralized, outpatient treatment for drug resistant (DR-) TB. We aim to analyze the impact of these changes on l...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3762-x
更新日期:2018-12-17 00:00:00
abstract:BACKGROUND:People who use substances experience high levels of substance-related stigma, both within and outside of health care settings, which can prevent people from help-seeking and contribute further to health inequities. Recognizing and respecting how political, social, economic, and historical conditions influenc...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05915-x
更新日期:2020-11-23 00:00:00
abstract:BACKGROUND:Substantial government funding has been invested to support the training of General Practitioners (GPs) in Australia to serve rural communities. However, there is little data on the impact of this expanded training on smaller communities, particularly for smaller rural and more remote communities. Improved u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05684-7
更新日期:2020-08-31 00:00:00
abstract::Following publication of the original article [1], the author reported that their first names and last names were swapped. The original article has been corrected. ...
journal_title:BMC health services research
pub_type: 杂志文章,已发布勘误
doi:10.1186/s12913-018-3597-5
更新日期:2018-10-11 00:00:00
abstract:BACKGROUND:Measuring quality of care is essential to improve primary care. Quality of primary care for patients is usually assessed by patient satisfaction questionnaires. However, patients may not be able to judge quality of care without also reflecting their perception of the environment. We determined the effect tha...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-016-1647-4
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Four social audits in 1998, 2003, 2006 and 2009 identified actions that Nicaragua could take to reduce corruption and public perception in primary health care and other key services. METHODS:In a 71-cluster sample, weighted according to the 1995 census and stratified by geographic region and settlement type...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-S2-S3
更新日期:2011-12-21 00:00:00
abstract:BACKGROUND:Research shows us that auditory hallucinations or 'hearing voices' may be more common than previously thought, particularly in childhood and adolescents. Importantly, not all individuals are affected negatively by their voice hearing experiences, yet child and adolescent mental health services (CAMHS) have t...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-014-0527-z
更新日期:2014-11-05 00:00:00
abstract:BACKGROUND:Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patien...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-31
更新日期:2012-02-02 00:00:00
abstract:BACKGROUND:Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually va...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2628-y
更新日期:2017-10-02 00:00:00
abstract:BACKGROUND:The disparity between government health expenditures across regions is more severe in developing countries than it is in developed countries. The capitation subsidy method has been proven effective in developed countries in reducing this disparity, but it has not been tested in China, the world's largest dev...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1635-8
更新日期:2016-08-19 00:00:00
abstract:BACKGROUND:Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. Over the last 4 years, the neonatal unit of Dr. Ram Manohar Lohia Hospital in Delhi has innovated and...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4017-1
更新日期:2019-03-21 00:00:00
abstract:BACKGROUND:A research project, which aims to improve the situation of children of parents with a mental illness (COPMI) is currently underway in the Austrian region of Tyrol. The project aims to strengthen formal and informal support structures around the child, through enhancing their village of collaborative support....
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05184-8
更新日期:2020-04-19 00:00:00
abstract:BACKGROUND:Patients with knee osteoarthritis [OA] are commonly treated by physiotherapists in primary care. Measuring physiotherapy performance is important before developing strategies to improve quality. The purpose of this study was to measure physiotherapy performance in patients with knee OA by comparing clinical ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-145
更新日期:2008-07-08 00:00:00
abstract:BACKGROUND:Strategies adopted by health administrations and directed towards drug cost control in primary care (PC) can, according to earlier studies, generate tension between health administrators and healthcare professionals. This study collects and analyzes the opinions of general practitioners (GPs) regarding curre...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-209
更新日期:2009-11-18 00:00:00
abstract:BACKGROUND:We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan. METHODS:We derived from the National Health Insurance Research Database of Taiwan data pertaining to 3- to 12-year-old children for the period 2008-2010. Ba...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4193-z
更新日期:2019-06-04 00:00:00
abstract:BACKGROUND:The necessity of outpatient postpartum care has increased due to shorter hospital stays. In a health care system, where postpartum care after hospital discharge must be arranged by families themselves, this can be challenging for those experiencing psychosocial disadvantages. Therefore, we compared character...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05359-3
更新日期:2020-06-22 00:00:00
abstract:BACKGROUND:There is a growing number of adolescents and young adults living with HIV (YPLHIV) who require the transfer of care from pediatric/ adolescent clinics to adult Antiretroviral therapy (ART) clinics. A successful transition is critical for optimum health outcomes, yet facilities may lack infrastructure, human ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05701-9
更新日期:2020-09-05 00:00:00
abstract:BACKGROUND:Job satisfaction is an important predictor of an individual's intention to leave the workplace. It is increasingly being used to consider the retention of health workers in low-income countries. However, the determinants of job satisfaction vary in different contexts, and it is important to use measurement m...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-016-1558-4
更新日期:2016-07-27 00:00:00
abstract:BACKGROUND:As the proportion of older people increases, so will the consumption of health services. The aim of this study was to describe the contact characteristics among older people and to identify factors associated with the degree of urgency at the Norwegian out-of-hours (OOH) emergency primary health care service...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05219-0
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:A key constraint to saturating coverage of interventions for reducing the burden of childhood illnesses in Low and Middle Income Countries (LMIC) is the lack of human resources. Community health workers (CHW) are potentially important actors in bridging this gap. Evidence exists on effectiveness of CHW in ma...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-10-286
更新日期:2010-10-13 00:00:00
abstract:BACKGROUND:Maternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05747-9
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patien...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-26
更新日期:2011-02-04 00:00:00
abstract:BACKGROUND:Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of ca...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1396-4
更新日期:2016-05-24 00:00:00
abstract:BACKGROUND:P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public. The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-25
更新日期:2012-01-27 00:00:00
abstract:BACKGROUND:This study aims to identify the statistical software applications most commonly employed for data analysis in health services research (HSR) studies in the U.S. The study also examines the extent to which information describing the specific analytical software utilized is provided in published articles repor...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-252
更新日期:2011-10-06 00:00:00
abstract:BACKGROUND:QUALMAT project aimed at improving quality of maternal and newborn care in selected health care facilities in three African countries. An electronic clinical decision support system was implemented to support providers comply with established standards in antenatal and childbirth care. Given that health care...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2457-z
更新日期:2017-08-07 00:00:00