Hospitals in-patients

Sweden Co-payment, with maximum levels of sharing in health service bills, with the exception of hospital in-patient bills Per diem co-payment for in-patient services. Co-payment for therapeutic referrals Co-payment for the first drug prescribed, with significantly lower co-payments for subsequent prescriptions. RP system for medicines with generic equivalents... 

Dronedarone doubled the interval between episodes of atrial fibrillation recurrence in patients with paroxysmal or persistent atrial fibrillation. It is the first antiarrhythmic drug to demonstrate a reduction in mortality or hospitalization in patients with atrial fibrillation. 

All hospital in-patients will have a personal drug chart. This chart details all the medication that is supplied to a patient during their stay. Each hospital has its own style of drug chart, but they are similar in layout. 

Home care or hospital at home is defined as a service that provides active treatment by healthcare professionals in the patient s home of a condition that otherwise would require acute hospital in-patient care, always for a limited time period. ... 

Adgey AA, Oevlin JE, Webb SW, Mulholland HC. Initiation of ventricular fibrillation outside hospital in patients with acute ischaemic heart disease. Br Heart J 1982 47 55. 

Collet J-P, Shapiro S, Ernst P, Renzi P, Ducruet T, Robinson A, P-ISSCaR Group Effects of an Immunostimulating agent on acute exacerbations and hospitalizations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997 156 1719-1724. 

In addition to their benefits in patients with established heart failure, ACE inhibitors also are effective for prevention of heart failure. The SOLVD prevention trial showed that enalapril decreased the risk of hospitalization for worsening heart failure and reduced the composite end point of death and heart failure hospitalization in patients with asymptomatic left ventricular dysfunction. The development of diabetes mellitus, an important risk factor for cardiovascular disease that also increases morbidity and mortality in heart failure patients, is reduced by enalapril in patients with chronic heart failure. In a post-hoc analysis of the Heart Outcomes Prevention Evaluation (HOPE) trial, ramipril reduced the development of new-onset heart failure by nearly 25% in patients with normal EFs and no symptoms of heart failure. ... 

The development of ARF is one of the most serions events that can happen to a hospitalized patient, regardless of the reason for hospitalization. In patients admitted for cardiac surgery, the mortality risk is seven- to eightfold higher if the patient develops ARF." Patients who develop ARF following administration of intravenous radiocontrast dye and requiring dialysis have twice the mortality rate of similar patients receiving radiocontrast dye who do not experience an increase in their serum creatinine values."... 

The combined use of ACE inhibitors and ARBs in the treatment of heart failure offers the intriguing possibility of additive therapeutic benefit by virtue of distinctive modes of angiotensin antagonism. Some experts suggest that the addition of an AT blocker to a heart failure regimen that includes an ACE inhibitor can be considered in an effort to reduce hospitalizations. ATj antagonists also appear to reduce hospitalization in patients with diastolic heart failure. 

A study is reported of the sudden withdrawal of antiparkinsonian medication in a group of chronic mental hospital in-patients who were receiving a variety of major tranquillizers. Of the 32 patients who had completed the study at the time of the report, none had required urgent renewal of antiparkinsonian medication and only 4 had shown a return of symptoms which were thought to justify further medication within 3 weeks of drug withdrawal. Subsequent follow-up of the patients for a minimum of 133 days revealed no further patients requiring antiparkinsonian medication (30 ). 

Intrinsic asthma, also called idiopathic asthma, usually develops in adulthood. In intrinsic asthma allergic factors are not demonstrable. Episodes of intrinsic asthma may be triggered by a variety of stimuli, eg, emotional state, exposure to cold air, or inert dusts. Both intrinsic and extrinsic asthmatics can be prone to exercise-induced attacks. Individuals who experience a combination of extrinsic and intrinsic asthmatic reactions have mixed asthma. Status asthmaticus refers to an especially acute life-threatening asthma attack which is resistant to normal treatments and which may require hospitalization in order to stabilize the patient. 

Clinically, GM-CSF or G-CSF have been used to accelerate recovery after chemotherapy and total body or extended field irradiation, situations that cause neutropenia and decreased platelets, and possibly lead to fatal septic infection or diffuse hemorrhage, respectively. G-CSF and GM-CSF reproducibly decrease the period of granulocytopenia, the number of infectious episodes, and the length of hospitalization in such patients (152), although it is not clear that dose escalation of the cytotoxic agent and increased cure rate can be rehably achieved. One aspect of the effects of G-CSF and GM-CSF is that these agents can activate mature cells to function more efficiently. This may, however, also lead to the production of cytokines, such as TNF- a, that have some toxic side effects. In general, both cytokines are reasonably well tolerated. The side effect profile of G-CSF is more favorable than that of GM-CSF. Medullary bone pain is the only common toxicity. 

One test, made at the Radcliffe Infirmary in Oxford, " identified two areas of the UK in which the incidence of stomach cancer was particularly high and two in which it was particularly low. People attending hospitals in these areas as visitors rather than patients were asked to provide samples of saliva. The hypothesis suggested that samples from the high-risk areas should contain more nitrite and nitrate than those from the low-risk areas, but this was not so. The samples from the low-risk populations had nitrate concentrations 50% greater than those from the high-risk areas. 

In 1844, John Gorrie, Florida, described in the Apalachicola Commercial Advertiser his new machine for making ice. The delays in ice delivei y from the Boston lakes forced Gorrie to build his ice machine so that his hospital fever patients could be assured that ice would always be available. 

Busto UE, Romach MK, Sellers EM Multiple drug use and psychiatric comorbidity in patients admitted to the hospital with severe benzodiazepine dependence. J Clin Psychopharmacol 16 51-57, 1996... 

Schmidt LG, Grohmann R, Mttller-Oerlinghausen B, et al Prevalence of benzodiazepine abuse and dependence in psychiatric in-patients with different nosology an assessment of hospital-hased drug surveillance data. Br J Psychiatry 154 839— 843, 1989... 

Borleffs JC, Jager JC, Marinus JJ (1990) Hospitalcost for patient with HIV infection in a university hospital in The Netherlands, Health Pohcy 16 43-54 Bozette S, Joyce G, McCaffrey DE et al (2001) Expenditures for the care of HIV-infected patients in the era of highly active antiretroviral therapy, N Engl J Med 344 817-823 Breidert C (2006) Estimation of wilhngness-to-pay theory, measurement, application, Deutscher Universitats-Verlag, Wiesbaden... 

Uncontrolled mirror-image studies (Table 2.4) largely support these findings. Of seven published studies, five suggested that the use of risperidone reduced hospital bed-stay and some calculated savings in health-care expenditure resulting from this. Conversely, Viale et al (1997) calculated that in-patient savings were offset by increases in community services costs, and Hammond et al (1999) estimated a substantial overall cost increase for community patients switched to risperidone for at least 3 months. 

Reid WH, Mason M (1998). Psychiatric hospital utilization in patients treated with clozapine for up to 4.5 years in a State mental health care system. J Clin Psychiatry 189—94. 

J> < 0.01) and also more cost-effective, mainly because of the higher number of hospital admissions in the TCA group. This study had limitations in that patients prescribed TCAs were not randomly selected, a quarter of the patients in the TCA group failed to receive an effective dose, and objective measurements of outcome were not employed. Multivariate analysis suggested that despite the methodological limitations of the study, the differences in cost were due to the treatment received, and not to differences in patient characteristics. This study provides the first, albeit tentative, evidence of superior cost-effectiveness for SSRIs over TCAs in the UK. 

Out-patient treatment is substantially cheaper than in-patient management and is generally as effective (Lowman, 1991). A French study on patients with generalized anxiety disorder estimated costs per patient over 3 months to he US 423 for hospitalization, 335 for out-patient services and 43 for medications (Souetre et al, 1994). Comorbid conditions (mostly alcoholism and depression) doubled these direct health-care costs. Over three-quarters of all patients were taking anxiolytic medication. 

The sources of direct costs include the costs of hospitalization in psychiatric hospitals or general medical wards, and the costs of medication and laboratory tests. Out-patient... 

Babson proposed a-naphthyl phosphate as an essentially specific substrate for the activity of prostatic acid phosphatase in serum (104). However Marshall, Price, and Amador found that this substrate is not specific for the prostatic enzyme because urine of human females contain 50 times more acid a-naphthyl phosphatase than male serum and 50% as much activity as male urine. Platelets have significant activity and the serum activity can increase to abnormal values following clotting. These workers also observed elevated activities in females with skeletal metastases of the breast. In 50 hospitalized male patients who had no evidence of prostatic cancer and 25 hospitalized female patients, the incidence of false positive results was 12%, a magnitude sufficient to preclude meaningful clinical interpretation (105). 

---