Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: The quality of care delivered and clinical outcomes of care are of paramount importance. Wide variations in the outcome of emergency care have been suggested, but the scale of variation, and the way in which outcomes are inter-related are poorly defined and are critical to understand how best to improve services. This study quantifies the scale of variation in three outcomes for a contemporary cohort of patients undergoing emergency medical and surgical admissions. The way in which the outcomes of different diagnoses relate to each other is investigated.
Methods: A retrospective study using the English Hospital Episode Statistics 2005-2010 with one-year follow-up for all patients with one of 20 of the commonest and highest-risk emergency medical or surgical conditions. The primary outcome was in-hospital all-cause risk-standardised mortality rate (in-RSMR). Secondary outcomes were 1-year all-cause risk-standardised mortality rate (1 yr-RSMR) and 28-day all-cause emergency readmission rate (RSRR).
Results: 2,406,709 adult patients underwent emergency medical or surgical admissions in the groups of interest. Clinically and statistically significant variations in outcome were observed between providers for all three outcomes (p < 0.001). For some diagnoses including heart failure, acute myocardial infarction, stroke and fractured neck of femur, more than 20% of hospitals lay above the upper 95% control limit and were statistical outliers. The risk-standardised outcomes within a given hospital for an individual diagnostic group were significantly associated with the aggregated outcome of the other clinical groups.
Conclusions: Hospital-level risk-standardised outcomes for emergency admissions across a range of specialties vary considerably and cross traditional speciality boundaries. This suggests that global institutional infra-structure and processes of care influence outcomes. The implications are far reaching, both in terms of investigating performance at individual hospitals and in understanding how hospitals can learn from the best performers to improve outcomes.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4099147 | PMC |
| http://dx.doi.org/10.1186/1472-6963-14-270 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Inhibition of Interleukin-1 Receptor-Associated Kinase-1 by Pacritinib Is a Therapeutic Strategy to Overcome Melanoma Resistance.
J Environ Pathol Toxicol Oncol
January 2025
Department of Pharmacy, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China.
Despite advancements in systemic therapy, the mortality rate for patients with metastatic melanoma remains around 70%, underscoring the imperative for alternative treatment strategies. Through the establishment of a chemoresistant melanoma model and a subsequent drug investigation, we have identified pacritinib, a medication designed for treating myelofibrosis and severe thrombocytopenia, as a potential candidate to overcome resistance to melanoma therapy. Our research reveals that pacritinib, administered at clinically achievable concentrations, effectively targets dacarbazine-resistant melanoma cells by suppressing IRAK1 rather than JAK2.
View Article and Find Full Text PDFDesign, Synthesis and Biological Evaluation of 7-(1-Methyl-1-indole-3-yl)-5-pyrrolo[2,3-]pyrazine Derivatives as Novel Covalent pan-FGFR Inhibitors to Overcome Clinical Resistance.
J Med Chem
September 2025
State Key Laboratory of Bioactive Molecules and Druggability Assessment, Guangdong Basic Research Center of Excellence for Natural Bioactive Molecules and Discovery of Innovative Drugs, International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Discovery o
Aberrant activation of fibroblast growth factor receptors (FGFRs) plays a critical role in tumorigenesis across multiple cancer types, driving the development of various FGFR inhibitors. Despite clinical advances, therapeutic efficacy remains limited by the emergence of drug resistance, primarily mediated by gatekeeper mutations in FGFRs. To overcome this challenge, we designed and synthesized a novel series of 7-(1-methyl-1-indole-3-yl)-5-pyrrolo[2,3-]pyrazine derivatives as covalent pan-FGFR inhibitors targeting both wild-type and gatekeeper mutants.
View Article and Find Full Text PDFNeed Analysis of Clinician-Oriented Integrated Precision Oncology Decision Support Tools: Qualitative Descriptive Study.
JMIR Hum Factors
September 2025
College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China.
Background: The rapid advancement of next-generation sequencing has significantly expanded the landscape of precision medicine. However, health care professionals face increasing challenges in keeping pace with the growing body of oncological knowledge and integrating it effectively into clinical workflows. Precision oncology decision support (PODS) tools aim to assist clinicians in navigating this complexity, yet their current functionalities only partially address clinical needs.
View Article and Find Full Text PDFEnhancing Team Strategies and Tools to Enhance Performance and Patient Safety Performance Through Medical Movies, Massive Open Online Courses, and 3D Virtual Simulation-Based Interprofessional Education: Mixed Methods Double-Blind Quasi-Experimental Study.
J Med Internet Res
September 2025
Chulalongkorn University, Bangkok, Thailand.
Background: The interprofessional educational curriculum for patient and personnel safety is of critical importance, especially in the context of the COVID-19 pandemic, to prepare junior multiprofessional teams for emergency settings.
Objective: This study aimed to evaluate the effectiveness of an innovative interprofessional educational curriculum that integrated medical movies, massive open online courses (MOOCs), and 3D computer-based or virtual reality (VR) simulation-based interprofessional education (SimBIE) with team co-debriefing to enhance interprofessional collaboration and team performance using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). This study addressed 3 key questions.
Personalized Interactive Music Systems for Physical Activity and Exercise: Exploratory Systematic Review and Meta-Analysis.
JMIR Hum Factors
September 2025
Department of Music, Arts and Culture Studies, Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän yliopisto, Jyväskylä, 40014, Finland, 358 6643034.
Background: Personalized Interactive Music Systems (PIMSs) are emerging as promising devices for enhancing physical activity and exercise outcomes. By leveraging real-time data and adaptive technologies, PIMSs align musical features, such as tempo and genre, with users' physical activity patterns, including frequency and intensity, enhancing their overall experience.
Objective: This exploratory systematic review and meta-analysis evaluates the effectiveness of PIMSs across physical, psychophysical, and affective domains.