Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients

Molecular evidence indicates that P. jirovecii may be nosocomially transmitted to severely immunosuppressed patients

Développement d'un indicateur pour évaluer le niveau de référence et de recours des activités hospitalières en soins de courte durée

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Real life management of patients hospitalized with multiple myeloma in France.

Patients with multiple myeloma included in prospective clinical trials are highly selected and therefore are expected not to be representative of the entire patient population. Additionally recommendations based on literature data and randomized trials are not systematically implemented in all patients. We sought to determine how patients hospitalized with a diagnosis of multiple myeloma are currently treated in France.We performed a nation-wide search using the Programme de Médicalisation des Systèmes d'Information (PMSI) database which includes anonymous data for all patients hospitalized in France. We identified newly diagnosed cases in 2012 and analyzed the number and duration of hospital stays, coexisting conditions and treatment modalities with data available until the end of 2015. A diagnosis of multiple myeloma was determined for the first time during a hospitalization in France in 2012 in 6,282 patients (3,234 males and 3,048 females). The median age at diagnosis was 74 years (72 in males and 76 in females). A majority (55.3%) of patients were diagnosed and treated in a single heath center, including 37% in a university hospital and 52% in a non-university public hospital. Comorbidities potentially impacting on myeloma treatment were present in 57.5% of patients at diagnosis, and 15% had an associated diagnosis of another neoplasia. Intensive therapies with stem cell transplants were performed in 1033 patients (16% of total), the majority of which were aged less than 65 (881 patients, 85.3%). Stem cell transplants were performed more frequently in males while the distance between the site of residence and the transplant center had no impact on likelihood of receiving a transplant. Only 60% of patients less than 65 years old who were treated for their disease underwent intensification with stem cell transplant within the 4-year follow-up period.A large majority of patients hospitalized with a diagnosis of multiple myeloma are elderly, in particular females, and not eligible for transplants. Among the patients aged less than 65 and receiving therapy for their disease, 40% do not undergo transplants. These data emphasize the need for alternative therapies

Elderly patients hospitalized in the ICU in France: a population-based study using secondary data from the national hospital discharge database

Rationale, aims and objectives: In the global context of population ageing, understanding and monitoring intensive care use by the elderly is a strategic issue. National-level data are needed to overcome sampling biases that often limit epidemiologic studies of the critically ill elderly. The objective of this study was to describe intensive care use for hospitalized elderly patients using secondary data from the French national hospital discharge database. Method: Structured assessment of the national database coverage and accuracy; cross- sectional analysis of hospitalizations including at least one admission in an intensive care unit (ICU) for patients aged ≥ 80 years from 1 January to 31 December 2009. Results: In 2009, people aged ≥ 80 years accounted for 5.4% of the population but 15.3% of the 215 210 adult hospitalizations involving intensive care in France. In this elderly group, the mean age was 84.0 (± 3.56) years, and 51.6% were male. In-hospital mortality was 33.9%. The median time spent in the ICU was 3 [interquartile range (IQR), 2–8] days, the median time spent in hospital was 14 (IQR, 8–24) days and 9% of hospitalizations ended by the patient’s death involved intensive care. A surgical procedure was included in 43% of hospitalizations. Medical and surgical diagnosis-related group hospitalizations were characterized by significant differences in volume, mortality, ICU days and costs. Conclusions: There was marked clinical heterogeneity in the population of elderly patients hospitalized in the ICU. These data provide baseline information and prompt further studies comparing intensive care utilization across age groups, between countries and over time

Geographical distribution of stem cell transplants in France in patients newly diagnosed with myeloma in 2012.

<p>Fig 2A. Geographical distribution of stem cell transplants performed in patients less than 65 years old at diagnosis during their follow-up. Stem cell transplants were performed in 39 administrative areas or “Départements”. Fig 2B. Probability of proceeding to a stem cell transplant according to place of residence in patients less than 65 years old and having received therapy in the hospital for their disease.</p

Associated diagnoses of neoplasia in patients diagnosed with myeloma in 2012.

<p>Associated diagnoses of neoplasia in patients diagnosed with myeloma in 2012.</p

National cost study versus hospital cost accounting for organ recovery cost assessment in a French hospital group

Abstract Background The choice of cost data sources is crucial, because it influences the results of cost studies, decisions of hospital managers and ultimately national directives of policy makers. The main objective of this study was to compare a hospital cost accounting system in a French hospital group and the national cost study (ENC) considering the cost of organ recovery procedures. The secondary objective was to compare these approaches to the weighting method used in the ENC to assess organ recovery costs. Methods The resources consumed during the hospital stay and organ recovery procedure were identified and quantified retrospectively from hospital discharge abstracts and the national discharge abstract database. Identified items were valued using hospital cost accounting, followed by 2010–2011 ENC data, and then weighted using 2010–2011 ENC data. A Kruskal–Wallis test was used to determine whether at least two of the cost databases provided different results. Then, a Mann–Whitney test was used to compare the three cost databases. Results The costs assessed using hospital cost accounting differed significantly from those obtained using the ENC data (Mann–Whitney; P-value < 0.001). In the ENC, the mean costs for hospital stays and organ recovery procedures were determined to be €4961 (SD €7295) and €862 (SD €887), respectively, versus €12,074 (SD €6956) and €4311 (SD €1738) for the hospital cost accounting assessment. The use of a weighted methodology reduced the differences observed between these two data sources. Conclusions Readers, hospital managers and decision makers must know the strengths and weaknesses of each database to interpret the results in an informed context

Worrying decrease in hospital admissions for myocardial infarction during the COVID-19 pandemic

International audienc

Additional file 1: of Mixed method versus full top-down microcosting for organ recovery cost assessment in a French hospital group

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