The impact of quality of life in the formation of the rehabilitation cost of trauma patients after ICU stay

Introduction: Road accidents are a national and social problem that needs immediate attention. The accident affects areas of the trauma patient every day, such as his physical functioning and his mental health, thus changes his Quality of Life (QOL). Objectives: The aim of this study was to assess the changes in QOL and the rehabilitation cost of the trauma patient from traffic accidents, after discharge from the hospital. It studied how the QOL of trauma patients during 2 years after discharge from the hospital changed, and how this change affects the configuration of the rehabilitation cost. Methods: To evaluate the health status of trauma patients, the EQ-5D questionnaire was used, which is a general and reliable tool for measuring QOL. Patients or their caregivers were asked to respond to the questionnaire EQ-5D at 6, 12, 18 and 24 months after leaving the hospital. In order to evaluate the rehabilitation cost at each measurement, variables of direct and indirect costs were summed. Results: The studied population consisted of 85 patients with mean age 38.8 ± 18.1 years. The 80% (n = 68) are male and 20% (n = 17) female. The 67.1% (n = 57) were working, while 33% (n = 28) had monthly family income >1500€. The 25.9% (n = 22) had received higher education, while 87.1% (n=74) were living together with others at home. Age, marital status, living with other people at home, monthly family income and the existence of traumatic brain injury, are factors that affect the QOL of trauma patients, after discharge from the hospital. The increased monthly family income and the absence of traumatic brain injury are associated with increase in the EQ VAS. The frequency of serious mobility problems, self-service, daily activities, pain/discomfort and anxiety/depression decreased over time. The marital status, the presence of children, the monthly family income, the existence of traumatic brain injury and the index EQ VAS are factors that affect the rehabilitation cost. Conclusions: Up to 2 years after discharge from the hospital, the QOL of the trauma patients continues to improve, without being stabilized or even approaching the levels of QOL before the accident. The rehabilitation cost required for the trauma patient is high, but with the passage of time it is significantly reduced.Εισαγωγή: Τα τροχαία ατυχήματα αποτελούν εθνικό και κοινωνικό πρόβλημα που χρειάζεται άμεση αντιμετώπιση. Λόγω του ατυχήματος επηρεάζονται τομείς της καθημερινότητας του τραυματία, όπως η σωματική του λειτουργία και η ψυχική του υγεία, με αποτέλεσμα να μεταβάλλεται και η ποιότητα της ζωής του. Σκοπός: Σκοπός της παρούσης μελέτης ήταν να εκτιμηθεί η μεταβολή της ποιότητας ζωής και του κόστους αποκατάστασης των τραυματιών από τροχαία ατυχήματα μετά την έξοδό τους από το νοσοκομείο. Μελετήθηκε πώς μεταβάλλεται η ποιότητα ζωής των ασθενών κατά τη διάρκεια 2 ετών μετά την έξοδο από το νοσοκομείο και πως αυτή η μεταβολή επηρεάζει τη διαμόρφωση του κόστους αποκατάστασης. Υλικό-Μέθοδος: Η αξιολόγηση της κατάστασης υγείας των ασθενών έγινε με το ερωτηματολόγιο EQ-5D, το οποίο αποτελεί ένα γενικό και αξιόπιστο εργαλείο μέτρησης της ποιότητας ζωής. Οι ασθενείς ή οι φροντιστές τους κλήθηκαν να απαντήσουν στο ερωτηματολόγιο EQ-5D σε 6, 12 ,18 και 24 μήνες μετά την έξοδό τους από το νοσοκομείο, ενώ για τον υπολογισμό του κόστους αποκατάστασης, σε κάθε στιγμή μέτρησης, αθροίστηκαν μεταβλητές άμεσου ή έμμεσου κόστους. Αποτελέσματα: Ο μελετώμενος πληθυσμός αποτελείτο από 85 ασθενείς με μέση ηλικία 38.8±18.1 έτη. Το 80% (n=68) είναι άντρες και το 20% (n=17) γυναίκες. Το 67.1% (n=57) ήταν εργαζόμενοι, ενώ το 33% (n=28) είχαν μηνιαίο οικογενειακό εισόδημα >1500 ευρώ. Το 25.9% (n=22) είχαν λάβει ανώτερη μόρφωση, ενώ το 87.1% (n=74) συμβίωναν με άλλους στο σπίτι. Η ηλικία, η οικογενειακή κατάσταση, η συμβίωση με άλλα άτομα στο σπίτι, το μηνιαίο οικογενειακό εισόδημα και η ύπαρξη κρανιοεγκεφαλικής κάκωσης, αποτελούν παράγοντες που επηρεάζουν την ποιότητα ζωής των τραυματιών, μετά την έξοδό τους από το νοσοκομείο. Το αυξημένο μηνιαίο οικογενειακό εισόδημα και η απουσία κρανιοεγκεφαλικής κάκωσης σχετίζονταν με αύξηση του δείκτη EQ VAS. Η συχνότητα των σοβαρών προβλημάτων κινητικότητας, αυτοεξυπηρέτησης, καθημερινών δραστηριοτήτων, πόνου/δυσφορίας και άγχους/κατάθλιψης μειωνόταν με το πέρασμα του χρόνου. Το κόστος αποκατάστασης ήταν αρχικά υψηλό, αλλά μειωνόταν όσο περνούσε ο χρόνος με τη μεγαλύτερη μείωση να καταγράφεται στους άνδρες. Η οικογενειακή κατάσταση, η ύπαρξη παιδιών, το μηνιαίο οικογενειακό εισόδημα, η ύπαρξη κρανιοεγκεφαλικής κάκωσης και ο δείκτης EQ VAS αποτελούν παράγοντες που επηρεάζουν το κόστος αποκατάστασης. Συμπεράσματα: Με το πέρασμα του χρόνου, έως και 2 χρόνια μετά την έξοδο από το νοσοκομείο, η ποιότητα ζωής των τραυματιών βελτιώνεται συνεχώς, υπολείπεται όμως σαφώς σε σχέση με το επίπεδο πριν το ατύχημα. Το κόστος που απαιτείται για την αποκατάσταση των τραυματιών είναι υψηλό, αλλά μειώνεται αισθητά με το πέρασμα του χρόνου

Health related smartphone applications: a literature review

The rapid evolution of technology, has offered access to a variety of applications and technologies to healthcare professionals. New operating systems developed in the field of mobile devices revolutionized the way in which they are used. One of the main features offered by advanced software of a smartphone is the user’s access to a wealth of new, impressive applications across several operating systems for smartphones. The health related applications provided through smartphones, promote more active involvement of patients and healthcare professionals to provided care and are a new tool for improving health. The purpose of this abstract paper or article was to refer to applications currently used in the health sector, indicating specific capabilities they offer through review of electronic literature, focusing on scientific articles published in databases (PubMed, Scopus, etc.) referring to the potentials they offer. It seems that several health related applications have been developed, that can be classified into two main categories. One category comprises applications that are informative, i.e. provide information to the user about health issues, allowing a person to read, gather resources to make decisions, but also to introduce its own data. These applications are mostly used by health care professionals. The second major category of applications refers to those related to help with the diagnosis, treatment and decision-making on various health related issues and in some cases take the form of consultancy, substituting the health care professional. As technology advances, the development of new health related applications is expected, specialized, with new features. Finally, the use of such applications by health care professionals is essential

The importance of vital signs in the triage of injured patients

Background: Vital signs are indicators of a patient presenting to an emergency department (ED). Abnormal vital signs have been associated with an increased likelihood of admission to the hospital. Physicians have long recognized the importance of vital sign observations, and vital sign measurement has proven to be useful for detecting serious diseases during triage in EDs. Methods: The study included all patients with injuries presented to the ED of a general hospital in Greece. For these patients, sex, age, cause of injury, vital signs at the time of admission to ED (systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, and oxygen saturation), and the course of the patient (admission to hospital, discharge from ED) were recorded. The statistical analysis of data was done by the statistical package SPSS 15. It was performed using univariate regression and Spearman correlation coefficient. Results: A total of 2703 patients were registered, of which 71% were men aged 31.9 ± 0.38 years and 29% were women aged 45.7 ± 0.79 years. The main causes of injury were car accident, motor accident, pedestrian accident, fall from a height, and assault. By logistic regression, the correlation was found between mean blood pressure, systolic blood pressure, oxygen saturation, and hospitalization or discharge of the patients. Conclusions: The measurement of mean blood pressure, systolic blood pressure, and oxygen saturation of the injured patients during the admission to the ED can predict the disease course of patients. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Data on patient’s satisfaction from an emergency department: Developing strategies with the Multicriteria Satisfaction Analysis

This article presents data that examine the patient׳s satisfaction from the services of an Emergency Department in Greece during the economic crisis. 490 questionnaires have been collected for the assessment of patient satisfaction by taking into account criteria like cleanliness, waiting room, access to the hospital, courtesy, friendliness and professional attitude of the emergency department staff, service processes and waiting times. In order to examine the satisfaction levels of the patients and moreover to design possible strategic actions we use the MUSA method. Keywords: Emergency department, Patient satisfaction, Decision making, MUSA (Multicriteria Satisfaction Analysis