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Births in Norwegian midwife-led birth units 2008-10; a population-based study.

https://arctichealth.org/en/permalink/ahliterature296870
Source
Tidsskr Nor Laegeforen. 2018 06 12; 138(10):
Publication Type
Comparative Study
Journal Article
Date
06-12-2018
Author
Pål Øian
Olaug Margrete Askeland
Inger Elise Engelund
Brit Roland
Marta Ebbing
Source
Tidsskr Nor Laegeforen. 2018 06 12; 138(10):
Date
06-12-2018
Language
English
Norwegian
Publication Type
Comparative Study
Journal Article
Keywords
Apgar score
Birthing Centers - statistics & numerical data
Delivery Rooms - statistics & numerical data
Delivery, obstetric - statistics & numerical data
Female
Humans
Midwifery
Norway
Parity
Patient Transfer - statistics & numerical data
Posture
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Outcome - epidemiology
Registries
Risk
Abstract
Fødestuene utgjør en del av en differensiert og desentralisert fødselsomsorg i Norge. Hensikten med studien var å undersøke forekomst og karakteristika ved planlagte og ikke-planlagte fødestuefødsler og årsaker til overflytting samt resultater for mor og barn.
I perioden 2008-10 ble et tilleggsskjema til rutinemeldingen til Medisinsk fødselsregister fortløpende utfylt av jordmor for 2 514 av i alt 2 556 (98,4 %) fødestuefødsler og for 220 fødsler som var planlagt i fødestue, men der fødselen foregikk andre steder. Data fra tilleggsskjema ble så koblet med rutinedata i Medisinsk fødselsregister og resultater fra fødestuefødsler sammenlignet med resultater fra en lavrisikofødepopulasjon i sykehus.
Av de 2 514 fødestuefødslene var 2 320 (92,3 %) planlagt å foregå der, mens 194 (7,7 %) ikke var det. Ved planlagt fødestuefødsel ble totalt 6,9 % overflyttet til sykehus under fødsel, hvorav 19,5 % blant førstegangsfødende. Det var 0,4 % operative vaginale fødsler ved vanlige fødestuer, 3,5 % ved forsterkede fødestuer og 12,7 % ved fødsler overflyttet fra fødestue til sykehus. Blant barn født i fødestue hadde 0,6 % apgarskår
Notes
CommentIn: Tidsskr Nor Laegeforen. 2018 Jun 12;138(10): PMID 29893095
PubMed ID
29893109 View in PubMed
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Births in two different delivery units in the same clinic--a prospective study of healthy primiparous women.

https://arctichealth.org/en/permalink/ahliterature150152
Source
BMC Pregnancy Childbirth. 2009;9:25
Publication Type
Article
Date
2009
Author
Britt Ingeborg Eide
Anne Britt Vika Nilsen
Svein Rasmussen
Author Affiliation
Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway. britt.ingeborg.eide@helse-bergen.no
Source
BMC Pregnancy Childbirth. 2009;9:25
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Cesarean Section - utilization
Delivery Rooms
Delivery, Obstetric - methods
Episiotomy - utilization
Female
Humans
Labor Pain - therapy
Midwifery
Norway
Obstetric Labor Complications - therapy
Parity
Patient Transfer - statistics & numerical data
Pregnancy
Prospective Studies
Abstract
Earlier studies indicate that midwife-led birth settings are associated with modest benefits, including reduced medical interventions and increased maternal satisfaction. The generalizability of these studies to birth settings with low intervention rates, like those generally found in Norway, is not obvious. The aim of the present study was to compare intervention rates associated with labour in low-risk women who begin their labour in a midwife-led unit and a conventional care unit.
Eligible participants were low-risk primiparas who met the criteria for delivery in the midwife-led ward regardless of which cohort they were allocated to. The two wards are localised at the same floor. Women in both cohorts received the same standardized public antenatal care by general medical practitioners and midwifes who were not involved in the delivery. After admission of a woman to the midwife-led ward, the next woman who met the inclusion criteria, but preferred delivery at the conventional delivery ward, was allocated to the conventional delivery ward cohort. Among the 252 women in the midwife-led ward cohort, 74 (29%) women were transferred to the conventional delivery ward during labour.
Emergency caesarean and instrumental delivery rates in women who were admitted to the midwife-led and conventional birth wards were statistically non-different, but more women admitted to the conventional birth ward had episiotomy. More women in the conventional delivery ward received epidural analgesia, pudental nerve block and nitrous oxide, while more women in the midwife-led ward received opiates and non-pharmacological pain relief.
We did not find evidence that starting delivery in the midwife-led setting offers the advantage of lower operative delivery rates. However, epidural analgesia, pudental nerve block and episiotomies were less often while non-pharmacological pain relief was often used in the midwife-led ward.
Notes
Cites: Aust N Z J Obstet Gynaecol. 2000 Aug;40(3):268-7411065032
Cites: Br J Obstet Gynaecol. 1986 Feb;93(2):182-73511958
Cites: Acta Obstet Gynecol Scand. 2002 Aug;81(8):731-712174157
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Cites: Cochrane Database Syst Rev. 2005;(1):CD00001215674867
Cites: Best Pract Res Clin Obstet Gynaecol. 2005 Feb;19(1):103-1515749069
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Cites: Acta Obstet Gynecol Scand. 2008;87(5):564-7318446541
Cites: Cochrane Database Syst Rev. 2008;(4):CD00466718843666
Cites: BMJ. 2002 Apr 13;324(7342):892-511950741
PubMed ID
19545412 View in PubMed
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Improving pancreas surgery over time: Performance factors related to transition of care and patient volume.

https://arctichealth.org/en/permalink/ahliterature279603
Source
Int J Surg. 2016 Aug;32:116-22
Publication Type
Article
Date
Aug-2016
Author
Jon Arne Søreide
Oddvar M Sandvik
Kjetil Søreide
Source
Int J Surg. 2016 Aug;32:116-22
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Length of Stay
Male
Middle Aged
Norway
Outcome Assessment (Health Care)
Pancreatectomy - standards - statistics & numerical data
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy - standards - statistics & numerical data
Patient Transfer - statistics & numerical data
Reoperation
Young Adult
Abstract
Pancreas surgery has evolved with better diagnostic imaging, changing indications, and improved patient selection. Outside high-volume tertiary centers, the documented effect of evolution in care and volumes are limited. Thus, we aimed to review indications and outcomes in pancreas surgery during the transition from community-based hospital to a university hospital.
All pancreatic surgeries performed between 1986 and 2012 within a well-defined Norwegian population were identified from the hospital's database. Indications and postoperative outcomes, including mortality, were investigated.
Of the 219 included patients (54% males; median age, 64 years), 150 (69%) underwent pancreatoduodenectomy; 55 (25%), distal resection; and 5 (2%), enucleation. The annual number of operations increased during the study period (from 20/yr). Most patients (169; 77%) underwent surgery for suspected malignancy. The 30-day mortality decreased significantly over time among patients treated for pancreatic cancer (from 16.1% to 3.5%; p = 0.012). Over time, significant reductions in median hospitalization time (19 versus 12 days; p 
PubMed ID
27373194 View in PubMed
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Is the general practitioner hospital a potential "patient trap"? A panel study of emergency cases transferred to higher level hospitals.

https://arctichealth.org/en/permalink/ahliterature33770
Source
Scand J Prim Health Care. 1998 Jun;16(2):76-80
Publication Type
Article
Date
Jun-1998
Author
I. Aaraas
H. Melbye
B O Eriksen
O. Irtun
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1998 Jun;16(2):76-80
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data
Female
Hospitals, General - statistics & numerical data
Humans
Iatrogenic Disease
Infant
Male
Middle Aged
Norway
Outcome and Process Assessment (Health Care)
Patient Transfer - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk
Abstract
OBJECTIVES: 1. To find out whether a stay in local general practitioner hospitals (GP hospitals) prior to an emergency admission to higher level hospitals aggravated or prolonged the course of the disease, or contributed to permanent health loss for some patients. 2. To detect cases where a transitory stay in a GP hospital might have been favourable. DESIGN: A retrospective expert panel study based on records from GP hospitals and general hospitals. The included patients had participated in a previous prospective study of consecutive admissions to GP hospitals during 8 weeks. SETTING: Fifteen out of 16 GP hospitals in Finnmark county, Norway. SUBJECTS: Seventy-three patients transferred to higher level hospitals from a total of 395 admitted to GP hospitals. MAIN OUTCOME MEASURES: Three outcome categories were considered for each patient: "possible permanent health loss", "possible significantly prolonged or aggravated disease course", and "possible favourable effect on the disease course". RESULTS: There was agreement about the possibility of negative effects in two patients (2.7%), while a possible favourable influence was ascribed to six cases (8.2%). CONCLUSION: Negative health effects due to transitory stays in GP hospitals are uncommon and moderate, and balanced by benefits, particularly with regard to early access to life saving treatment for critically ill patients.
PubMed ID
9689683 View in PubMed
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Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature133019
Source
BJOG. 2011 Oct;118(11):1357-64
Publication Type
Article
Date
Oct-2011
Author
S. Bernitz
R. Rolland
E. Blix
M. Jacobsen
K. Sjøborg
P. Øian
Author Affiliation
Department of Obstetrics and Gynaecology at Østfold Hospital Trust, Fredrikstad, Norway. stiber@so-hf.no
Source
BJOG. 2011 Oct;118(11):1357-64
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Acupuncture Analgesia - statistics & numerical data
Adult
Anal Canal - injuries
Analgesia, Epidural - statistics & numerical data
Apgar score
Cesarean Section - statistics & numerical data
Female
Humans
Midwifery - statistics & numerical data
Norway
Obstetrics and Gynecology Department, Hospital - statistics & numerical data
Patient Transfer - statistics & numerical data
Postpartum Hemorrhage - epidemiology
Pregnancy
Risk factors
Vacuum Extraction, Obstetrical - statistics & numerical data
Young Adult
Abstract
To investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within the same hospital.
Randomised controlled trial.
Department of Obstetrics and Gynaecology, Østfold Hospital Trust, Tromsø, Norway.
A total of 1111 women assessed to be at low risk at onset of spontaneous labour.
Randomisation into one of three birth units: the special unit; the normal unit; or the midwife-led unit.
Total operative delivery rate, augmentation, pain relief, postpartum haemorrhage, sphincter injuries and intrapartum transfer, Apgar score
Notes
Cites: Obstet Gynecol. 1992 Aug;80(2):161-51635724
Cites: Acta Obstet Gynecol Scand. 2010 Jun;89(6):813-620397761
Cites: Aust N Z J Obstet Gynaecol. 2000 Aug;40(3):268-7411065032
Cites: Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-1211207485
Cites: BMJ. 2002 Apr 13;324(7342):892-511950741
Cites: Acta Obstet Gynecol Scand. 2002 Aug;81(8):731-712174157
Cites: Am J Public Health. 2003 Jun;93(6):999-100612773368
Cites: BJOG. 2004 Jan;111(1):71-814687055
Cites: Midwifery. 2004 Mar;20(1):61-7115020028
Cites: Birth. 2004 Sep;31(3):222-915330886
Cites: Scand J Clin Lab Invest. 1971 May;27(3):239-455581186
Cites: Birth. 1990 Dec;17(4):2342285446
Cites: J Nurse Midwifery. 1991 Jul-Aug;36(4):215-201895169
Cites: Cochrane Database Syst Rev. 2010;(9):CD00001220824824
Cites: Br J Obstet Gynaecol. 1993 Apr;100(4):316-238494832
Cites: BMJ. 1994 Nov 26;309(6966):1400-47819846
Cites: Birth. 1996 Sep;23(3):128-358924098
Cites: Birth. 1997 Mar;24(1):17-269271963
Cites: J Obstet Gynaecol Res. 1999 Apr;25(2):107-1210379125
Cites: Birth. 2005 Mar;32(1):67-815725207
Cites: Tidsskr Nor Laegeforen. 2005 Oct 6;125(19):2635-716215608
Cites: BMJ. 2007 Sep 29;335(7621):667-817901518
Cites: Cochrane Database Syst Rev. 2008;(4):CD00466718843666
Cites: BJOG. 2009 Mar;116(4):537-42; discussion 542-419250365
Cites: BMC Pregnancy Childbirth. 2009;9:2519545412
Comment In: BJOG. 2012 Feb;119(3):377; author reply 377-822239420
Erratum In: BJOG. 2011 Dec;118(13):1688
PubMed ID
21749629 View in PubMed
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Maternal Colonization with Group B Streptococcus Is Associated with an Increased Rate of Infants Transferred to the Neonatal Intensive Care Unit.

https://arctichealth.org/en/permalink/ahliterature274119
Source
Neonatology. 2015;108(3):157-63
Publication Type
Article
Date
2015
Author
Anne Karin Brigtsen
Anne Flem Jacobsen
Lumnije Dedi
Kjetil K Melby
Drude Fugelseth
Andrew Whitelaw
Source
Neonatology. 2015;108(3):157-63
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
C-Reactive Protein - analysis
Delivery, Obstetric
Early Diagnosis
Female
Humans
Infant, Newborn
Infant, Newborn, Diseases
Intensive Care Units, Neonatal - organization & administration
Logistic Models
Male
Mothers
Norway
Patient Transfer - statistics & numerical data
Pregnancy
Prospective Studies
Streptococcal Infections - epidemiology
Streptococcus agalactiae - isolation & purification
Term Birth
Abstract
Streptococcus agalactiae (group B Streptococcus, GBS) is the most common cause of early neonatal infection, but restricting the diagnosis to culture-positive infants may underestimate the burden of GBS disease. Our objective was to determine whether maternal GBS colonization was associated with an increased risk of transfer of term infants to the neonatal intensive care unit (NICU) and, if so, to estimate the incidence of probable early-onset GBS disease.
We conducted a prospective cohort study of 1,694 term infants whose mothers had vaginal-rectal swabs collected at delivery. Data collected on each mother and infant included demographics, clinical findings and laboratory investigations. The medical staff were unaware of the maternal GBS colonization status.
A total of 26% of the mothers were colonized. Infants born to colonized mothers did not differ from infants born to non-colonized mothers with respect to birth weight or Apgar score. Altogether, 30 (1.8%) of the term infants were transferred to the NICU. Only 1 infant born to a colonized mother had culture-positive early-onset GBS disease. Infants born to colonized mothers were more than 3 times as likely to be transferred to the NICU compared to infants of non-colonized mothers (3.6 vs. 1.1%; OR 3.4, 95% CI 1.6-6.9, p = 0.001); 5 infants of colonized mothers had probable GBS disease with tachypnoea and raised C-reactive protein (3.0/1,000 live term births).
Maternal GBS colonization is associated with increased risk of transfer to the NICU in term infants. The burden of neonatal GBS disease may be greater than indicated by the number of culture-positive cases.
PubMed ID
26182960 View in PubMed
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Patient trajectories in a Norwegian unit of municipal emergency beds.

https://arctichealth.org/en/permalink/ahliterature290686
Source
Scand J Prim Health Care. 2017 Jun; 35(2):137-142
Publication Type
Journal Article
Observational Study
Date
Jun-2017
Author
Heidi Nilsen
Steinar Hunskaar
Sabine Ruths
Author Affiliation
a Research Unit for General Practice, Uni Research Health , Bergen , Norway.
Source
Scand J Prim Health Care. 2017 Jun; 35(2):137-142
Date
Jun-2017
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Aged
Aged, 80 and over
Bed Occupancy - statistics & numerical data
Comorbidity
Cross-Sectional Studies
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Length of Stay
Male
Middle Aged
Norway
Patient Admission - statistics & numerical data
Patient Selection
Patient Transfer - statistics & numerical data
Abstract
The Coordination reform was implemented in Norway from 2012, aiming at seamless patient trajectories. All municipalities are required to establish emergency care beds (MEBs) to avoid unnecessary hospital admissions. We aimed to examine occupancy rate, patient characteristics, diagnoses and discharge level of municipal care in a small MEB unit.
Cross-sectional, observational study.
A two-bed emergency care unit.
All patients admitted to the unit during one year.
Patients' age and gender, comorbidity, main diagnoses and municipal care level on admission and discharge, diagnostic and therapeutic initiatives, occupancy rate.
Sixty admissions were registered, with total bed occupancy 194 days, and an occupancy rate of 0.27. The patients (median age 83 years, 57% women) had mostly infections, musculoskeletal symptoms or undefined conditions. Some 48% of the stays exceeded three days and 43% of the patients were subsequently transferred to nursing homes or hospitals.
Occupancy rate was low. Patient selection was not according to national standards, and stays were longer. Many patients were transferred to nursing homes, indicating that the unit was an intermediate pathway or a short cut to institutional care. It is unclear whether the unit avoided hospital admissions.
Notes
Cites: Scand J Prim Health Care. 2016 Sep;34(3):317-24 PMID 27559763
Cites: BMC Fam Pract. 2014 Dec 10;15:198 PMID 25491726
Cites: BMC Fam Pract. 2013 Jun 22;14:87 PMID 23800090
Cites: Scand J Public Health. 2009 May;37(3):223-6 PMID 19406855
Cites: CMAJ. 2009 Jan 20;180(2):175-82 PMID 19153394
Cites: J Am Geriatr Soc. 2002 May;50(5):792-8 PMID 12028163
Cites: Scand J Prim Health Care. 2015 Jun;33(2):121-6 PMID 26158584
Cites: Aust N Z J Med. 2000 Apr;30(2):252-60 PMID 10833119
Cites: Br J Gen Pract. 2001 Feb;51(463):95-100 PMID 11217640
Cites: Fam Pract. 2004 Apr;21(2):173-9 PMID 15020387
Cites: Fam Pract. 2001 Apr;18(2):141-8 PMID 11264263
Cites: Scand J Prim Health Care. 2015 Jun;33(2):65-73 PMID 26059872
Cites: Fam Pract. 2016 Dec;33(6):709-714 PMID 27543796
PubMed ID
28587558 View in PubMed
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Pre- and inter-hospital transport of severely head-injured patients in rural Northern Norway.

https://arctichealth.org/en/permalink/ahliterature184823
Source
J Neurotrauma. 2003 Mar;20(3):309-14
Publication Type
Article
Date
Mar-2003
Author
Snorre Sollid
Jens Munch-Ellingsen
Mads Gilbert
Tor Ingebrigtsen
Author Affiliation
Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway. snorre.sollid@unn.no
Source
J Neurotrauma. 2003 Mar;20(3):309-14
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
Air Ambulances - utilization
Craniocerebral Trauma - mortality
Glasgow Coma Scale
Glasgow Outcome Scale
Humans
Norway
Patient Transfer - statistics & numerical data
Rural Health
Time and Motion Studies
Trauma Centers
Abstract
The purpose of this study was to survey the time consumed during the pre- and inter-hospital transport of severely head injured patients in Northern Norway. All patients (n = 85) operated for an intracranial mass lesions within 48 h after injury during the 10-year period 1986-1995 were included in this retrospective analysis. Ambulance records, transfer notes, and hospital records were reviewed. The transport of patients was classified as either direct from the trauma scene to the University Hospital (direct admission group) or as an inter-hospital transfer (transfer group). Forty-seven (55%) patients were in the direct admission group, and 38 (45%) were transferred through another hospital. The majority of patients (81%) were transported by air ambulance. Median time from injury to arrival in the emergency room was 5 (1-44) h. Time necessary for transport was significantly (p
PubMed ID
12820685 View in PubMed
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8 records – page 1 of 1.