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Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas.

https://arctichealth.org/en/permalink/ahliterature291196
Source
Soc Sci Med. 2017 06; 182:60-67
Publication Type
Journal Article
Date
06-2017
Author
Tiina Huotari
Harri Antikainen
Timo Keistinen
Jarmo Rusanen
Author Affiliation
Geography Research Unit, University of Oulu, PO Box 3000, FI-90014, Finland. Electronic address: tiina.huotari@oulu.fi.
Source
Soc Sci Med. 2017 06; 182:60-67
Date
06-2017
Language
English
Publication Type
Journal Article
Keywords
Catchment Area (Health) - statistics & numerical data
Finland
Geographic Mapping
Health Services Accessibility - standards - statistics & numerical data
Humans
Tertiary Care Centers - organization & administration - statistics & numerical data - supply & distribution
Abstract
The determination of an appropriate catchment area for a hospital providing highly specialized (i.e. tertiary) health care is typically a trade-off between ensuring adequate client volumes and maintaining reasonable accessibility for all potential clients. This may pose considerable challenges, especially in sparsely inhabited regions. In Finland, tertiary health care is concentrated in five university hospitals, which provide services in their dedicated catchment areas. This study utilizes Geographic Information Systems (GIS), together with grid-based population data and travel-time estimates, to assess the spatial accessibility of these hospitals. The current geographical configuration of the hospitals is compared to a normative assignment, with and without capacity constraints. The aim is to define optimal catchment areas for tertiary hospitals so that their spatial accessibility is as equal as possible. The results indicate that relatively modest improvements can be achieved in accessibility by using normative assignment to determine catchment areas.
PubMed ID
28414937 View in PubMed
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Outcomes following neonatal patent ductus arteriosus ligation done by pediatric surgeons: a retrospective cohort analysis.

https://arctichealth.org/en/permalink/ahliterature113671
Source
J Pediatr Surg. 2013 May;48(5):915-8
Publication Type
Article
Date
May-2013
Author
Katherine Hutchings
Andrea Vasquez
David Price
Brian H Cameron
Saeed Awan
Grant G Miller
Author Affiliation
Department of Surgery, Janeway Children's Hospital, St. John's Newfoundland, NL, Canada, A1B 3V6.
Source
J Pediatr Surg. 2013 May;48(5):915-8
Date
May-2013
Language
English
Publication Type
Article
Keywords
Blood Transfusion - utilization
Canada - epidemiology
Comorbidity
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Follow-Up Studies
General Surgery - education
Gestational Age
Hospital Mortality
Hospitals, Pediatric - organization & administration - statistics & numerical data
Hospitals, Teaching - organization & administration - statistics & numerical data
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Intensive Care Units, Neonatal - statistics & numerical data
Intraoperative Complications - epidemiology
Ligation - education
Male
Patient Transfer - statistics & numerical data
Pediatrics - education
Postoperative Complications - epidemiology
Respiration, Artificial - utilization
Retrospective Studies
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Patent Ductus Arteriosus (PDA) ligation in premature infants is an urgent procedure performed by some but not all pediatric surgeons. Proficiency in PDA ligation is not a requirement of Canadian pediatric surgery training. Our purpose was to determine the outcomes of neonatal PDA ligation done by pediatric surgeons.
We performed a retrospective review of premature infants who underwent PDA ligation by pediatric surgeons in 3 Canadian centers from 2005 to 2009. Outcomes were compared to published controls.
The review identified 98 patients with a mean corrected GA and weight at repair of 29 weeks and 1122 g, respectively. There were no intraoperative deaths. The 30-day and inhospital mortality rates were 1% and 5%. Mortality and morbidity were comparable to the published outcomes.
This study documents that a significant number of preterm infant PDA ligations are safely done by pediatric surgeons. To meet the Canadian needs for this service by pediatric surgeons, proficiency in PDA ligation should be considered important in pediatric surgery training programs.
PubMed ID
23701759 View in PubMed
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Outcomes of neonatal patent ductus arteriosus ligation in Canadian neonatal units with and without pediatric cardiac surgery programs.

https://arctichealth.org/en/permalink/ahliterature113672
Source
J Pediatr Surg. 2013 May;48(5):909-14
Publication Type
Article
Date
May-2013
Author
Charles Wong
Michael Mak
Sandesh Shivananda
Junmin Yang
Prakeshkumar S Shah
Wendy Seidlitz
Julia Pemberton
Peter G Fitzgerald
Brian H Cameron
Author Affiliation
McMaster Pediatric Surgery Research Collaborative, Hamilton ON, Canada.
Source
J Pediatr Surg. 2013 May;48(5):909-14
Date
May-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Brain Diseases - epidemiology - etiology - ultrasonography
Canada
Cardiology Service, Hospital - organization & administration
Combined Modality Therapy
Databases, Factual
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Hospital Departments - organization & administration
Hospital Mortality
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Ligation
Male
Patient Transfer - statistics & numerical data
Pediatrics - organization & administration
Postoperative Complications - epidemiology - etiology - ultrasonography
Retrospective Studies
Sepsis - epidemiology - etiology
Severity of Illness Index
Surgery Department, Hospital - organization & administration
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
PubMed ID
23701758 View in PubMed
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Pandemic management in a pediatric hospital.

https://arctichealth.org/en/permalink/ahliterature116342
Source
Clin Pediatr (Phila). 2013 Apr;52(4):322-8
Publication Type
Article
Date
Apr-2013
Author
Savithiri Ratnapalan
Maria Athina Tina Martimianakis
Justine H Cohen-Silver
Bruce Minnes
Daune Macgregor
Upton Allen
Susan E Richardson
Jeremy N Friedman
Cindy Bruce-Barrett
Lutfi Haj-Assaad
Judy Noordermeer
Denis Daneman
Author Affiliation
Division of Emergency Medicine, Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, ON, Canada. savithiri.ratnapalan@sickkids.ca
Source
Clin Pediatr (Phila). 2013 Apr;52(4):322-8
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Anthropology, Medical
Child
Child, Preschool
Health Planning - organization & administration
Hospitals, Pediatric - organization & administration - statistics & numerical data
Humans
Infant
Infant, Newborn
Infection Control - methods - organization & administration
Influenza A Virus, H1N1 Subtype
Influenza, Human - diagnosis - epidemiology - therapy
Ontario - epidemiology
Pandemics
Personal Narratives as Topic
Tertiary Care Centers - organization & administration - statistics & numerical data
Abstract
To describe our experiences in the management of the second wave of influenza A H1N1 (pH1N1) pandemic in a tertiary-care children's hospital.
An autoethnographic study of the pandemic planning and management committee members involved in managing the second wave of pH1N1 was conducted.
Staffing, surge capacity, communications and emergency operations planning by adding leaders of frontline workers and other key operational roles to the incident management team, and creating a tactical response team emerged as important factors in pandemic management in our hospital. The emergency department visits increased by 50%, necessitating increased staffing of the emergency department. Communications using existing chains of command had to be used to reach frontline staff during the pandemic.
Incident management teams managing pandemics and other disasters have to be dynamic and create tactical teams to ensure implementation and facilitate bidirectional communication with frontline workers.
PubMed ID
23406719 View in PubMed
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