Pressure ulcers (PUs) impose a significant economic burden on healthcare systems, affecting patient quality of life and leading to substantial treatment costs. This study presents a cost-of-illness analysis of PU treatment in hospitalized patients in the Czech Republic, based on real-world clinical data. The analysis was conducted using a comprehensive methodology at a Czech university hospital, involving 304 hospitalizations. The study included all hospitalized patients with PUs. Data were collected employing a bottom-up, person-based approach, which refers to the collection and analysis of cost data at the individual patient level. This method captures detailed resource utilization for each patient. The methodology accounted for both systemic and local costs, including materials, medications, caregiver time, and procedures. The study involved 304 hospitalizations, with a mean length of stay of 13 days. The total cost of PU treatment, excluding pharmacotherapy, had a median of €678, while including pharmacotherapy, the median cost rose to €929. Younger patients incurred higher treatment costs. Significant cost variations were observed among different departments. We developed and applied a novel cost model to quantify the expenses associated with PUs, which accurately highlighted the financial burden in the hospital care setting. We present a rigorous methodology for PU cost-of-illness analysis, providing a valuable tool for future research and clinical practice. This comprehensive approach supports the development of targeted interventions to reduce the incidence and severity of PUs, ultimately improving patient care and reducing healthcare costs.
- MeSH
- dekubity * ekonomika terapie MeSH
- délka pobytu ekonomika statistika a číselné údaje MeSH
- dospělí MeSH
- hospitalizace ekonomika MeSH
- lidé středního věku MeSH
- lidé MeSH
- náklady na zdravotní péči statistika a číselné údaje MeSH
- nemocnice univerzitní * ekonomika MeSH
- osobní újma zaviněná nemocí * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Purpose: Dysphagia may occur in all critically ill patients, and large-scale clinical data show that post-extubation dysphagia (PED) is commonly observed in intensive care unit (ICU) patients. The study aimed to determine how dysphagia is diagnosed after extubation, and what factors influence the incidence of dysphagia after invasive airway support in selected ICUs. Methods: A prospective observational study was conducted for five months (07/2023 to 11/ 2023), in the acute ICU and long-term ICU of the Teaching hospital in the Czech Republic. Results: Of the 101 extubated patients in the study, only 27.7% (n = 28) were examined by a physician, and PED was confirmed in 26.7% (n = 27), representing 99% of all extubated patients. Age, gender, and ICU type were not significantly related to PED occurrence. However, the type of airway management (p < 0.001), duration of mechanical ventilation (p = 0.017), and main diagnosis (p < 0.001) were significantly associated with PED occurrence. Conclusion: The study confirmed the underdiagnosis of PED in ICU patients post-extubation. Higher PED incidence was linked to tracheostomy + endotracheal cannula use, mechanical ventilation longer than 9 days, and neurological diagnoses. Training health professionals to identify PED symptoms is essential to establish uniform procedures for diagnosing and preventing PED-related complications.
- MeSH
- extubace * metody škodlivé účinky MeSH
- intratracheální intubace metody škodlivé účinky MeSH
- lidé MeSH
- mechanické ventilátory klasifikace škodlivé účinky MeSH
- péče o pacienty v kritickém stavu metody MeSH
- poruchy polykání * diagnóza etiologie MeSH
- prospektivní studie MeSH
- tracheostomie metody škodlivé účinky MeSH
- umělé dýchání metody přístrojové vybavení škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
Background: Despite trends towards greater professionalisation of the nursing profession and an improved public image in certain countries, studies also show that large proportions of the public still do not fully appreciate nurses' competencies. Mapping differences in the societal and professional recognition of nurses allows for benchmarking among countries. Aim: To investigate the level of societal recognition of the nursing profession in nine European countries, and the level of professional recognition perceived by European nurses themselves; to compare levels of recognition between countries; and to identify influencing factors. Methods: A cross-sectional study was conducted. Through an online survey, the study surveyed both the general public and nurses from various healthcare settings across nine countries between December 2022 and June 2023. The instrument used was a combination of self-developed questions on societal and professional recognition, the Work Motivation Scale and an adapted version of the Multidimensional Work Motivation Scale. Data were analysed using SPSS v.29.0, with socioeconomic prestige scores for the public and work environment/work motivation scores for nurses calculated accordingly. Results: A total of 1618 adult citizens and 2335 nurses participated. The public predominantly characterised nurses with attributes such as friendliness, warmth, empathy and compassion. The mean socioeconomic prestige score assigned to nurses was 7.2/10 (SD 1.9), with Portugal having the highest score (M 7.5/10, SD 2.0) and Norway the lowest (M 5.8/10, SD 1.4; p < 0.001). Professional recognition experienced by nurses was generally low (54% indicated rather low, 17% very low). Slovenia, the Netherlands and Belgium had slightly higher mean scores (all M 1.4/3) compared to other countries (p < 0.001). High professional recognition could be predicted for 33% by work environment score (OR = 1.21; 95% CI [1.19-1.24]), work motivation score (OR = 1.02; 95%CI[1.01-1.02]), expertise outside the hospital (OR = 1.57; 95% CI [1.25-1.97]) and work experience (OR = 1.01; 95% CI [1.00-1.02]) corrected for country. Conclusion: The study highlights the need for targeted interventions to improve the professional and public image of the nursing profession while addressing disparities in professional recognition between countries. Longitudinal studies are recommended to monitor changes in public perception and professional recognition among nurses.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- zdravotní sestry * normy psychologie statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Cíle: V roce 2022 byl připraven adaptovaný Klinický doporučený postup (KDP) zahrnující diagnos- ticko-terapeutické postupy u pacientů s Parkinsonovou nemocí. Doporučení mají pomoci odborníkům z klinické praxe v rozhodovacích schopnostech a cílem KDP je zkvalitnění poskytovaných služeb na národní úrovni a zefektivnění nákladovosti. Metodika: Retrospektivní dotazníkový průzkum s cílem ověřit využití KDP odborníky z klinické praxe (lékaři a nelékařští zdravotničtí pracovníci). Sběr dat byl realizován od začátku června do konce července v roce 2023 sdílením na webovém portále České neurologické společnosti (ČNS) a Extrapyramidovou sekcí ČNS v elektronické podobě. Využit byl dotazník vlastní konstrukce a data byla analyzována pomocí deskriptivní analýzy. Výsledky: Průzkumu se zúčastnilo celkem 51 respondentů (30 žen a 21 mužů) průměrného věku 43,3 roku. V souboru bylo zastoupeno 31 lékařů, tj. 61 % (12 ambulantní péče a 19 lůžková péče), a 20 sester, tj. 39 % (11 ambulantní péče a 9 lůžková péče), s průměrnou délkou klinické praxe 15,2 roku. Využívání KDP v plném znění neuvedla ani jedna všeobecná sestra ve srovnání s lékaři, kde jich šest uvedlo využívání KDP (p = 0,036) a ohodnotilo jej ve vysoké kvalitě. V souvislosti s dalšími návrhy na aktualizaci KDP bylo doporučeno doplnění nových léčivých přípravků (n = 5) a komplexní rozpracování informací pro pacienty (n = 2). Závěr: Parkinsonova nemoc představuje významnou ekonomickou zátěž pro zdravotnické systémy a snížení kvality života pro pacienty v rámci postupné progrese onemocnění. KDP na národní úrovni má za cíl snižovat geografické, demografické a další rozdíly v přístupu k pacientům. Bude realizována pravidelná aktualizace KDP diagnostiky a léčby Parkinsonovy nemoci dle potřeb Extrapyramidové sekce. Doplněna budou doporučení s posledními registrovanými léčivy a diagnosticko- -terapeutickými postupy a také budou v rámci aktualizace připravena komplexní doporučení pro pacienty v laickém jazyce.
Aims: Adapted Clinical Practice Guidelines (CPG) covering diagnostic and therapeutic procedures for patients with Parkinson‘s disease were developed in 2022. The recommendations are intended to assist clinical practitioners in their decision-making abilities, and the CPG aims to improve the quality of services provided nationally including cost-effectiveness. Methodology: A retrospective questionnaire survey to examine the use of CPG by clinical practitioners (physicians and non-physician health professionals). Data collection was conducted from early June to late July in 2023 by sharing it electronically on the Czech Neurological Society (CNS) web portal and the Extrapyramidal Section of the CNS. A self-constructed questionnaire was used and data were analyzed using descriptive analysis. Results: A total of 51 respondents (30 women and 21 men) took part in the survey with an average age of 43.3 years. There were 31 physicians, i.e. 61% (12 ambulatory care and 19 inpatient care) and 20 nurses, i.e. 39% (11 ambulatory care and 9 inpatient care) with an average length of clinical experience of 15.2 years. None of the general nurses reported full use of CPG compared to physicians, where 6 of them reported using CPG (P = 0.036) and rated it as high quality. Other suggestions for updating the CPG included the addition of new medicines (N = 5) and comprehensive development of patient information (N = 2). Conclusion: Parkinson‘s disease represents a significant economic burden on healthcare systems and a reduction in quality of life for patients as the disease progresses. The national CPG aims to reduce geographic, demographic, and other disparities in patient access. Regular updates to the CPG on the diagnosis and treatment of Parkinson‘s disease will be implemented as required by the Extrapyramidal Section. Recommendations will be updated with the latest registered drugs and diagnostic and therapeutic procedures, and comprehensive recommendations for patients in lay language will be prepared as part of the update.
Burns are a major global healthcare concern, often complicated by the presence of bacteria such as Pseudomonas aeruginosa in the wounds. Silver-based dressings are commonly used in the treatment of burns but can cause skin irritation and delay healing time. Medical-grade honey (MGH) provides an interesting alternative. This study investigated the antimicrobial effects and possible cytotoxicity of L-Mesitran Soft (MGH-gel) and its individual components, Medihoney (Manuka), Flammazine (silver sulphadiazine), and silver nitrate (AgNO3) in an ex vivo human burn wound model. Bacterial survival and wound healing parameters, including re-epithelialization and keratinocyte proliferation were assessed. L-Mesitran, Flammazine, and AgNO3 reduced P. aeruginosa numbers below detection levels. L-Mesitran Soft exhibited a significantly stronger antimicrobial effect compared to Medihoney. The individual components of L-Mesitran contributed significantly to its antibacterial efficacy, thus suggesting synergistic activities. Moreover, L-Mesitran, Flammazine, and AgNO3 slightly inhibited re-epithelialization while Medihoney treatment resulted in a complete lack of re-epithelialization and keratinocyte proliferation. Furthermore, clinical cases illustrated the effectiveness of MGH therapy in infected burns. Overall, L-Mesitran Soft had similar effects as silver-based products on bacterial load and epidermal regeneration, but outperformed Medihoney. Therefore, supplemented MGH could be used as an effective alternative to silver-based dressings for P. aeruginosa-infected burns.
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
nestr.
Podstatou řešení projektu je příprava a ověření metodiky pro sledování nákladovosti dekubitů u hospitalizovaných pacientů. V projektu budou sbírána a vyhodnocována standardní data o výskytu a léčbě dekubitů, následně bude vytvořen speciální dataset umožňující posouzení nákladovosti péče o dekubity (léčebné i ošetřovatelské intervence). Východiskem pro analýzu dat budou stávající registry, nemocniční informační systém a identifikace benefitů a limitů údajů získaných z hospitalizačních záznamů. Hlavním aplikovaným výstupem projektu bude detailní metodika (ekonomický model) pro komplexní sledování nákladovosti dekubitů u hospitalizovaných pacientů využitelný v klinické praxi pro lůžkové poskytovatele zdravotních služeb.; The essence and main focus of the project is the preparation and validation of the methodology for monitoring the cost of pressure ulcers (cost analyses) in hospitalized patients. The standard data on the occurrence and treatment of pressure ulcers during hospitalization will be collected and evaluated, followed by the creation of a special dataset to assess the cost of care for pressure ulcers (both curative/treatment and nursing interventions). The basis for data analysis will be existing registers, the hospital information system and the identification of benefits and limitations of data obtained from hospitalization records. The main applied output of the project will be a detailed methodology for monitoring the cost of pressure ulcers (comprehensive economical model) in hospitalized patients that can be used in clinical practice for inpatient providers of healthcare services.
- Klíčová slova
- analýza, dekubitus, nákladovost, nákladnost, pressure ulcer, cost, expensiveness, hospitalizační záznam, medical record, analyses,
- NLK Publikační typ
- závěrečné zprávy o řešení grantu AZV MZ ČR
- MeSH
- časové faktory MeSH
- dekubity * terapie MeSH
- kvalita zdravotní péče MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- úvodníky MeSH
