Appropriateness of Hospital Admissions in a University Hospital in Egypt: Analyzing a Preintervention Phase

Background: Identifying the magnitude of this improper use and applying interventions to eliminate unnecessary hospitalization will reduce health-care expenditure, improve the quality of care for patients, and increase the accessibility to care for actual patients in need on waiting lists. Aim of Work: To measures the rate of inappropriate admissions at the Ain Shams University Hospital. Methods: This research is the preintervention phase of a study conducted to improve the appropriateness of patient admission at this hospital. The appropriateness evaluation protocol (AEP) was used to review the appropriateness of 576 hospital admissions over 100 days. The patients’ medical records were stratified according to the admission route into two groups, namely emergency and outpatient admission. Next, the systematic random samples were taken from each stratum based on the admission list of the previous day. Results: The results showed that 20.5% of the sampled cases were inappropriately admitted. Furthermore, a statistically significant difference was observed between appropriately and inappropriately admitted cases regarding gender and shifts during which admission occurred in addition to body systems affected; inappropriate admissions were more among females, and admissions occurred most frequently during the morning shifts (8:00 am–2:00 pm). The remaining other factors that were studied also proved insignificant. Conclusion: It can be concluded that a considerable proportion of hospital admissions is inappropriate, especially in the elective surgery department, and these admissions vary according to patient’s gender, shifts during which admission occurred, and the affected body systems. Recommendations: Adopting hospital admission policies based on the AEP criteria in addition to training of physicians on these criteria would help prevent inappropriate admission and ensure optimization during use of hospital facilities.

Multiple tobacco use among young adult waterpipe smokers in Egypt

Background: The use of multiple tobacco products is an emerging trend. Studies on multiple use among waterpipe smokers are limited. Objectives: We aimed to estimate the proportion of other tobacco products used by current adult waterpipe smokers in Egypt and identify the determinants of multiple tobacco product use. Methods: Population-based surveys were conducted using interview questionnaires during 2015–2017 in urban Cairo and rural Menoufia. Participants aged 18 years and older were selected using purposive quota non-random sampling. The total sample included 2 014 participants. We analysed the data on 1 490 current waterpipe smokers. Variables recorded included: tobacco use, health beliefs, waterpipe smoking behaviour, sociodemographic characteristics, and perceived effectiveness of pictorial health warnings on waterpipe tobacco packs. Current waterpipe smokers were classified as waterpipe-only users and multiple tobacco product users. Results: Almost half [47.9%] of the current waterpipe smokers used multiple tobacco products; 93.4% were dual users and 6.6% poly-users. The other tobacco products used were cigarettes [86.4%], electronic nicotine delivery systems [ENDS] [7.0%] or both [6.6%]. Multiple users were more likely to be younger than waterpipe-only users. Young adult female waterpipe smokers used ENDS 12 times more than young adult males [48.8% versus 4.1% respectively]. Non-daily waterpipe smoking, usually smoking at cafes, higher education and knowledge of pictorial health warnings were independent predictors of multiple tobacco product use. Conclusion: Multiple tobacco product use was common among current waterpipe smokers in our study. Interventions to tackle non-cigarette and multiple tobacco use, especially in young adults, are urgently needed

Knowledge, attitudes and practice with regard to the articles of the framework convention on tobacco control among Egyptian adults

Egypt signed the Framework Convention on Tobacco Control [FCTC] in 2003, and it was ratified by the Egyptian Parliament in February 2005. Although most of the articles of the FCTC are reflected in Egyptian law and regulations, enforcement is rare for many reasons. The aim of the study was to evaluate knowledge, attitudes and practice toward the FCTC among Egyptian adults. Cross-sectional survey with an interview questionnaire about knowledge, attitudes and practice as regards the FCTC among 2941 people from them 1584 smokers [97% men, 3% women] in two governorates of Egypt. The prevalence of smoking varied, being higher among men [97%] than women [3%] and was higher among adults under the age of 55 years. Most smokers [74%] knew that smoking by children and adolescents was not allowed, and that tobacco contains tar and nicotine, which are hazardous to health. Half of the smokers were unaware of the presence of warning signs on boxes. Most smokers knew that advertising of cigarettes is not allowed [66.8%], the media do not advocate for smoking prevention [67.8%], not enough information is given about its hazards [64.3%], and there is no media campaign against smoking [83.9%].Most smokers [62.2%] considered that there is no active strategy against smoking, and 77.3% said that there was no Government policy against smoking. Half the smokers [50.4%] thought that people in the community were not interested in smoking prevention, and medical personnel should help; 70.7% concluded that little was being done to prevent smoking. The data from this study could be used as a baseline for future evaluations of tobacco control programmes implemented by the Ministry of Health of Egypt