ABSTRACT
@#Introduction: Patients undergoing emergency general surgery (EGS) are at risk for death and complications. Information on the burden of EGS is critical for developing strategies to improve the outcomes. Methods: In this retrospective cohort study, medical records of all general surgical operations in a public hospital were reviewed for the period 1st January 2017 to 31st December 2017. Data on patient demographics, operative workload, case mix, time of surgery and outcomes were analysed. Results: Of the 2960 general surgical operations that were performed in 2017, 1720 (58.1%) of the procedures were performed as emergencies. The mean age for the patients undergoing emergency general surgical procedures was 37.9 years (Standard Deviation, ±21.0), with male preponderance (57.5%). Appendicitis was the most frequent diagnosis for the emergency procedures (43%) followed by infections of the skin and soft tissues (31.6%). Disorders of the colon and rectum ranked as the third most common condition, accounting for 6.7% of the emergency procedures. Majority of emergency surgery (59.3%) took place after office hours and on weekends. Post-operative deaths and admissions to critical care facilities increased during EGS when compared to elective surgery, p<0.01. Conclusions : EGS constitutes a major part of the workload of general surgeons and it is associated significant risk for death and post-operative complications. The burden of EGS must be recognised and patient care systems must evolve to make surgery safe and efficient.
ABSTRACT
This study aimed to investigate pharmacy service needs of patients and peace of mind of patients in relation to out-of-hours pharmacy services. For patients who came to the health insurance pharmacy, we conducted a survey on the patients’ attitudes toward composition and consultation needs and peace on mind in relation to out-of-hours pharmacy services to investigate the potential characteristic of the needs regarding pharmacy services. We also found that a factor that influenced their peace of mind with regard to services offered by pharmacies was out-of-hours dispensation services. We analyzed patient attributes and local and composition and consultation needs using chi-square test. As a result, significant difference was observed in a ratio of distribution of the composition needs in six items including “sex” and “age.” Similarly, significant difference was observed in four items including “sex.” In addition, in a patient with multiple factors that needs becomes higher, it was shown that composition and consultation had a big influence of “the living together with a child.” The patient attribute that composition and consultation became high in the needs together was “a woman”, “under 60 years old”, “the living together with a child” and “local region”. For analysis by Generalized Linear Model, the two factors of “consultation during holiday,” “nighttime dispensation” were extracted. Furthermore, in a crowd “a woman” and “local region”, “consultation during holiday” was extracted, and a difference was seen in influence in a case for the whole. In this study, it became clear that pharmacy service to give the peace of mind to a patient was a holiday and night composition. From the result, in the community medicine system, it was suggested that the improvement of these service offers was important.