Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19

ABSTRACT Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. Results: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom were discharged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176-3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A total of 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). Conclusion: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.

Influence of Ordering Kiosk Nutrition Information Transparency and Information Quality on the Customer Behavioral Intention in Fast Food Restaurants

This study examined the perception and behavior of fast food restaurant customers toward ordering kiosk nutrition information. Specifically, the influence of nutrition information transparency and information quality on behavioral intention and revisit intention were identified. In addition, the difference in the nutrition information transparency and information quality was analyzed according to the health consciousness of the customers. The study employed a self-administered survey that was distributed both online and offline from November 8~22, 2018. The sample of the study was customers who had experienced ordering from the kiosk in a fast food restaurant in the six months prior to taking the survey. A total of 250 (98.0%) respondents completed the survey, which was used for data analysis. As a result, there was a significant relation between transparency and nutrition information quality (P<0.001). The higher the visibility and inferability of the nutrition information, the better the nutrition information quality. Nutrition information quality has a significant impact on the levels of customer satisfaction and revisit intention (P<0.001). For the differences in the transparency and nutrition information quality by health consciousness of customers, the results indicated that groups with high health consciousness (3.74 or higher) perceived a higher transparency and nutritional information quality than those with a lower health consciousness. These findings can form the basis of a strategy in developing nutrition information of ordering kiosks in restaurants. In addition, it can be applied to academia and industry.

Factors Associated with Emergency Department Revisits and Hospitalization Following Discharged Acute Asthma Exarcerbation

The objectives were to identify factors associated with early revisit of adult patients with acute asthma exarcebation discharged from the Emergency Department (ED). It was a retrospective cohort study with patients aged 12 years or more within a period of 1 month and who were treated for acute asthma and discharged from the ED of Sarawak General Hospital. A total of 397 patients fulfilled sampling criteria and out of this number, 13.9% had revisit to the ED within 2 weeks. In all of these revisit cases, 9.1% were actually admitted. Prescription rate of oral corticosteroid was found to be low (24.9%) and abscond rate was high (25.1%). Patients who absconded from the ED and their concurrent infection were associated with early ED revisit.

Research on the current situation of re-visiting at 4 traditional Chinese clinics in urban area of Beijing / 国际中医中药杂志

ObjectiveTo research the current situation at traditional Chinese clinics in urban area of Beijing,and to propagate the importance of re-visiting.Methods500 outpatients were selected randomly from 4 traditional Chinese clinics in urban area of Beijing from April 1st in 2010 to March 31st in 2011.Questionnaires were undertaken by these patients,including 120 first visitors and 380 re-visitors,then SPSS17.0 was used to statistically analyze the re-visiting proportion,influence factors and reasons for re-visiting.Results The highest re-visiting proportion was 56.7％ in 4 clinics and the total was 47.0％; 13.6％ patients who didn't have re-visit choice for their having no significant curative effect,12.6％ for having no time,10.3％ for having been recovered; patients who had curative effect and doctor's advice to re-visit may be the related influence factors of re-visiting; in the investigation of reasons,73.0％ patients made re-visit choice for having curative effect,35.9％ for doctors' good medical ethics,35.9％ for doctors' advice.ConclusionThere was a low re-visiting proportion in these 4 traditional Chinese clinics in urban area of Beijing; the top three non-revisiting reasons were no significant curative effect,having no time and having recovered.Having curative effect and doctor's advice to re-visit may be the related influence factors of re-visiting; the top three re-visiting reasons were curative effect,doctor's good medical ethics and doctor's exhortation.

Factors Associated with Early Revisits and Hospitalization after a Revisit to the Emergency Department in Elderly Patients

BACKGROUND: The purpose of this study was to find out what factors affect revisits by elderly patients to the emergency department (ED) with the same symptoms within 72 hours and hospitalization after a revisit. Delineating these factors can reduce unnecessary revisits to the ED and minimize problems with diagnosing and treating, improving the quality of treatment provided and of discharge decisions. METHODS: This is a retrospective study involving 3790 elderly patients who presented initially to a general hospital ED between May 1, 2007 to June 30, 2009. Of these, 176 cases revisited the ED within 72 hours with the same symptoms. Their medical records were reviewed. A comparative analysis was conducted of the early revisit group by classifying them into 'discharge' and 'admission' considering age, gender, insurance status, means of arrival, chief complaint, diagnosis, length of stay, time of arrival, comorbidity disease, time lapse, and day of the week. RESULTS: The factors affecting revisits were age ( or =80 years), means of arrival (by ambulance), increasing length of stay, and high comorbidity index (> or =2). CONCLUSION: The factors affecting revisits to the ED or hospitalization after a revisit were age, insurance status, means of arrival, chief complaint, length of stay, and comorbidity index. Physicians should be more careful when deciding discharge for elderly patients, especially those with the above factors.

Development of a revisit prediction model for the outpatient in a hospital / 대한의료정보학회지

OBJECTIVES: This study is for developing the prediction model of outpatient's revisit in target hospital. Using this model, hospital managers can make efficient customer relationship. METHODS: This is based on the medical record data of patients in target hospital (with 967 beds). They are divided into two groups, which are used each for different purpose. One(raw data) is used to make the prediction model of revisit and the other(test data) is used to evaluate the model. For raw data were used the 4,273 outpatient cases, where patients visited the first time between august and september in 2000, and visited till december in 2003. For the test data were used 9,392 outpatient cases, where patients visited the first time between august and september in 2003, and visited till december in 2006. That is, each data was selected from the outpatient's medical records for three-years. RESULTS: The decision tree model is better than the logistic regression model as prediction model of outpatient's revisit in target hospital. The decision tree model is evaluated more excellent in ROC curve and classification accuracy in test data. For predicting the outpatient's revisit, it is more useful to have 4 variables - non-insured expenses, special medical service, cooperation service with oriental medicine and visit via ER. We can predict the revisit of outpatients over 39.5% rate by these variables. CONCLUSIONS: By using decision tree model, target hospital can make more accurate prediction of outpatient's revisit and make good customer relation management. So, target hospital can use some CRM program including 4 variables. To make more useful model for other hospitals in Korea, each hospital managers need to understand more their hospital environment and patient's characteristics.

The Impacts of Customer Characteristics and Service Quality on Attitudes and Behaviors of Bakery Cafe Customers / 대한지역사회영양학회지

The purposes of this study were to examine the impacts of characteristics of bakery cafe customers and service quality on customer perceived value, customer satisfaction, intention to revisit, and intention to recommend, and to provide comprehensive understanding on attitudes and behaviors of bakery cafe customers. The questionnaire was developed through literature review and focus group interviews and was modified after pilot test. The questionnaires for the main survey were distributed to 320 males and females aged 20 and over in Seoul. A total of 275 questionnaires were used for analyses (85.9%) and the statistical analyses were completed using SPSS Win (12.0) for descriptive analyses, regression analyses, and correlation analysis. The main results were as follows. There were significant differences of intention to revisit between groups of different gender, age, and personal expenses. The service quality of product dimension affected all tested variables, and the service quality of services and price dimension had effects on customer perceived value and intention to recommend. Customer satisfaction was a unique variable that is affected by service quality of the interior environments dimension. Overall, researchers and managers of bakery cafes should understand customer attitudes and behaviors, and the results of this study would help to establish marketing strategies that meet target customers' needs.

Strengthen the Revisit Management of Patients to Promote the Development of Hospital Marketing / 中国医学伦理学

The article discusses a number of important marketing ideas which should be clarified and fully understood in strengthening the follow-up management of patients,including understanding of the meaning of customers,the formation of the concept of market and the evolution of marketing.The adoption of patient follow-up management could delivered value to customers and promote their satisfaction.In the end,the article proposes that a long-term marketing mechanism of patient follow-up services should be established in order to achieve the a better development of hospitals.