Factors associated with the workload of health professionals in hospital at home: a systematic review.

BACKGROUND: Understanding the factors related to workload, could help hospital at home (HaH) managers to make decisions on the most appropriate and efficient use of the HaH services. Published studies on this topic are scarce, so we have conducted a systematic review to identify such factors according to published evidence. METHODS: Due to the heterogeneity of HaH models, HaH was defined as a care that provides a set of medical and nursing care and attention of hospital rank to patients at home, when they no longer require hospital infrastructure but still need active monitoring and complex care. The electronic data base literature search was conducted in MEDLINE (Ovid), EMBASE (Ovid), and Cinahl (EBSCOhost) from inception to December 2021, including grey literature. Search terms related to `hospital at home´, `workload´ and `care time´ were used. There was no restriction on language, type of study or year of publication. Quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist and certainty in the body of evidence was assessed using the GRADE Pro Tool. Results were summarised in a tabulated format. RESULTS: Eighteen studies with 56,706 patients were included. Workload was measured as time, number of visits or both. The predictive factors of the workload included variables related to patient characteristics and other valid and reliable patient classification systems, as well as characteristics of the institutions where the studies were conducted. The factors associated with higher workloads were: being older, male, living in a rural environment, presenting a higher number of diagnoses, having worse functional status and being unable to assume self-care. CONCLUSIONS: The identified predictors of workload are mostly associated with home nursing care. The results could be useful and applicable to different organisational models of HaH health systems. More studies that include physicians and proxy measures of workload are needed.

Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España / Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain

Introducción: Varios estudios advierten que el sobrepeso y la obesidad se han convertido en una epidemia con graves consecuencias sobre la salud de la población. El objetivo del presente estudio es estimar la prevalencia de sobrepeso y obesidad en Castilla y León en una muestra de niños a los 6, 11 y 14 años de edad, describir su evolución y su asociación con hábitos de vida y antecedentes. Metodología: Estudio observacional, de cohorte retrospectivo, realizado por los pediatras de la Red Centinela Sanitaria, que se enmarca en un proyecto conjunto con el Centro Nacional de Investigación sobre la Evolución Humana de Burgos para conocer el patrón de crecimiento y desarrollo de la población infantil de Castilla y León. En 2012 se realizó un examen de salud y una recogida retrospectiva a partir de la historia clínica en una muestra de 326 niños, de la cohorte de nacidos en 1998. Resultados: Según los criterios de la OMS, a los 14 años había un 25,3% de sobrepeso entre los niños y un 18,5% entre las niñas. En cuanto a la obesidad, esta afectaba al 8,2 y 4,8%, respectivamente. A los 11 años se produce un pico de sobrepeso en las niñas y de obesidad en los niños. El entorno urbano-no urbano, la calidad y duración del sueño, así como el índice de masa corporal (IMC) de los padres han sido algunos de los factores asociados con el peso de los niños. Discusión: En Castilla y León, como en otras poblaciones de nuestro entorno, existe un grave problema de sobrepeso y obesidad infantil. Para su control, es necesario profundizar sobre los estilos de vida y los antecedentes relacionados con el nacimiento, así como el cálculo de la velocidad de crecimiento en la edad pediátrica

Introduction: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. Material and methods: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. Results: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. Discussion: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age

Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain. / Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España.

INTRODUCTION: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. MATERIAL AND METHODS: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. RESULTS: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. DISCUSSION: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age.