Potential predictors of hospital length of stay and hospital charges among patients with all-terrain vehicle injuries in rural Northeast Texas.

BACKGROUND: All-Terrain Vehicles (ATVs) have become popular for recreation use in recent years. Texas has had more ATV related fatalities than any other state in the nation, with rural Northeast Texas having even higher rates of injuries. There is limited data examining the relationship between ATV injuries and the length of hospital stay, as well as hospital costs. This paper examines both issues in children as well as adults. METHODS: The regional trauma registry was analyzed for all ATV related injuries between January 2011- October 2016. Injury Severity Score, Glasgow Coma Scale and if they are seen at a Level I Trauma center are predictive for both hospital length of stay and charges. RESULTS: Length of Stay was predicted positively by Injury Severity Score, Emergency Department Respiration Rate and facility at which patients were treated and negatively by Glasgow Coma Scale. Hospital charges were predicted positively by age, Injury Severity Score, facility of treatment, means of transportation, and Emergency Department pulse and negatively by Glasgow Coma Scale. CONCLUSIONS: The study found that vital signs can be useful in predicting length of stay and hospital charges. This study not only confirms the findings of other studies regarding what predictors can be used, but expands the research into rural traumatic injuries. It is hoped that this data can help contribute to the development of algorithms to predict which patients will be most likely to require resource intensive treatment.

Return on Investment of Free Colorectal Cancer Screening Tests in a Primarily Rural Uninsured or Underinsured Population in Northeast Texas.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the USA. Its economic impact is extensive, and preventive screening services are warranted to help prevent it. OBJECTIVE: We sought to examine the return on investment, in terms of reduced costs attributed to cancer prevention, of a CRC screening outreach program providing education and screening in a primarily rural region targeting the uninsured and underinsured. METHODS: The expenditures of the Northeast Texas CRC screening program were calculated for the years of 2016 and 2017. Prices ($US) were adjusted for inflation and converted to year 2017 values. The costs saved were calculated using the estimated costs of CRC care present in the literature. RESULTS: For fiscal years 2016 and 2017, the program provided an average return of $US1.46-2.06 for every tax dollar spent. Estimated cost avoidance was $US165,080 per avoided case and estimated cost avoidance of $US245,601 among early-stage cancer cases detected, resulting in potential savings ranging from $US3,893,676 to $US4,837,923. CONCLUSION: A CRC outreach program providing education and screening operating in less densely populated regions yields a positive return on investment.

A Longitudinal Pilot Study for Examining Symptom Reduction in Patients With Cancer in a Palliative Care Program: A Primarily Rural Northeast Texas Population.

Many patients with cancer live in rural areas and research is lacking on the efficacy of palliative care programs in rural community settings. This pilot study was conducted in a primarily rural setting where healthcare professionals delivered palliative care to 52 mostly lower income patients with a variety of cancers. They were assessed for physical, financial, psychosocial and overall symptom intensity at baseline and at three consequent assessments. This pilot study demonstrated the potential efficacy of an outpatient palliative care program in a mostly rural setting in the reduction of physical, psychosocial, and overall symptom intensity in patients with cancer.

Risk of Colorectal Polyps and Malignancies Among Predominantly Rural Hispanics.

Colorectal cancer is the fourth most frequently diagnosed cancer. However, due to variations in diet, it was hypothesized that risk of adenomatous or hyperplastic polyps or malignancies would be lower among Hispanics. Participants (n = 1671) underwent a colonoscopy. Results were grouped into one of four groups: normal, hyperplastic polyps only, adenomatous polyps, and malignancies. As expected, Hispanics had a lower risk of hyperplastic (p = .031, OR = 0.47) and adenomatous polyps (p = .031, OR = 0.66) than non-Hispanic Whites. Comparison between malignancies was not possible as no Hispanics had a malignancy. Contrary to expectations, risk of hyperplastic and adenomatous polyps and malignancies were no different between non-Hispanic Blacks and Whites. Among rural and mostly rural populations, Hispanics had a lower risk of hyperplastic and adenomatous polyps.

Examining the Return on Investment of the Breath of Life Mobile Pediatric Asthma Clinic in a Rural Region with Small Metropolitan Statistical Areas.

The current study sought to examine the return on investment (ROI) of a mobile pediatric asthma clinic in a rural region with small metropolitan statistical areas, in terms of reduced costs attributed to preventable emergency department visits, inpatient admission, school absenteeism, cost of education, and parent work absenteeism. For fiscal years 2015 and 2016, an average return of $1.32 and a community ROI of $1.45 was estimated. Estimated benefits were $445,125.00 and cost avoidance was $263,853.01. A mobile pediatric asthma clinics operating in less densely populated regions is able to yield a positive ROI.

The effects of Reiki therapy and companionship on quality of life, mood, and symptom distress during chemotherapy.

This pilot study examined the effects of Reiki therapy and companionship on improvements in quality of life, mood, and symptom distress during chemotherapy. Thirty-six breast cancer patients received usual care, Reiki, or a companion during chemotherapy. First, data were collected from patients receiving usual care. Second, patients were randomized to either receive Reiki or a companion during chemotherapy. Questionnaires assessing quality of life, mood, symptom distress, and Reiki acceptability were completed at baseline and chemotherapy sessions 1, 2, and 4. Reiki was rated relaxing with no side effects. Reiki and companion groups reported improvements in quality of life and mood that were greater than those seen in the usual care group. Interventions during chemotherapy, such as Reiki or companionship, are feasible, acceptable, and may reduce side effects.

Why do comparative assessments predict health? The role of self-assessed health in the formation of comparative health judgments.

OBJECTIVE: Research has shown that self-assessments of health are strong predictors of morbidity and mortality regardless of format (i.e., self or comparative). In this study, the authors examined the relationship between 2 of these health assessments, self-assessed health (SAH) and comparative health (CH). On the basis of social psychological theory, they hypothesized that CH is predictive of health outcomes because it is based on SAH. Additionally, the authors examined whether motivational and dispositional factors influenced CH and whether these factors were able to account for the differences between CH and SAH. METHOD: Data were obtained from 851 community-dwelling older adults (M = 73 years). Participants responded to questionnaires assessing personality characteristics (e.g., trait affectivity, dispositional optimism and pessimism), and health status (e.g., functional limitations). All-cause mortality was tracked for a 10-year period. RESULTS: Correlation and agreement analyses revealed that both judgments had a high degree of similarity. As expected, survival analysis showed that CH predicted mortality but only until SAH was added into the model. Analysis examining the factors that influence CH showed that after controlling for SAH, high levels of trait positive affectivity, low levels of functional limitations, and low levels of fatigue-lack of energy were associated with high CH ratings. Examination of CH-SAH difference scores showed that only participants' age accounted for differences between these 2 judgments. CONCLUSIONS: These data revealed that CH judgments were, to a great extent, based on SAH. Results showed that motivational factors influence CH judgments but do not explain the differences between SAH and CH.