BACKGROUND Early discharge after myocardial infarction is safe and feasible. Factors that delay discharge need to be identified in order to improve care and reduce bed occupancy. OBJECTIVE To investigate the potential of the restricted weekend service that operates in most hospitals to delay patient discharge. DESIGN Prospective cohort study. SUBJECTS AND SETTING 2541 consecutive patients...

BACKGROUND Patient outcomes in specialist burns units have been used as a metric of care needs and quality. Besides patient factors there are service factors that might influence Length of Stay (LOS) and mortality, e.g. pressure on beds. Although the bed needs of UK hospitals have dropped significantly over the past three decades, with changes in policies and practices, recent reports suggest t...

Waiting times for cardiac surgery is a significant problem in the medical world. The fact that patients' length of stay varies considerably makes effective hospital operation a difficult job. This paper analyzes patients' length of stay in hospital wards following cardiac surgery. Three scenarios for hospital management are presented and evaluated using Markov chain theory and simulation experi...

The organisation and design of field hospitals within the British Army has been under review since the Gulf War. This paper discusses principles for the organisation and design of field hospitals and makes suggestions for further development. The paper describes the deployment of field hospitals from a 25 bed hospital troop up to a 200 bed field hospital.

Manipulation . . . . . . . . . . . . . . . . . . . . . 391 Oscillatory techniques . . . . . . . . . . . . . . . . 398 Sustained traction . . . . . . . . . . . . . . . . . . 399 Sinuvertebral nerve block . . . . . . . . . . . . . . 399 Bed rest . . . . . . . . . . . . . . . . . . . . . . . 399 Surgery: removal of protruded discs . . . . . . . . 399 Prevention of recurrence . . . . . . . . . . . ...

OBJECTIVES To estimate the impact of increased physical activity on utilization of hospital services among older adults in Canada. METHODS The paper uses the Canadian Community Health Survey Cycle 2.1, and count data regression models. The study sample includes 18,196 adults aged 65 and above. Specification tests are used in order to identify the appropriate count data model, and sensitivity ...

BACKGROUND Trauma system expansion is a complex process often governed by financial and health care system imperatives. We sought to propose a new, informed approach to trauma system expansion through the use of geospatial mapping. We hypothesized that geospatial mapping set to specific parameters could effectively identify optimal placement of new trauma centers (TC) within an existing trauma ...

AIM To identify factors contributing to significant differences between two university hospital departments of ophthalmology, one in Paris, France, and the other in Zagreb, Croatia, in their clinical effectiveness and cost-efficiency. METHOD Structural, clinical, and financial characteristics of a Croatian and French ophthalmology department were compared for the 1996-2000 period. We used Par...

Until recently, bed bugs have been considered uncommon in the industrialized world. This study determined the extent of reemerging bed bug infestations in homeless shelters and other locations in Toronto, Canada. Toronto Public Health documented complaints of bed bug infestations from 46 locations in 2003, most commonly apartments (63%), shelters (15%), and rooming houses (11%). Pest control op...

OBJECTIVE To determine the effect on cardiac arrests and overall hospital mortality of an intensive care-based medical emergency team. DESIGN AND SETTING Prospective before-and-after trial in a tertiary referral hospital. PATIENTS Consecutive patients admitted to hospital during a 4-month "before" period (May-August 1999) (n = 21 090) and a 4-month intervention period (November 2000 -Februa...