The delirium epidemic in frail hospitalized patients

Marco Inzitari
 

 

Cardiff Delirium Study

Delirium, formerly known as acute confusion syndrome, affects around 20% of patients older than 70 years admitted to hospitals, such as reflected a recent study from Australia, a country of 24.6 million inhabitants with a population less aged than ours. This syndrome significantly increases the stays of hospitalized patients, for example, due to femur fracture (7.4 days on average), or aortic valve replacement (4.2 days), with avoidable extra costs.

Hospital outpatient department, the great mess

Jordi Varela
Editor

 

Hospital day services don’t stop growing to the detriment of traditional hospitalizations, to the extent that the NHS has estimated that, in England, patient movements to hospitals generate 5% of road traffic throughout the country. Many of these services, such as surgery without admission, chemotherapy, anticoagulants or endoscopies, have been very well outlined since their origin, external consultations in general, on the other hand, are multipurpose devices where each speciality has accumulated outpatient services of very different characteristics until they become overflowing spaces that are difficult to manage, precisely because they have not defined what is expected of each of their activities. To give an example, a rheumatologist told me that it was unfortunate that they were evaluated due to the relationship between first and subsequent visits, when it’s known that his patients are complex forever, and he suggested that it would be convenient to be able to assess their service based on the quality of life their patients get, about the costs of prescribed treatments.

The crisis as an accelerator of latent changes

Cristina Adroher
 

It has been said by active and passive: a different society will emerge from this crisis, with profound changes in its values and practices. As for the healthcare system, there will be a time to analyze it, once the storm subsides but those of us in the backstage can go paving the way. Here are three proposals for aspects that I think could begin to be amended.

Telemedicine and telemonitoring: theory and practice for the era of coronavirus

Frederich Llordachs
Co-founder of Doctoralia, partner at Docplanner Group and partner at Braincats Consulting

The basic definition of telemedicine is the one that corresponds to its etymology: this is how the provision of medical services at a distance is defined (from the Greek “tele”, distance, and medicine). This definition is broader than it seems since it encompasses traditional technologies that would also be telemedicine, such as the warning bells of the arrival of lepers or requests for health resources and medicines by cable telegraph during the American Civil War.

Patient safety and iatrogenesis

Andreu Segura

Among the most important public health problems today, the harmful effects associated with clinical and health care practice stand out, the relevance of which is unquestionable given their impact and, above all, their aetiology. Hence the development of the so-called patient safety strategy, the purpose of which is to limit as much as possible the damage that medical and health care interventions can cause provided that such damage can be avoided.