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To research the benefits of using a medical network platform for patients receiving day surgery in the outpatient plastic and cosmetic department. During the study period, 86 patients (day surgery in the plastic and aesthetic Department) were selected as the observation objects, and the treatment period was from August 2021 to August 2022. A retrospective analysis was conducted on the relevant customer data of the aforementioned patients. The patients were divided into two groups using the random number table method, with 43 individuals in each group. The controlling group consisted of the patients who got traditional nursing care, while the observational group consisted of the patients who engaged in continual nursing based on the medical network platform. The differences in patient quality of life, changes in psychological and emotional condition, and awareness of knowledge, contentment, and compliance with postoperative nursing between the two groups were also contrasted. Patients in the observational group reported more nursing contentment than those in the control group (P < .001). Compared to the control group, the observational group's patient compliance was higher (P = .019). The awareness of nursing knowledge was analyzed. The awareness rates of dressing and stitching time, wound self-observation nursing, follow-up time and process, rest and signs, pain nursing, and diet nursing of patients in the observational group were higher than those in the control group (P = .001, .009, .001, .001, .017, .001). Following nursing, patients in the observational group had lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) grades than patients in the controlling group (P < .001). Those in the observational group had greater grades for physical function, physical pain, social function, vitality, general health, psychological health, physical wellbeing, and psychological function than patients in the control group (P < .001). The effects of continuing nursing based on the medical network platform among patients with day surgery in the plastic and aesthetic department of outpatient are significant, and the effects are ideal in improving patients' psychological and emotional state, compliance, and quality of life, with reference application value.

Introduction Patient satisfaction is important for chronic care quality; however limited evidence exists regarding satisfaction patterns and demographic predictors among outpatients with chronic illnesses in Saudi Arabia. This study investigated patient satisfaction levels and identified demographic factors affecting satisfaction in chronic care settings. Methods A cross-sectional survey was conducted among 397 outpatients with chronic illnesses attending healthcare facilities in Medina, Saudi Arabia (August–September 2024). The validated Patient Satisfaction Questionnaire Short Form (PSQ-18) was administered electronically in Arabic and English. Demographic predictors were analyzed using ordinal logistic regression with satisfaction tertiles. Doctor-patient interaction correlations were assessed using Spearman coefficients. Results Participants included 213 females (53.6%) and 184 males (46.4%), with median age 45 years. Overall PSQ-18 satisfaction score was 64.4% of maximum possible. Age was the primary satisfaction predictor, with patients aged 45–60 years showing 2.31 times higher odds of superior satisfaction compared to younger patients (18–30 years, P -value = 0.010). Doctor-patient interaction measures showed strong correlations with overall satisfaction: physical comfort ( ρ  = 0.635), respect and empathy ( ρ  = 0.602), and comfort asking questions ( ρ  = 0.500, all P -value < 0.001). Gender and employment status showed no significant associations with satisfaction levels. Accessibility and convenience scored lowest (60% satisfaction), while interpersonal manner, communication, and financial aspects achieved highest scores (70% satisfaction). Conclusions Age-appropriate care delivery and enhanced doctor-patient interactions represent the most promising targets for improving chronic care satisfaction. Healthcare systems should prioritize interpersonal care training and accessibility improvements to optimize patient experiences across all age groups.

To evaluate the impact of the integrated outpatient clinic for chronic diseases (IOC-CD) on the quality of life of hypertension patients in Rural medical alliance of Zhejiang Province, and offer optimization suggestions. We conducted a cross-sectional study using the EuroQol five-dimensional questionnaire (EQ-5D) from October to November 2023. A total of 295 outpatients with essential hypertension were enrolled through random sampling. Trained investigators collected data via face-to-face paper-based questionnaires in waiting areas, and health utility values were calculated accordingly. The average EQ-VAS and utility scores of hypertensive patients in the integrated chronic disease outpatient clinics of the sampled areas are both at a high level. Among the sampled population, the dimension with the most problems is pain/discomfort, while the dimension with the fewest problems is self-care. Multivariate analysis showed that being over 60 negatively impacted health utility and VAS scores. Have a family doctor and satisfaction with pre-/post-visit services positively affected these scores, while satisfaction with in-visit services improved health utility. Hypertensive patients in Zhejiang’s county-level medical alliances receiving chronic disease integrated outpatient care have good health-related quality of life. Future work should expand this integrated clinic model, optimize resource allocation, and improve clinic management and service quality to better meet patients’ health needs and enhance their quality of life.

Abstract Background Fungal diseases range from relatively-minor superficial and mucosal infections to severe, life-threatening systemic infections. Delayed diagnosis and treatment can lead to poor patient outcomes and high medical costs. The overall burden of fungal diseases in the United States is challenging to quantify, because they are likely substantially underdiagnosed. Methods To estimate the total, national, direct medical costs associated with fungal diseases from a healthcare payer perspective, we used insurance claims data from the Truven Health MarketScan 2014 Research Databases, combined with hospital discharge data from the 2014 Healthcare Cost and Utilization Project National Inpatient Sample and outpatient visit data from the 2005–2014 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. All costs were adjusted to 2017 dollars. Results We estimate that fungal diseases cost more than $7.2 billion in 2017, including $4.5 billion from 75055 hospitalizations and $2.6 billion from 8993230 outpatient visits. Hospitalizations for Candida infections (n = 26735, total cost $1.4 billion) and Aspergillus infections (n = 14820, total cost $1.2 billion) accounted for the highest total hospitalization costs of any disease. Over half of outpatient visits were for dermatophyte infections (4981444 visits, total cost $802 million), and 3639037 visits occurred for non-invasive candidiasis (total cost $1.6 billion). Conclusions Fungal diseases impose a considerable economic burden on the healthcare system. Our results likely underestimate their true costs, because they are underdiagnosed. More comprehensive estimates of the public health impact of these diseases are needed to improve their recognition, prevention, diagnosis, and treatment. To provide insight into the burden of fungal diseases in the United States, we used several administrative data sources to estimate their total direct healthcare costs. We estimate that fungal disease healthcare costs exceed $7 billion annually.

Background Depressive disorders are among the common mental health conditions in the general outpatient setting and affect patients’ load and treatment outcomes. People who suffer from depression frequently consult general practitioners and prefer to attribute their symptoms to physical illness rather than mental illness. Little is known about the magnitude and associated factors of depression among patients attending general outpatient services in Somalia. The study aimed at determining the prevalence and associated factors of depression among them. Methods This is an institution-based cross-sectional study among randomly selected 422 patients who attended general outpatient services of two hospitals in Mogadishu. We applied three standardized instruments, such as the Somali version of the Patient Health Questionnaire (PHQ-9), the Oslo Social Support Scale (OSSS-3), and the Perceived Stress Scale-10 (PSS-10). We analyzed data using the statistical software SPSS version 29. We calculated prevalence and its 95% Confidence Interval (CI) and identified associated factors by bivariate and Multivariate analysis. We considered the association significant when p value is < 0.05. Results The prevalence of depression symptoms was found to be 55% (95% CI 50–60%). The result also showed that 55.0% were females, 50.7% were aged between 26 and 44 years, 44.3% were single, 29.9% achieved tertiary education, and 44.3% were unemployed. Multivariate analysis established that age of between 26 and 44 years (aOR = 2.86, 95%CI:1.30–6.29, p  = 0.009), being separated/divorced (aOR = 2.37, 95%CI: 1.16–4.82, p  = 0.018), income level of ≤$100 (aOR = 3.71, 95% CI:1.36–10.09, p  = 0.010), and high stress levels (aOR = 20.06, 95%CI:7.33–54.94, p  < 0.001) were independent factors that significantly associated with depressive symptoms. Conclusion This study found high levels of depression among patients attending outpatient clinics, with age, marital status, education level, income level, family history of psychiatry disorder, and stress level being key predictors. Regular screening among patients in outpatient clinics and proper referral are crucial in ensuring that those at high risk of depression are managed effectively.

Noise is a common problem in hospitals, and it is known that social behavior can influence sound levels. The aim of this naturally-occurring field experiment was to assess the influence of a non-talking rule on the actual sound level and perception of patients in an outpatient infusion center. In a quasi-randomized trial two conditions were compared in real life. In the control condition, patients (n = 137) were allowed to talk to fellow patients and visitors during the treatment. In the intervention condition patients (n = 126) were requested not to talk to fellow patients and visitors during their treatment. This study measured the actual sound levels in dB(A) as well as patients' preferences regarding sound and their perceptions of the physical environment, anxiety, and quality of health care. A linear-mixed-model showed a statistically significant, but rather small reduction of the non-talking rule on the actual sound level with an average of 1.1 dB(A). Half of the patients preferred a talking condition (57%), around one-third of the patients had no preference (36%), and 7% of the patients preferred a non-talking condition. Our results suggest that patients who preferred non-talking, perceived the environment more negatively compared to the majority of patients and perceived higher levels of anxiety. Results showed no significant effect of the experimental conditions on patient perceptions. In conclusion, a non-talking rule of conduct only minimally reduced the actual sound level and did not influence the perception of patients.

Patient navigation improves colorectal cancer screening among underserved populations, but limited resources preclude widespread adoption in minority-serving institutions. We evaluated whether a patient's self-selected social contact person can effectively facilitate outpatient screening colonoscopy. From September 2014 to March 2017 in an urban tertiary center, 399 black participants scheduled for outpatient screening colonoscopy self-selected a social contact person to be a facilitator and provided the person's phone number. Of these, 201 participants (50.4%) were randomly assigned to the intervention arm for their social contact persons to be engaged by phone. The study was explained to the social contact person with details about colonoscopy screening and bowel preparation process. The social contacts were asked to assist the participants, provide support, and encourage compliance with the procedures. The social contact person was not contacted in the usual care arm, n = 198 (49.6%). We evaluated attendance to the scheduled outpatient colonoscopy and adequacy of bowel preparation. Analysis was performed by intention to treat. The social contact person was reached and agreed to be involved for 130 of the 201 participants (64.7%). No differences were found in the proportion of participants who underwent screening colonoscopy (77.3% vs 77.2%; relative risk = 1.01; 95% confidence interval: 0.91-1.12), but there was a modest increase in the proportion with adequate bowel preparation with social contact involvement (89.1% vs 80.9%; relative risk = 1.10; 95% confidence interval: 1.00-1.21). Engaging a patient's social network to serve in the role of a patient navigator did not improve compliance to outpatient screening colonoscopy but modestly improved the adequacy of bowel preparation.

ABSTRACT BACKGROUND Anterior cervical discectomy and fusion (ACDF) is being increasingly offered on an outpatient basis. However, the safety profile of outpatient ACDF remains poorly defined. OBJECTIVE To review the medical literature on the safety of outpatient ACDF. METHODS We systematically reviewed the literature for articles published before April 1, 2018, describing outpatient ACDF and associated complications, including incidence of reoperation, stroke, thrombolytic events, dysphagia, hematoma, and mortality. A random-effects analysis was performed comparing complications between the inpatient and outpatient groups. RESULTS We identified 21 articles that satisfied the selection criteria, of which 15 were comparative studies. Most of the existing studies were retrospective, with a lack of level I or II studies on this topic. We found no statistically significant difference between inpatient and outpatient ACDF in overall complications, incidence of stroke, thrombolytic events, dysphagia, and hematoma development. However, patients undergoing outpatient ACDF had lower reported reoperation rates (P < .001), mortality (P < .001), and hospitalization duration (P < .001). CONCLUSION Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF. However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients. Patients with advanced age and comorbidities such as obesity and significant myelopathy are likely not suitable for outpatient ACDF. Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF.

Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0 . 05. Results The monthly average length of waiting time decreased 3 . 49 min ( P  = 0 . 003) for consultations and 8 . 70 min ( P  = 0 . 02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions ( P  =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services ( r  = −0 . 71, P  = 0 . 004). Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This case provides a model of carrying out continuous quality improvement and optimizing management process with the support of relevant evidence.