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Health Care Science 2022年第3期1卷 160-165页

作者： Sze Ling Chan Elaine Lum Marcus E.H.Ong nicholas graves Health Services Research Centre SingHealthSingaporeSingapore Health Services and Systems Research Duke-NUS Medical SchoolSingaporeSingapore Department of Emergency Medicine Singapore General HospitalSingaporeSingapore

Healthcare systems face many competing demands and insufficient *** innovations to improve efficiency are important to address this *** can range from new pharmaceuticals,alternate models of care,novel devices,and the use other *** implementation can mean lost *** review article aims to highlight the role of implementation science,summarize how settings have leveraged this methodology to promote translation of innovation into practice,and describe our own experience of embedding implementation science into an academic medical center in *** science offers a range of methods to promote systematic uptake of research findings about innovations and is gaining recognition worldwide as an important discipline for health services *** systems around the world have tried to promote implementation research in their settings by establishing(1)dedicated centers/programs,(2)offering funding,and(3)building knowledge and capacity among *** science is a critical piece in the translational pathway of“evidence to innovation”.The three efforts we describe should be strengthened to integrate implementation science into the innovation ecosystem around the world.

关键词： evidence translation implementation research intervention

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Decision-making for early major amputation in selected diabetic foot ulcer patients with peripheral vascular disease

Health Care Science

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Health Care Science 2022年第2期1卷 58-68页

作者： Lim York Tee Gorden Ying Fangting Ariel Ho Pei Lingyan Meng N.G.Yi Zhen nicholas graves Wound Care Innovation for the Tropics Programme Skin Research Institute of SingaporeA*STARSingaporeSingapore Health Services and Systems Research Duke‐NUS Medical SchoolSingaporeSingapore Department of Surgery Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore

Objective:To estimate the costs from delaying major amputation in patients with concurrent diabetic foot ulcer and peripheral vascular *** seek to model economic benefits from saved costs from promoting timely major amputations among these ***:Retrospective modeling using data from National University Hospital,*** identified patients who might have delayed major amputations by applying a hierarchical clustering *** then modeled the transitions of all patients over time with a Markov process using a number of relevant health states to enable estimation of cost *** next summarized the expected changes to the bed days used and cost outcomes arising from reassigning some patients who may have had a delayed amputation to timely *** findings from the sample were scaled to reflect national incidence rates for this disease for the years 2014-2019 in *** and Conclusions:Nine of the 137 patients(6.57%)would be suitable for a major amputation at 3 months,yet in reality,their amputation was *** on this,and assuming a timely amputation is done for the entire population of patients in Singapore we expect annual savings of 264,791 bed days and $211 million in *** findings are preliminary and *** value of this paper is to show a method for estimating outcomes,report the findings from a small sample,and stimulate future *** cohort studies might be designed to capture a wider range of outcomes and recruit a larger sample of individuals.

关键词： amputations patients costs

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Retrospective matched cohort study of incidence rates and excess length of hospital stay owing to pressure injuries in an Asian setting

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Health Care Science 2023年第2期2卷 82-93页

作者： nicholas graves Raju Maiti Fazila Abu Bakar Aloweni Ng Yi Zhen Ang Shin Yuh Priya Bishnoi Tze Tec Chong David Carmody Keith Harding Health Services and Systems Research Duke-NUS Medical SchoolSingaporeSingapore Centre for Quantitative Medicine Duke-NUS Medical SchoolSingaporeSingapore Singapore General Hospital SingaporeSingapore Skin Research Institute of Singapore Agency for ScienceTechnology and Research(A*STAR)SingaporeSingapore Wound Care Innovation for the Tropics Programme SingaporeSingapore

Background:Little is known about stage 1 and 2 pressure injuries that are health *** report incidence rates of health care-acquired stage 1 and stage 2 pressure injuries,and,estimate the excess length of stay using four competing analytic *** discuss the merits of the different ***:We calculated monthly incidence rates for stage 1 and 2 health care-acquired pressure injuries occurring in a large Singapore acute care *** estimate excess stay,we conducted unadjusted comparisons with a control cohort,performed linear regression and then generalized linear regression with a gamma ***,we fitted a simple state-based *** design for the cost attribution work was a retrospective matched cohort ***:Incidence rates in 2016 were 0.553%(95%confidence interval[CI]0.55,0.557)and 0.469%(95%CI 0.466,0.472)in *** data censored at 60 days’maximum stay,the unadjusted comparisons showed the highest excess stay at 17.68(16.43-18.93)days and multi-state models showed the lowest at 1.22(0.19,2.23)***:Poor-quality methods for attribution of excess length of stay to pressure injury generate inflated estimates that could mislead decision *** findings from the multi-state model,which is an appropriate method,are plausible and illustrate the likely bed-days saved from lowering the risk of these *** 1 and 2 pressure injuries are common and increase costs by prolonging the length of *** will be economic value investing in *** biased estimates of excess length of stay will overstate the potential value of prevention.

关键词： health care-acquired pressure injury incidence rates costs attribution methods

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比较多种改进院内手卫生干预措施的效果：系统性综述和网络荟萃分析

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英国医学杂志中文版 2016年第1期19卷 8-9页

作者： Nantasit Luangasanatip Maliwan Hongsuwan Direk Limmathurotsakul Yoel Lubell Andie S Lee Stephan Harbarth nicholas P J Day nicholas graves BenS Cooper 肖颖不详首都医科大学附属北京朝阳医院

目的评估世界卫生组织（WH0）2005年提出的方法（WHO-5）和其他干预措施对于提升院内医务人员手卫生的相对效果，同时总结资源利用情况。设计系统性综述和网络荟萃（meta）分析。数据来源联机医学文献分析和检索系统（Medline）、荷兰... 详细信息

目的评估世界卫生组织（WH0）2005年提出的方法（WHO-5）和其他干预措施对于提升院内医务人员手卫生的相对效果，同时总结资源利用情况。设计系统性综述和网络荟萃（meta）分析。数据来源联机医学文献分析和检索系统（Medline）、荷兰医学文摘数据库（Embase）、护理学数据库（CINAHL）、英国国家健康体系经济评价数据库、英国国家健康体系评论和传播中心、考克兰图书馆、EPOC存储器f2009年12月-2014年2月）；以相同检索词获取的系统性综述（1980-2009）中筛选出的研究。

关键词：疗效比较网络系统医院

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