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Association of early follow-up visits with reduced hospital readmissions of newborns:a French population-based data-linkage study

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世界儿科杂志（英文版） 2024年第11期20卷 1138-1144页

作者： Camille Ravel Marion Nimal Steve Nauleau David Lapalus Olivier Bernard Elise Gras sophie tardieu Farid Boubred APHM Hospital University La ConceptionNeonatal UnitService de Médecine Néonatale147 Boulevard Baille13005 MarseilleFrance Regional Health Agency Provence-Alpes-Côte d'AzurFrance APHM Public Health and Medical Information DepartmentEA 3279CEReSS-Health Service Research and Quality of Life CentreMarseilleFrance APHM Hospital University La ConceptionNeonatal UnitService de Médecine Néonatale147 Boulevard Baille13005 MarseilleFrance Aix-Marseille University INSERMINRAEC2VNMarseilleFrance

Background Newborn care guidelines recommend assessments within a week of discharge from maternity ***,the optimal timing and effectiveness to prevent neonatal hospital readmission are *** study aimed to determine the association between early follow-up visits(EFVs)within three days of postpartum discharge and hospital readmission of newborns up to 15 days of life.Methods This population-based data-linkage study used data from the French National Health Care Database."Healthy"singleton term infants with a gestational age(GA)of ≥ 36 weeks,born between January 1,2017,and November 30,2018,in Southern France,were included.A multivariate regression analysis was performed.Results Among the 67,359 included infants,1519(2.25％)were *** principal causes of hospitalization were infectious diseases(42.4％)and jaundice or growth/nutrition disorders(36.1％).Hospitalized infants were more likely to be born to young and socioeconomically deprived mothers,to be male(54.4％vs.50.6％,P＜0.001),or born early(GA＜38 weeks;28.5％vs.20.5％,P＜0.001).They received 6％less EFVs than non-hospitalized infants(63.7％vs.67.8％,P＜0.001).The multivariable regression logistic analysis revealed that infants who received EFVs had 13％lower odds of being hospitalized than infants without EFVs,with an adjusted odds ratio of 0.87(95％confidence interval=0.78-0.96;P＜0.01).Conclusion EFVs within three days were associated with a 13％reduction in the rate of neonatal hospital ***,EFVs should be implemented to improve infant health and reduce healthcare costs.

关键词： Breastfeeding Bronchiolitis Neonatal jaundice Postpartum discharge Socioeconomic status

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COVID-19 patient experiences in prehospital pathways:a processual approach using life-events calendar method and state sequence analysis shows detrimental delays

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Family Medicine and Community Health 2024年第1期12卷 45-56页

作者： Romain Lutaud Sebastien Cortaredona Lea Delorme Patrick Peretti-watel Juliette Mirouse Manon Borg Lucie Cattaneo Didier Thery Gaetan Gentile Christian Pradier Touitou Irit Philippe Brouqui sophie tardieu Michel Carles Stéphanie Gentile Department of General Practice Aix-Marseille UniversityMarseilleFrance ADES MarseilleFrance Institut de Recherche pour le Développement(IRD) MarseilleFrance Assistance Publique-Hôpitaux de Marseille(AP-HM) MarseilleFrance INSERM MarseilleFrance Department of Public Health Archet University HospitalNiceFrance MEPHI MarseilleFrance CEReSS-Health Service Research and Quality of life Center MarseilleFrance Department of Infectious Diseases Centre Hospitalier Universitaire de NiceNiceFrance

Objectives To our best knowledge,no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19.‘Patients’voice is an excellent means to capture data on primary care *** aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences,and to test whether these clusters were associated with a higher risk of poor clinical *** Cross-sectional online survey using life-event *** All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in *** 312 patients responded to the *** outcome measures From the day of symptom onset to the day of hospitalisation,we defined a symptom sequence as the time-ordered vector of the successive symptom grades(grade 1,grade 2,grade 3).State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom *** logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit(ICU)and COVID-19 sequelae after *** Three clusters of symptom sequences were identified among 312 complete prehospital pathways.A specific group of patients(29%)experienced extended symptoms of severe COVID-19,persisting for an average duration of 7.5 days before *** group had a significantly higher probability of being admitted to ICU(adjusted OR 2.01).They were less likely to know a loved one who was a healthcare worker,and more likely to have a lower level of ***,this group of patients,who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time,may have been inclined to postpone reassessment when their health *** relatives played a decisive role in their *** and relevance This study h

关键词： admitted likely life

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