跳到主要內容

臺灣博碩士論文加值系統

(44.200.169.3) 您好!臺灣時間:2022/12/04 10:12
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:史飛碩
研究生(外文):Sithembiso Sifiso Msibi
論文名稱(外文):Cardiovascular diseases (CVDs) patients’ in-hospital mortality rate and length of hospital stay in Swaziland: 2001-2013
指導教授:許怡欣許怡欣引用關係
指導教授(外文):Elsa
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:醫務管理學研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:74
中文關鍵詞:心血管疾病院內死亡住院天數
外文關鍵詞:Cardiovascular Diseasesin-hospital mortalitylength of hospital stay.
相關次數:
  • 被引用被引用:0
  • 點閱點閱:122
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
Background: Cardiovascular diseases (CVDs) are one of the leading non-communicable diseases (NCDs). A global analysis reveals that some of the poorest countries in the world have among the highest age-standardized mortality rates of CVDs. They are the leading cause of death globally. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths [1].
Objectives: 1. Calculate and analyze the trend of in-hospital mortality rate of CVDs patients in public health facilities over a period of 13 years 2. Analyze the trend of length of hospital stay of patients with CVDs. 3. Analyze the association between the CVDs mortality and the independent variables (gender, age, and region). 4. Analyze the association between the length of hospital stay and independent variables
Methods: Government data from 21 health facilities that offer in-patient services all over Swaziland was analyzed. Data for Cardiovascular Disease (CVD) in-patients, from 2001 to 2013, was used for the purpose of this study. 17809 patients were admitted for CVDs in the above-mentioned timeline and of those, there were 2955 in-hospital deaths. The study focuses on the CVD deaths. The association between outcome variables and the patients’ independent variables. Trend analysis on in-hospital CVD mortality and length of stay (LOS) over the 13 year period.
Results: There was a significant rise on the CVD deaths over the years (p= 0.007). More patients are being admitted and the deaths also increase. For the LOS, there was no significant increase or decrease over the years. Region (urbanization) was found to be a significant variable for all outcome variables, i.e. CVD mortality, LOS and Discharge status with p= 0.01, 0.011 and 0 respectively. CVD mortality was also dependent on gender. There were significantly more female cases than males.
Conclusion: Different studies, including this one, have shown that CVDs together with other non-communicable diseases are on the rise in lower middle income countries (LMIC) like Swaziland. The country has been plagued by the double burden of infectious diseases and NCDs. A lot of work has been done in combating most infectious diseases, more attention through government intervention policies, should be afforded to these NCDs.


Table of Contents
Acknowledgements…………………………………………………………………………i
Abstract………………………………………………………………………………ii
CHAPTER 1: INTRODUCTION 2
1.1 Background…………………………………………………………………..2
1.2 Research Motivation and Problem Statement………………………………..5
1.3 Significance of Study………………………………………………………..7
1.4 Aim and Objectives………………………………………………………….8
CHAPTER 2: LITERATURE REVIEW 9
2.1 Cardiovascular Diseases……………………………………………………9
2.2 Risk factors of CVDs……………………………………………………….12
2.3 CVDs in Swaziland…………………………………………………………16
2.4 In-hospital mortality rate……………………………………………………18
2.5 Length of hospital stay……………………………………………………...19
2.6 Health System in Swaziland………………………………………………...21
CHAPTER 3: METHODOLOGY 24
3.1 Data Source…………………………………………………………………25
3.2 Data Analysis……………………………………………………………….29
CHAPTER 4: RESULTS 30
CHAPTER 5: DISCUSSION AND CONCLUSIONS 46
5.1 Discussion…………………………………………………………………46
5.2 Conclusion………………………………………………………………...50
5.3 Recommendations…………………………………………………………51
5.4 Limitation of Study………………………………………………………..52
REFERENCES 55



REFERENCES
AlJaroudi, W., Alraies, M. C., Halley, C., Rodriguez, L., Grimm, R. A., Thomas, J. D., & Jaber, W. A. (2013). Effect of Age, Gender, and Left Ventricular Diastolic Function on Left Atrial Volume Index in Adults Without Known Cardiovascular Disease or Risk Factors. The American Journal of Cardiology, 111(10), 1517-1522. doi: http://dx.doi.org/10.1016/j.amjcard.2013.01.
Andersson T, Magnuson A, Bryngelsson I-L, Frobert O, Henriksson KM, Edvardsson N, et al. Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients. International Journal of Cardiology. 2014;177(1):91-9.
Atsma F, Bartelink ML, Grobbee DE, van der Schouw YT. Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis. Menopause (New York, NY). 2006;13(2):265-79.
Authority, N. H. P. (2013). Hospital Performance:
Length of stay in public hospitals in 2011-12: National Health Performance Authority.
Bottle, A., Jarman, B., & Aylin, P. (2011). Hospital Standardized Mortality Ratios: Sensitivity Analyses on the Impact of Coding. Health Services Research, 46(6 Pt 1), 1741–1761. doi:10.1111/j.1475-6773.2011.01295.x
Brotemarkle, R. A., Resnick, B., Michaels, K., Morton, P., & Wells, C. (2015). Length of hospital stay and discharge disposition in older trauma patients. Geriatric Nursing, 36(2, Supplement), S3-S9. doi: http://dx.doi.org/10.1016/j.gerinurse.2015.02.016
Brown, T. M., Deng, L., Becker, D. J., Bittner, V., Levitan, E. B., Rosenson, R. S., . . . Muntner, P. Trends in Mortality and Recurrent Coronary Heart Disease Events Following an Acute Myocardial Infarction among Medicare Beneficiaries, 2001 – 2009. American Heart Journal(0). doi: http://dx.doi.org/10.1016/j.ahj.2015.04.027
Cao, K., Xu, J., Shangguan, Q., Hu, W., Li, P., Cheng, X., & Su, H. (2015). Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: An updated meta-analysis of cohort studies. International Journal of Cardiology, 189(0), 211-219. doi: http://dx.doi.org/10.1016/j.ijcard.2015.04.079
Fernando, L., Pamela, S., & Alejandra, L. (2014). Cardiovascular Disease in Latin America: The Growing Epidemic. Progress in Cardiovascular Diseases, 57(3), 262-267. doi: http://dx.doi.org/10.1016/j.pcad.2014.07.007
Gaziano, T. A. (2007). Reducing The Growing Burden Of Cardiovascular Disease In The Developing World: Disease burden can be lowered with cost-effective interventions, especially by reducing the use of tobacco around the world. Health affairs (Project Hope), 26(1), 13-24. doi: 10.1377/hlthaff.26.1.13
He, Q., Wu, C., Luo, H., Wang, Z.-Y., Ma, X.-Q., Zhao, Y.-F., . . . He, J. (2014). Trends in In-Hospital Mortality among Patients with Stroke in China. PLoS ONE, 9(3), e92763. doi: 10.1371/journal.pone.0092763
Jarman, B., Gault, S., Alves, B., Hider, A., Dolan, S., Cook, A., . . . Iezzoni, L. I. (1999). Explaining differences in English hospital death rates using routinely collected data. BMJ, 318(7197), 1515-1520.
Kato, N., Kondo, M., Okubo, I., & Hasegawa, T. (2014). Length of hospital stay in Japan 1971–2008: Hospital ownership and cost-containment policies. Health Policy, 115(2–3), 180-188. doi: http://dx.doi.org/10.1016/j.healthpol.2014.01.002
Khan, H., Kalogeropoulos, A. P., Zannad, F., Marti, C. N., Wilson, P. W. F., Georgiopoulou, V. V., . . . for the Health, A. B. C. S. (2014). Incident heart failure in relation to vascular disease: Insights from the Health, Aging, and Body Composition Study. European Journal of Heart Failure, 16(5), 526-534. doi: 10.1002/ejhf.69
Khanam, M. A., Streatfield, P. K., Kabir, Z. N., Qiu, C., Cornelius, C., & Wahlin, A. (2011). Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh: A Cross-sectional Study. Journal of Health, Population, and Nutrition, 29(4), 406-414.
Lee, C., Joseph, L., Colosimo, A., & Dasgupta, K. (2012). Mortality in diabetes compared with previous cardiovascular disease: A gender-specific meta-analysis. Diabetes & Metabolism, 38(5), 420-427. doi: http://dx.doi.org/10.1016/j.diabet.2012.04.002
Liu, S., Heaman, M., Kramer, M. S., Demissie, K., Wen, S. W., & Marcoux, S. (2002). Length of hospital stay, obstetric conditions at childbirth, and maternal readmission: A population-based cohort study. American Journal of Obstetrics and Gynecology, 187(3), 681-687. doi: http://dx.doi.org/10.1067/mob.2002.12576
Malan L, Schutte AE, Malan NT, Wissing MP, Vorster HH, Steyn HS, et al. Specific coping strategies of Africans during urbanization: Comparing cardiovascular responses and perception of health data. Biological Psychology. 2006;72(3):305-10.
Mathers, C. D., & Loncar, D. (2006). Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Medicine, 3(11), e442. doi:10.1371/journal.pmed.0030442
Mikkola, T. S., Gissler, M., Merikukka, M., Tuomikoski, P., & Ylikorkala, O. (2013). Sex Differences in Age-Related Cardiovascular Mortality. PLoS ONE, 8(5), e63347. doi: 10.1371/journal.pone.0063347
Ministry of Health, S. (2010). Service Availability Mapping. Mbabane, Swaziland.
Ministry of Health, S. (2013). Service Availability Mapping Mbabane, Swaziland.
Mueller NT, Odegaard AO, Gross MD, Koh WP, Yuan J-M, Pereira MA. Age at menarche and cardiovascular disease mortality in Singaporean Chinese women: the Singapore Chinese Health Study. Annals of Epidemiology. 2012;22(10):717-22.
Nirantharakumar, K., Saeed, M., Wilson, I., Marshall, T., & Coleman, J. J. (2013). In-hospital mortality and length of stay in patients with diabetes having foot disease. Journal of Diabetes and its Complications, 27(5), 454-458. doi: http://dx.doi.org/10.1016/j.jdiacomp.2013.05.003
Ocana-Riola R, Mayoral-Cortes JM, Fernandez-Ajuria A, Sanchez-Cantalejo C, Martin-Olmedo P, Blanco-Reina E. Age, Period, and Cohort Effects on Mortality From Ischemic Heart Disease in Southern Spain. Revista Espanola de Cardiologia (English Edition). 2015;68(5):373-81.
Parissis JT, Mantziari L, Kaldoglou N, Ikonomidis I, Nikolaou M, Mebazaa A, et al. Gender-related differences in patients with acute heart failure: Management and predictors of in-hospital mortality. International Journal of Cardiology. 2013;168(1):185-9.
Rodopoulou, S., Chalbot, M.-C., Samoli, E., DuBois, D. W., San Filippo, B. D., &Kavouras, I. G. (2014). Air pollution and hospital emergency room and admissions for cardiovascular and respiratory diseases in Dona Ana County, New Mexico. Environmental Research, 129(0), 39-46. doi: http://dx.doi.org/10.1016/j.envres.2013.12.006
Ski, C. F., King-Shier, K. M., & Thompson, D. R. (2014). Gender, socioeconomic and ethnic/racial disparities in cardiovascular disease: A time for change. International Journal of Cardiology, 170(3), 255-257. doi: http://dx.doi.org/10.1016/j.ijcard.2013.10.082
Streatfield, P. K., Khan, W. A., Bhuiya, A., Hanifi, S. M. A., Alam, N., Bagagnan, C. H., . . . Byass, P. (2014). Adult non-communicable disease mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites. Global Health Action; Vol 7 (2014): incl Supplements.
Swaminathan, R. V., Rao, S. V., McCoy, L. A., Kim, L. K., Minutello, R. M., Wong, S. C., . . . Feldman, D. N. (2015). Hospital Length of Stay and Clinical Outcomes in Older STEMI Patients After Primary PCI: A Report From the National Cardiovascular Data Registry. Journal of the American College of Cardiology, 65(12), 1161-1171. doi: http://dx.doi.org/10.1016/j.jacc.2015.01.028
Suarez, A. L., Bascunana-Quirell, A., Elvira-Gonzalez, J., Beltran-Robles, M., Aboza-Lobaton, A., & Solis-Diaz, R. (2013). Community-based incidence rate of cardiovascular disease and mortality in 50–75-year-old adults. Revista Clinica Espanola (English Edition), 213(6), 278-284. doi: http://dx.doi.org/10.1016/j.rceng.2013.05.005
Tom, S. E., Cooper, R., Wallace, R. B., & Guralnik, J. M. (2012). Type and Timing of Menopause and Later Life Mortality Among Women in the Iowa Established Populations for the Epidemiological Study of the Elderly Cohort. Journal of Women''s Health, 21(1), 10-16. doi: 10.1089/jwh.2011.2745
Vaidya, D., Becker, D. M., Bittner, V., Mathias, R. A., & Ouyang, P. (2011). Ageing, menopause, and ischaemic heart disease mortality in England, Wales, and the United States: modelling study of national mortality data. BMJ, 343.
WHO. (2011). Global Atlas on Cardiovascular Disease prevention and control. In P. P. a. B. N. Shanthi Mendis (Ed.). France.
WHO. (2012). Cardiovascular diseases. Retrieved 15 March, 2015
WorldBank. (2013). Urban Development. Retrieved 20 April, 2015
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52.
Zahra A, Lee EW, Sun Ly, Park JH. Cardiovascular disease and diabetes mortality, and their relation to socio-economical, environmental, and health behavioural factors in worldwide view. Public Health. 2015;129(4):385-95.
Zhang, Y., Agnoletti, D., Iaria, P., Protogerou, A. D., Safar, M. E., Xu, Y., & Blacher, J. (2012). Gender difference in cardiovascular risk factors in the elderly with cardiovascular disease in the last stage of lifespan: The PROTEGER study. International Journal of Cardiology, 155(1), 144-148. doi: http://dx.doi.org/10.1016/j.ijcard.2011.09.073
Zomer, A. C., Ionescu-Ittu, R., Vaartjes, I., Pilote, L., Mackie, A. S., Therrien, J., . . . Marelli, A. J. (2013). Sex Differences in Hospital Mortality in Adults With Congenital Heart Disease: The Impact of Reproductive Health. Journal of the American College of Cardiology, 62(1), 58-67. doi: http://dx.doi.org/10.1016/j.jacc.2013.03.056




QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top