• Admissions and costs to acute hospitals resulting from road traffic crashes, 2005-2009.

      Sheridan, A; Howell, F; McKeown, N; Bedford, D; Department of Public Health, HSE Dublin North East, Railway St, Navan, Co Meath. (2012-03-01)
      Road traffic crashes (RTCs) remain a leading cause of death and injury. The aim of this study was to explore the use of hospital data as a source of RTC-related injury data in Ireland, as current systems are believed to under-estimate the burden. Information on inpatient discharges for years 2005-2009, admitted with RTC-related injuries were extracted from HIPE. There were 14,861 discharges; 9,661 (65.0%) were male, with an average age of 33 years. The median length of stay was two days. The most common diagnosis was head injury (n = 4,644; 31.2%). The average inpatient hospital cost was Euro 6,395 per discharge. 1,498 (10.1%) were admitted to intensive care units. This study has identified 3.5 times more serious injuries (14,861) than identified in the Road Safety Authority (RSA) statistics (4,263) indicating that the extent of road injuries is greater than previously estimated. Hospital data could be used annually in conjunction with RSA and other data; ideally the data should be linked.
    • General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

      Brabazon, E D; Carton, M W; Murray, C; Hederman, L; Bedford, D; Department of Public Health, Health Service Executive Dublin North East, Navan, County Meath, Ireland. elaine.brabazon@hse.ie (2010)
      The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.
    • Interpreting asymptomatic bacteriuria.

      Cormican, Martin; Murphy, Andrew W; Vellinga, Akke; Centre for Health from Environment, Ryan Institute, and Medical School, NUI Galway, Galway, Ireland. martin.cormican@hse.ie (BMJ (Clinical research ed.), 2011)
    • Patient satisfaction with a hepatitis B vaccination programme among persons with an intellectual disability.

      Cooney, Fionnuala; Department of Public Health Medicine, Bridgewater House, Rockwood Parade, Sligo, Ireland. fionnuala.cooney@hse.ie (Journal of intellectual disabilities : JOID, 2009-09)
      This article demonstrates that a patient satisfaction survey can be carried out to evaluate the acceptability of a hepatitis B vaccination programme among persons with an intellectual disability. In this exploratory study, involving six clients, 41 care staff and three managers of intellectual disability services, core themes were identified on the acceptability of the programme. The following recommendations are made: a respectful attitude should be shown to all clients by the healthcare providers; appropriate information about the programme should be provided that is tailored to the needs and receptive capability of all recipients and their carers; the intervention should be delivered in an environment, and by healthcare personnel, familiar to clients; carers should be attentive to the possibility of adverse effects; and explicit, ethically stringent policies should be in place on the use of physical restraint. The article makes suggestions regarding future work in assessing patient satisfaction among this client group.
    • Potential organ donor audit in Ireland.

      Hegarty, M; O'Neill, W; Colreavy, F; Dwyer, R; Cunningham, P; Hanlon, M; Department of Public Health, HSE Dublin Mid-Leinster, Tullamore, Co Offaly. mary.hegarty@hse.ie (2010-11)
      As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1/9/07-31/8/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information/education campaigns.
    • Sub-optimal asthma control in teenagers in the midland region of Ireland.

      Kelly, I; Fitzpatrick, P; Department of Public Health, HSE, Arden Road, Tullamore, Co. Offaly, Ireland. ina.kelly@hse.ie (Irish journal of medical science, 2011-12)
      Internationally, many children with asthma are not attaining achievable asthma control.
    • Trends in viral meningitis hospitalisations and notifications in the North Eastern Health Board (1997 - 2001): a cause for concern?

      Brabazon, E D; O'Farrell, A; Murray, C A; Finnegan, P; Dept. of Public Health, HSE North East, Navan, Co. Meath, Ireland. Elaine.Brabazon@hse.ie (2004)
      This study aimed to compare trends in both hospital admissions and notifications of viral meningitis in the North Eastern Health Board (NEHB). Hospital admissions from 1997 to 2001, involving NEHB residents with an infectious disease diagnosis, were examined and viral meningitis cases were analyzed. During this period 265 NEHB residents were admitted to hospital with viral meningitis--an increase of 429% between 1997 and 2001 with the bulk of this increase during 2000 and 2001. A total of 1,234 bed days were taken up by this cohort and the mean length of stay was 4.5 days (95% CI 4.2 - 4.9). The number of viral meningitis notifications in the NEHB was 38 (ranging from 4 in 1997 to 11 in 2001). This number is much lower than expected given the corresponding number of hospital admissions for the same period. Thus, most cases were not notified which means that current surveillance systems under-estimate the disease burden of viral meningitis. Such under-reporting has implications for infectious disease policy in Ireland.
    • Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

      Brabazon, E D; O'Farrell, A; Murray, C A; Carton, M W; Finnegan, P; Department of Public Health, Health Service Executive, Navan, Co Meath, Ireland. elaine.brabazon@hse.ie (2008-02)
      Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to 'infectious and parasitic diseases' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were 'missed' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a health board region in Ireland, which is a cause for concern from a surveillance point of view. If this under-reporting is similar in other health boards, then it would appear that the epidemiology of some notifiable diseases is incomplete both regionally and nationally. This under-reporting negatively impacts on the effectiveness of the notification process as a 'real-time' surveillance tool and an early warning system for outbreaks.