In a recent study, Rebecca Schwei et al. found that among surveyed participants, institutional trust was lower in African Americans and Mexican-Hispanics than whites, as well as in people who previously had a negative health care experience. The authors concluded that improving health care experiences, especially for racial/ethnic minority groups, has the potential to improve institutional trust and decrease health disparities.
Impact of sociodemographics & previous interactions with the health care system on institutional trust
The roles of primary care PAs and NPs caring for older adults with diabetes
Dr. Christine Everett et al. used EHR and Medicare data to characterize PA and NP roles on panels of primary care patients with diabetes. They found that PAs and NPs perform a variety of roles with different levels of involvement, complexity of patients, and delivery of chronic care, and they frequently perform multiple roles within a clinic.
Rehospitalization to primary versus different facilities following abdominal aortic aneurysm repair
In a recent study, Dr. Scott Saunders et al. found that among patients who underwent abdominal aortic aneurysm repair, readmission to a facility different from the primary hospital where the surgery occurred is common. The distance of a patient's residence from the primary hospital was the greatest predictor of readmission to a different hospital, and the median total 30-day payments were significantly lower at different versus primary hospitals. Read more
Undiagnosed hypertension among young adults with regular primary care use
In a retrospective analysis published in the Journal of Hypertension and summarized in a CDC Science-in-Brief article, Dr. Heather Johnson et al. found that young adults were less frequently diagnosed with hypertension and had a 33% slower rate of receiving a diagnosis when compared to adults >60 years old. They also found that young adults with current tobacco use, white ethnicity, and non-English primary language were likely to have a slower diagnosis rate.
Observation and inpatient status: clinical impact of the 2-midnight rule
Dr. Ann Sheehy et al. recently published a study in the Journal of Hospital Medicine on the clinical impact of the CMS rule that classifies most hospital encounters of less than 2 midnights as observation and 2 midnights or greater as inpatient. They found that applying the rule predicted a net loss of nearly 15% inpatient stays. Only 1 of the 5 top ICD-9 codes was the same for inpatient and observation stays that were less than 2 midnights, and observation encounters that started before 8:00 am spanned 2 midnights less frequently than encounters that started later in the day. Today's Hospitalist recently published an article about the study.