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.
Undiagnosed hypertension among young adults with regular primary care use
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.
A simple framework for complex system improvement
In a recent article by Dr. Sally Kraft et al., a framework for describing and organizing large-scale performance and quality improvements at the health care organization level is discussed. The framework draws from the health services, organizational behavior, and industrial engineering fields. Read more
Adjuvant chemotherapy for stage II right-sided and left-sided colon cancer: Analysis of SEER-Medicare data
Dr. Jennifer Weiss et al. found in a recent Annals of Surgical Oncology study that a large number of Medicare patients with stage II colon cancer receive adjuvant chemotherapy, but it did not improve overall 5-year survival for either right- or left-sided colon cancers. Adjuvant chemotherapy did, however, improve overall 5-year survival among patients with stage III colon cancer. Read the article here and a corresponding editorial here.
Rehospitalization to primary versus different facilities following abdominal aortic aneurysm repair
In a study to characterize readmissions to primary vs. different hospitals after open or endovascular abdominal aortic aneurysm repair, Dr. Scott Saunders et al. found that 13.1% of patients were readmitted within 30 days. Among those patients, 70.7% returned to the same facility as their primary admission, while 29.3% returned to a different facility. The strongest predictor of readmission to a different facility was greater distance from the patient's residence to the primary hospital. Read more