Journal of hospital medicine最新文献

{"title":"Medical debt in America, Part II: Financial support for the most vulnerable","authors":"Blake N. Shultz MD, JD,&nbsp;Ahmed M. Ahmed MD, MPP, MSc,&nbsp;Luke Messac MD, PhD","doi":"10.1002/jhm.70002","DOIUrl":"10.1002/jhm.70002","url":null,"abstract":"<p>In this second part of a series on medical debt and the costs of care, we examine the past and present financial protections for low-income patients at nonprofit hospitals. Born of almshouses and religious orders, nonprofit hospitals were devoted at their founding to the care of the poor. However, over the course of the twentieth century, they became more focused on high-priced care for paying patients. Federal regulations surrounding tax exemption and charity care have been loosened to allow hospitals to spend relatively little on financial assistance, contributing to inequitable and inadequate financial protections for low-income patients.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"645-648"},"PeriodicalIF":2.4,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questions still unanswered: Future directions in exploring physician inpatient handoffs","authors":"Stephanie Thomas MD,&nbsp;Nicole D. Damari MD, MS,&nbsp;Jennifer K. O'Toole MD, MEd","doi":"10.1002/jhm.13596","DOIUrl":"10.1002/jhm.13596","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"653-654"},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical progress note: Diagnostic approach to dizziness and vertigo","authors":"Susrutha Kotwal MD, MEHP,&nbsp;Daniel Gold DO,&nbsp;Jonathan A. Edlow MD","doi":"10.1002/jhm.13595","DOIUrl":"10.1002/jhm.13595","url":null,"abstract":"<p>Dizziness is a common clinical presentation that incurs huge financial costs. It is frequently misdiagnosed due to a wide differential involving both benign (inner ear disease) and serious (stroke) disorders. Traditional frameworks that emphasize symptom quality (dizziness/lightheadedness/vertigo) lack diagnostic utility. This Clinical Progress Note reviews the literature on acute dizziness evaluation in adult patients and presents an evidence-based framework for hospitalists to diagnose the majority of undifferentiated dizzy patients at the bedside. Future research should assess the validity of this approach with hospitalists' ability to accurately diagnose dizzy patients, and its impact on patient care and healthcare outcomes.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"597-602"},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Visual Vignettes","authors":"Samir S. Shah MD, MSCE, MHM,&nbsp;Manpreet Malik MD, SFHM","doi":"10.1002/jhm.13591","DOIUrl":"10.1002/jhm.13591","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing for the unthinkable: The resurgence of vaccine-preventable diseases","authors":"Samir S. Shah MD, MSCE, MHM,&nbsp;Erin E. Shaughnessy MD, MSHCM,&nbsp;Benjamin Kinnear MD, MEd","doi":"10.1002/jhm.13589","DOIUrl":"10.1002/jhm.13589","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 4","pages":"333-334"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factoring neighborhood context into readmission risk: An outstanding question for health systems and policymakers","authors":"Anna Morenz MD, MPH,&nbsp;Joshua M. Liao MD, MSc","doi":"10.1002/jhm.13587","DOIUrl":"10.1002/jhm.13587","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 5","pages":"532-533"},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician inpatient handoffs—Patient and physician outcomes: A systematic review","authors":"Joshua Allen-Dicker MD, MPH,&nbsp;Matthew Kerwin MD,&nbsp;Joseph S. Wallins MD, MPH,&nbsp;Nisha Rao MD,&nbsp;Rezana Mara MD,&nbsp;Marina Chilov MLS,&nbsp;Chanan Batra DO, MHSA,&nbsp;Susan Chimonas PhD,&nbsp;Deborah Korenstein MD","doi":"10.1002/jhm.13583","DOIUrl":"10.1002/jhm.13583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pubmed, Embase, and Cochrane Central Register of Controlled Trials were searched on January 13th, 2022. We included experimental or quasi-experimental studies that examined handoff communication between inpatient physicians and reported patient clinical, patient experiential, physician experiential, or cost and utilization outcomes. Studies were excluded if they examined handoffs between facilities or levels of care, or only reported subjective measures of patient safety or physician experience. Risk of bias was assessed using the ROBINS-1 and RoB-2 tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 42 included studies, six were randomized controlled trials. Most studies were conducted at academic centers (67%) and involved only residents (64%). An educational intervention was used in 52% of studies and a structural intervention was used in 43%, with 9% using both. Adverse events were significantly improved in three of 16 studies, medical errors in three of seven studies, and length of stay in three of seven studies. Four studies examined mortality, and none reported a significant improvement. Studies that used both structural and educational components reported significant improvements more frequently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The literature is mixed on the impact of efforts to improve handoffs, though there are few randomized trials. Few studies reported patient experiential or cost/utilization outcomes, or involved hospitalist physicians, which represent potential areas for future research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"607-622"},"PeriodicalIF":2.4,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of neighborhood socioeconomic disadvantage on 30-day readmissions: A systematic review","authors":"Lindsey Garrett MA,&nbsp;Adil Muhammad MPH,&nbsp;Ambar Kulshreshtha MD, PhD","doi":"10.1002/jhm.13581","DOIUrl":"10.1002/jhm.13581","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The area deprivation index (ADI) is a measure of neighborhood disadvantage. It uses census-level information to quantify a person's neighborhood deprivation level based on their address. Recent studies have used ADI to examine the relationship between a patient's address and various health outcomes, including 30-day readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review was conducted to determine the effect of ADI on 30-day readmissions for both medical and surgical conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a comprehensive literature search in scientific databases, including PubMed, Embase, Web of Science, and SCOPUS from 2013 to 2024. Our search included terms related to ADI and 30-day readmissions in adult populations in the United States. Studies were included if they utilized ADI as their primary exposure and examined the risk of readmissions within 30 days as an outcome. Two reviewers independently extracted the data and assessed quality and biases in the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 66 papers found through database search, 23 (35%) were included. These studies focused on conditions such as cardiac, diabetic, neurological, and pulmonary diseases, as well as postsurgical and septic patients, with three studies examining all patients in general. When examining the highest level of ADI, 15 (65%) studies (6 of which focused on postsurgical patients) found that high ADI (most disadvantaged) is significantly associated with 30-day readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Living in a high ADI area moderately impacts 30-day readmissions, particularly for patients who have undergone surgery or have undifferentiated problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 5","pages":"489-504"},"PeriodicalIF":2.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The virtue of vulnerability","authors":"Justin J. Roesch MD, FACP","doi":"10.1002/jhm.13582","DOIUrl":"10.1002/jhm.13582","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"661-662"},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Please","authors":"Sydney Katz MD","doi":"10.1002/jhm.13580","DOIUrl":"10.1002/jhm.13580","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 5","pages":"544-545"},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}