JAMA network open
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Multicenter Study
Epidemiologic Trends in Clostridioides difficile Infections in a Regional Community Hospital Network.
Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies. ⋯ The findings suggest that, despite the modest improvement in health care facility-associated CDI rates, a better understanding of community-acquired CDI incidence is needed for future infection prevention efforts.
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Comparative Study
Association of Clinical Frailty Scores With Hospital Readmission for Falls After Index Admission for Trauma-Related Injury.
Falls have been associated with morbidity and mortality in elderly patients. Assessment of frailty at hospital admission may help health care professionals evaluate fall risk in patients with trauma-related injury. ⋯ Measurement of frailty at hospital admission may be an effective tool to assess fall risk and discharge disposition among patients with trauma-related injury aged 50 years and older.
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Flavors in tobacco products may appeal to young and inexperienced users. ⋯ In this longitudinal cohort study, flavors in tobacco products were associated with youth and young adult tobacco experimentation. First use of a flavored tobacco product may place youth, young adults, and adults at risk of subsequent tobacco use.
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Total knee arthroplasty (TKA) is one of the most common elective procedures performed in adults with end-stage arthritis. Racial disparities in TKA outcomes have been described in the literature. ⋯ This cohort study found that race/ethnicity was associated with higher odds of discharge to an IRF or SNF for postoperative care after primary TKA. Among patients younger than 65 years, African American patients were more likely than white patients to be readmitted to the hospital within 90 days. Discharge to an IRF or SNF for postoperative care and rehabilitation was also associated with a higher risk of readmission to an acute care hospital.
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Since the transition to the American Community Survey, data uncertainty has complicated its use for policy making and research, despite the ongoing need to identify disparities in health care outcomes. The US Centers for Medicare & Medicaid Services' new, stratified payment adjustment method for its Hospital Readmissions Reduction Program may be able to reduce the reliance on data linkages to socioeconomic survey estimates. ⋯ There was greater precision in socioeconomic adjusted readmission estimates when hospitals were stratified into the new payment adjustment criteria compared with safety net designations. A contributing factor for improved reliability of American Community Survey estimates under the new payment criteria was the merging of patients from low-income neighborhoods with greater homogeneity in survey estimates into groupings similar to those for higher-income patients, whose neighborhoods often exhibit greater estimate variability. Additional efforts are needed to explore the effect of measurement error on American Community Survey-adjusted readmissions using the new peer group-based classification methods.