Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Prior studies suggesting that the presence of emergency department (ED) observation units decrease overall ED hospital admissions have been either single-center studies or based on model simulations. The objective of this preliminary national study is to determine if the presence of ED observation units is associated with hospitals having lower ED admission rates. ⋯ In this preliminary study, we did not find an association between the presence of observation units and ED hospital admission rates. Further studies with larger sample sizes should be performed to further evaluate the impact of ED observation units on ED hospital admission rates.
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Dyspnea is a common symptom in patients hospitalized with acute cardiopulmonary diseases. Routine assessment of dyspnea severity is recommended by clinical guidelines based on the evidence that patients are not treated consistently for dyspnea relief. ⋯ Most hospitalists believe that routine assessment of dyspnea severity would enhance their clinical decision making and patient care. Measurement and documentation of dyspnea severity may represent an opportunity to improve dyspnea management.
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Outcomes for patients hospitalized on weekends are often worse for adults-the so-called "weekend effect." Less is known about the weekend effect for children. We examined 55,383 hospitalizations at a tertiary care children's hospital. We used logistic regression to examine the associations of weekend admission and weekend discharge with unplanned 30-day readmission. ⋯ Children admitted on the weekend had significantly higher odds of unplanned readmission compared to children admitted on weekdays (adjusted odds ratio = 1.09 [95% confidence interval: 1.004-1.18]). In contrast, being discharged on the weekend was not associated with readmission. In conclusion, children admitted on the weekend have higher rates of 30-day unplanned readmission than children admitted during the week, suggesting care differences on the weekend related to initial clinical management rather than discharge planning.