Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Comparative Study
Performance of Multihospital Health Systems' Flagship Hospitals in the CMS Star Rating Program.
Using the Hospital Compare overall hospital quality star ratings and other publicly available data on acute care hospitals, we examined star ratings for the flagship hospitals of a set of multihospital health systems in the United States. We compared star ratings and hospital characteristics of flagship and nonflagship hospitals across and within 113 health systems. The system flagship hospitals had significantly lower star ratings than did nonflagship hospitals, and they did not generally have the highest star ratings in their own systems. Higher teaching intensity, larger bed size, higher uncompensated care, and higher disproportionate share hospital (DSH) patient percentage were all significantly associated with lower star ratings of flagship hospitals when compared with nonflagship hospitals across all health systems; the flagship hospital of a system was more likely to have the lowest star rating in its system if the difference in DSH percentage was relatively large between the flagship and nonflagship hospitals in that system.
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Intravenous (IV) magnesium is used as an adjunct therapy in management of status asthmaticus with a goal of reducing intubation rate. A recent review suggests that IV magnesium use in status asthmaticus reduces admission rates. This is contrary to the observation of practicing emergency room physicians. ⋯ Outcomes were IV magnesium use, inpatient and intensive care unit admission rate, geometric mean length of stay, and 7-day all-cause readmission rate. IV magnesium use for asthma hospitalization more than doubled over 8 years (17% vs. 36%; P < .001). Yearly trends were not significantly associated with hospital or intensive care unit admission rate or 7-day all-cause readmissions, although length of stay was reduced (P < .001).
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Viral testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), particularly early in the COVID-19 pandemic, was limited by supply of reagents. We pooled nasopharyngeal samples from patients at low risk of SARS-CoV-2 infection in groups of 3 for testing. ⋯ This strategy resulted in the use of 340 fewer cartridges than if each test were performed on one patient sample. Pooled testing of low-risk populations allows for continued testing even when supplies are relatively scarce.