Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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We examined associations between a validated, multidimensional measure of social determinants of health and population-based hospitalization rates among children <18 years across 18 states from the 2017 Healthcare Cost and Utilization Project State Inpatient Databases and the US Census. The exposure was ZIP code-level Child Opportunity Index (COI), a composite measure of neighborhood resources and conditions that matter for children's health. ⋯ Decreasing neighborhood opportunity was associated with increasing hospitalization rates among children in 18 US states. These data underscore the importance of social context and community-engaged solutions for health systems aiming to eliminate care inequities.
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Monitoring the average daily census (ADC) is crucial for managing patient flow and allocating resources. This study analyzed hourly fluctuations in the ADC on a hospital medicine service at an academic medical center. Data from 8342 encounters and 6178 unique patients were collected over a year. ⋯ Understanding how ADC changes throughout the day will help hospital medicine programs to partner with administrators to optimize resource allocation and staffing. Measuring ADC at midnight, as traditionally done, may underestimate workload and therefore contribute to staffing shortages and physician burnout. Hospitals should consider measuring ADC at its peak, between 7 a.m. and 11 a.m., to ensure adequate staffing and high-quality patient care.