Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Longitudinal qualitative research (LQR) is an emerging methodology in healthcare and health professions education research that focuses on change in complex, dynamic transitions, and processes as that change unfolds. This approach allows for in-depth exploration of personal and professional transitions, developmental processes, and evolution in how individuals make sense of experiences and events. In this Methodological Progress Note, we define the key features of LQR, distinguish LQR from other qualitative methodologies, and present a case for longitudinal qualitative work to offer a lens of time that might illuminate gaps in the field of hospital medicine.
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The treatment of acute uncomplicated diverticulitis (UD) with antibiotics remains common despite substantial evidence supporting the non-inferiority of nonantibiotic outpatient management. In the past 15 years, there have been two landmark randomized-controlled clinical trials, follow-up studies, and numerous retrospective studies that have supported the non-inferiority of nonantibiotic management of UD. Multiple medical societies including the American Gastroenterological Association and the American College of Physicians recommend using antibiotics selectively rather than routinely in UD. We aim to raise physician awareness of the latest guideline recommendations through our article, potentially improving antibiotic stewardship and reducing related healthcare costs.
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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.
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Children with new-onset psychosis often require hospitalization for medical evaluation. ⋯ Study findings suggest that there has been a stable rate of hospitalization for children with new-onset psychosis, yet a significant variation in the medical evaluation exists. Significant increases and variations in resource utilization across all categories suggest an emerging need for robust evidence and consensus-based practice guidelines.