Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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To compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). ⋯ Anaerobic therapy appears to be important in the treatment of aspiration pneumonia in children with NI. While Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
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Excess days in acute care (EDAC) after total joint arthroplasty (TJA) represent a large economic burden. We developed an Orthopedic EDAC program that triages TJA patients to the appropriate service line (orthopedic vs medicine) and level of care (observation vs inpatient) on re-presentation. We developed and used evidence-based protocols for the treatment of TJA patients who are rehospitalized. ⋯ In this single-center, before-after pilot of a novel Orthopedic EDAC program, we demonstrated a reduction in readmissions and Orthopedic EDAC LOS, as well as improved continuity of care for TJA patients on representation.
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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.