Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Comparative Study
Conflicting measures of hospital quality: ratings from "Hospital Compare" versus "Best Hospitals".
In April 2005 the Centers for Medicare and Medicaid Services launched "Hospital Compare," the first government-sponsored hospital quality scorecard. We compared the ranking of U.S. News and World Report's "Best Hospitals" with Hospital Compare performance ratings. ⋯ Hospital Compare scores are frequently discordant with Best Hospital rankings, which is likely attributable to the markedly different methods each rating approach employs. Such discordance between major quality rating systems paints a conflicting picture of institutional performance for the public to interpret.
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Gastric stress ulceration and bleeding are common occurrences in the critically ill and prophylactic acid-suppression is used almost universally in this population. Evidence suggests that general medical patients hospitalized outside of the intensive care unit often receive similar therapy. ⋯ A significant number of general medical patients are prescribed acid-suppressive therapy for stress ulcer prophylaxis. The literature provides only sparse guidance on this issue with two randomized trials showing a possible benefit for prophylaxis. Further study is needed.
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There are no published studies of hospitalist comanagement of pediatric surgical patients. ⋯ The introduction of selective hospitalist comanagement of pediatric spinal fusion surgery patients was associated with significant decreases in LOS and variability in LOS.