Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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It is known that transgender people experience health inequalities. Disparities in hospital outcomes impacting transgender individuals have been inadequately explored. We conducted this retrospective cohort study using the National Inpatient Sample (01/2018-12/2019) to compare in-hospital mortality and utilization variables between cisgender and transgender individuals using regression analyses. ⋯ Transgender and cisgender individuals had similar adjusted odds ratios (aOR) for in-hospital mortality (aOR = 0.96; p = .88) and total hospital charges (aMD = -$3118; p = .21). However, transgender individuals had longer LOS (aMD = +0.46 days; confidence interval [CI]: 0.15-0.90; p = .04). When comparing mortality and resource utilization between cisgender and transgender individuals, differences were negligible.
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Hospital-acquired venous thromboembolism (HA VTE) is a preventable complication in hospitalized patients. ⋯ Among 849,059 encounters, 82.2% were classified as low risk by ePaduaKP, with 42.3% receiving pPPX. In the subset with clinician-assigned risk (608,512 encounters), low and high ePaduaKP encounters were classified as moderate risk in 87.5% and 92.0% of encounters, respectively. Overall, 56.7% of encounters with moderate clinician-assigned risk received pPPX, compared to 7.2% of encounters with low clinician-assigned risk. pPPX use occurred in a large portion of low ePaduaKP risk encounters. Clinicians frequently assigned moderate risk to encounters at admission irrespective of their ePaduaKP risk when retrospectively examined. We hypothesize that the current orderset design may have negatively influenced clinician-assigned risk choice as well as pPPX utilization. Future work should explore optimizing pPPX for high-risk patients only.