JAMA internal medicine
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JAMA internal medicine · May 2016
Quasi-Experimental Evaluation of the Effectiveness of a Large-Scale Readmission Reduction Program.
Feasibility, effectiveness, and sustainability of large-scale readmission reduction efforts are uncertain. The Greater New Haven Coalition for Safe Transitions and Readmission Reductions was funded by the Center for Medicare & Medicaid Services (CMS) to reduce readmissions among all discharged Medicare fee-for-service (FFS) patients. ⋯ This large-scale readmission reduction program reduced readmissions by 9.3% among the full population targeted by the CMS despite being delivered only to high-risk patients. However, it did not achieve the goal reduction set by the CMS.
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JAMA internal medicine · May 2016
Multicenter Study Observational StudyDietary Patterns and Fractures in Postmenopausal Women: Results From the Women's Health Initiative.
Considerable efforts have been undertaken to relate single nutrients to bone health. To this point, results are inconsistent. Suboptimal single nutrient intake does not occur in isolation but rather reflects a poor diet quality. ⋯ Higher adherence to a Mediterranean diet is associated with a lower risk for hip fractures. These results support that a healthy dietary pattern may play a role in maintaining bone health in postmenopausal women.
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JAMA internal medicine · May 2016
Comparative Study Observational StudyLikelihood of Unemployed Smokers vs Nonsmokers Attaining Reemployment in a One-Year Observational Study.
Studies in the United States and Europe have found higher smoking prevalence among unemployed job seekers relative to employed workers. While consistent, the extant epidemiologic investigations of smoking and work status have been cross-sectional, leaving it underdetermined whether tobacco use is a cause or effect of unemployment. ⋯ To our knowledge, this is the first study to prospectively track reemployment success by smoking status. Smokers had a lower likelihood of reemployment at 1 year and were paid significantly less than nonsmokers when reemployed. Treatment of tobacco use in unemployment service settings is worth testing for increasing reemployment success and financial well-being.
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JAMA internal medicine · May 2016
Comparative StudyPrimary Care Practitioners' Views on Incorporating Long-term Prognosis in the Care of Older Adults.
Clinical practice recommendations increasingly advocate that older patients' life expectancy be considered to inform a number of clinical decisions. It is not clear how primary care practitioners approach these recommendations in their clinical practice. ⋯ Despite clinical recommendations to increasingly incorporate patients' long-term prognosis in clinical decisions, primary care practitioners encounter several barriers and ambiguities in the implementation of these recommendations.