The American journal of medicine
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Comparative Study
Effects of weekend admission and hospital teaching status on in-hospital mortality.
The effect of reduced hospital staffing during weekends on in-hospital mortality is not known. We compared mortality rates between patients admitted on weekends and weekdays and whether weekend-weekday variation in rates differed between patients admitted to teaching and nonteaching hospitals in California. ⋯ Patients admitted to hospitals on weekends experienced slightly higher risk-adjusted mortality than did patients admitted on weekdays. While overall mortality was similar for patients admitted to all hospital categories, the weekend effect was larger in major teaching hospitals and is cause for concern.
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To assess the clinical and economic effects of disease management in patients with chronic diseases. ⋯ Disease management programs were associated with marked improvements in many different processes and outcomes of care. Few studies demonstrated a notable reduction in costs. Further research is needed to understand how disease management can most effectively improve the quality and cost of care for patients with chronic diseases.
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The goals of this study were to determine if very early revascularization might ameliorate the adverse prognosis associated with ST-segment depression in patients with unstable angina/non-ST-segment elevation myocardial infarction. ⋯ ST-segment depression and T-wave inversion on the admission ECG were important predictors of outcome in patients with unstable angina/non-ST-segment elevation myocardial infarction undergoing very early revascularization. In contrast to the considerable mortality seen in patients with ST-segment depression, T-wave inversion was associated with a more favorable outcome.