Journal of general internal medicine
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Detailed grading of chills is more useful for diagnosing bacteremia than simply classifying the presence or absence of chills. However, its value added to other clinical information has not been evaluated. ⋯ Differentiating shaking chills in comparison with dichotomized chills for predicting bacteremia allowed the correct identification of an additional 4.6% of patients with bacteremia. Detailed grading of chills can be assessed without additional time, cost, or burden on patients and can be recommended in the routine history taking.
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Patients who have been discharged "against medical advice" (AMA) are at increased risk of morbidity and mortality, but there is little research about patients who have had more than one AMA discharge. ⋯ Patients who have been discharged AMA more than once represent a vulnerable population with significant unmet needs.
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With more than half of all beneficiaries enrolled in Medicare Advantage (MA) plans, ensuring access to high-quality MA plans is a key concern for policymakers. Access to high-quality MA plans may be limited in certain areas if private insurers are not willing to offer high-quality MA plans in local areas with greater unmet health-related social needs. ⋯ As historically marginalized groups are more likely to reside in markets with greater unmet social needs, disparities in access to high-quality MA plans may widen existing health disparities. Therefore, monitoring the availability of high-quality MA plans in areas with greater unmet social needs is needed to improve health equity for MA beneficiaries.
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Structured faculty development programs focused on integrating health equity into medical education curricula remain limited. ⋯ Program strengths included its interdisciplinary nature, creating a space to address isolation experienced by faculty working to advance health equity within their departments, advancement of skills to integrate health equity into their teaching contexts, and the opportunity for participants to envision their scholarship as part of a more extensive approach within the social determinants of health, health equity, and community health framework.
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Despite increasing attention on health literacy and the inclusion of grade reading level recommendations in guidelines, it remains unclear if lowering the grade reading level of written health information to specific target grades improves patient-related outcomes. ⋯ ACTRN12623000224628p.