Journal of general internal medicine
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Comparative Study
Mentorship, productivity, and promotion among academic hospitalists.
United States academic hospitals have rapidly adopted the hospitalist model of care. Academic hospitalists have taken on much of the clinical and teaching responsibilities at many institutions, yet little is known about their academic productivity and promotion. ⋯ Most academic hospitalists had not presented a poster at a national meeting, authored an academic publication, or presented grand rounds at their institution. Many academic hospitalists lacked mentorship and this was associated with a failure to produce scholarly activity. Mentorship may improve academic productivity among hospitalists.
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Comparative Study
Changes in disparities following the implementation of a health information technology-supported quality improvement initiative.
Health information technology (HIT)-supported quality improvement initiatives have been shown to increase ambulatory care quality for several chronic conditions and preventive services, but it is not known whether these types of initiatives reduce disparities. ⋯ Generalized and provider-directed quality improvement initiatives can decrease racial disparities for some chronic disease and preventive care measures, but achieving equity in areas with persistent disparities will require more targeted, patient-directed, and systems-oriented strategies.
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To report chronic opioid therapy discontinuation rates after five years and identify factors associated with discontinuation. ⋯ Over half of persons receiving 90 days of continuous opioid therapy remain on opioids years later. Factors most strongly associated with continuation were intermittent prior opioid exposure, daily opioid dose ≥ 120 mg MED, and possible opioid misuse. Since high dose and opioid misuse have been shown to increase the risk of adverse outcomes special caution is warranted when prescribing more than 90 days of opioid therapy in these patients.