J Natl Med Assoc
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The novel coronavirus, SARS-CoV-2, has caused a global pandemic with high morbidity and mortality. It was first observed to cause a severe acute respiratory syndrome. However, gastrointestinal and hepatic manifestations have been increasingly recognized. ⋯ Patients with diarrhea and liver disease may have a worse prognosis. The rapidly evolving literature continues to reveal a growing body of information which enables updated guidance for management. More investigation is needed which focuses on vulnerable patients, including the elderly, those with underlying illness, as well as, racial and ethnic minorities.
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The Center for Medicare and Medicaid Services (CMS) has targeted hospital readmissions, which cost $17 billion per year, as one potential solution to reduce rising health care costs. Studies have documented the ability of Transitions of care (TOC) services to reduce readmissions in high risk patients. However, the vast majority of studies have not explored TOC services for all-cause admissions nor TOC clinics led by hospitalists. The goal of this study is to provide preliminary data regarding the potential effectiveness of a hospitalist-led TOC clinic servicing all patients on hospital readmission rates. ⋯ Among Medicare and Medicaid beneficiaries and commercial health insurance patients, this hospitalist-led TOC intervention was associated with a statistically significant reduction in 30-day readmissions following discharge for all-cause hospital admissions.
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Racial minority and female trainees undergo residency attrition at significantly higher rates than their counterparts. We hypothesize that racial minority, and female trainees will report significantly different training experiences from non-minority and male trainees, respectively. Further, we hypothesize that thoughts of withdrawal and summative description of residency experience will be significantly impacted by access to mentorship and feelings of isolation. ⋯ Minority status and female gender impact some of the key elements of the residency experience, manifesting as decreased respect afforded to these trainees. Thoughts of withdrawal and overall residency experience are significantly impacted by access to mentorship and feelings of isolation during residency. Attention should be paid to ensuring that high risk trainees have adequate access to mentorship, making deliberate efforts to cultivate a sense of community and camaraderie among residents, and emphasizing the value of diversity and inclusion.