J Natl Med Assoc
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Compared to COVID-19 cases with established epidemiological trace, little is known about the patients without one. This study reports an association between time of symptom onset (TOS) and length of hospital stay (LOS) in COVID-19 infection without epidemiological link. ⋯ In COVID-19 cases without typical epidemiological links, patients with later symptom onset had relatively shorter LOS.
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Socioeconomic inequities have direct implications in COVID presentation, severity of illness and prognosis. From practice of prophylactic measures to availability of personal protective equipment, from access to diagnostic tests to treatment resources, there are many facets and distinct disease processes of a virus that, among many things, serves to expose and highlight our global disparities.
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Transparency about the costs that patients incur is an increasingly important factor in making decisions throughout the course of diagnosis and treatment. Both patients and providers regard honest, informed discussions about these costs as critical to providing person-centered care, but often encounter a range of barriers to initiating and maintaining these conversations. ⋯ These include components of financial toxicity for patients, both related to direct costs and to quality of life, as well as questions as to who should initiate these conversations, when they should take place, and what kind of information and training are needed to make these conversations meaningful. This article reports the results of this work with recommendations for providers about how to incorporate cost of care discussions into the normal clinical work flow and patient life flow.
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Discussions about whether to continue breast cancer screening in older women are complex, particularly for African American women. Decision aids may be helpful in guiding these conversations; however, little is known about the feasibility and acceptability of using breast cancer decision aids in older African American women. This study explored African American women's knowledge of breast cancer screening guidelines in older adults, prior conversations with providers regarding continuation of screening, and their understanding/willingness to engage in discussions about individualized breast cancer screening decision-making using two versions of tested decision aids. ⋯ Older African American women are willing to engage in discussions about whether or not to continue breast cancer screening and found decision aids helpful.