Archives of internal medicine
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Review Meta Analysis
Rapid Response Teams: A Systematic Review and Meta-analysis.
Although rapid response teams (RRTs) increasingly have been adopted by hospitals, their effectiveness in reducing hospital mortality remains uncertain. We conducted a meta-analysis to assess the effect of RRTs on reducing cardiopulmonary arrest and hospital mortality rates. ⋯ Although RRTs have broad appeal, robust evidence to support their effectiveness in reducing hospital mortality is lacking.
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Serious safety concerns related to the use of antipsychotics have not decreased the prescribing of these agents to nursing home (NH) residents. We assessed the extent to which resident clinical characteristics and institutional prescribing practice were associated with antipsychotic prescribing. ⋯ The NH antipsychotic prescribing rate was independently associated with the use of antipsychotics in NH residents. Future research is needed to determine why such a prescribing culture exists and whether it could result in adverse health consequences.
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As issues of health care cost escalation and parity of payment between primary care and other physicians have become more important, one proposal has been to eliminate consultation codes. Little is known about the current payment accuracy or financial impact of such a change. ⋯ Consultation codes are being billed erroneously at a high rate. Furthermore, the differential cost to Medicare of these codes over those for new patient evaluation and management codes is over half a billion dollars per year. With the growing needs for cost savings as well as encouraging payment parity for cognitive services for primary care physicians, it is time these codes are reevaluated.