Southern medical journal
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Southern medical journal · Oct 2021
Association of the All-Patient Refined Diagnosis-Related Groups Severity of Illness and Risk of Mortality Classification with Outcomes.
Diagnosis-related groups (DRGs) is a patient classification system used to characterize the types of patients that the hospital manages and to compare the resources needed during hospitalization. The DRG classification is based on International Classification of Diseases diagnoses, procedures, demographics, discharge status, and complications or comorbidities and compares hospital resources and outcomes used to determine how much Medicare pays the hospital for each "product/medical condition." The All-Patient Refined DRG (APR-DRG) incorporated severity of illness (SOI) and risk of mortality (ROM) into the DRG system to adjust for patient complexity to compare resource utilization, complication rates, and lengths of stay. ⋯ This study indicates that the APR-DRG SOI and ROM scores provide a classification system that is associated with mortality and correlates with other clinical variables, such as the shock index and lactate levels, which are available on admission.
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Southern medical journal · Oct 2021
Observational StudyAssociation between Opioids Prescribed to Medical Inpatients with Pain and Long-Term Opioid Use.
Opioid receipt during medical hospitalizations may be associated with subsequent long-term use. Studies, however, have not accounted for pain, which may explain chronic use. The objective of this study was to identify the association between opioid exposure during a medical hospitalization and use 6 to 12 months later. ⋯ Although opioid receipt at discharge was associated with long-term use, the number of patients this applied to was small. Pain severity was an important predictor of long-term use and should be accounted for in future studies.
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Southern medical journal · Oct 2021
Health Disparities of Coronavirus Disease 2019 in Texas, March-July 2020.
Although disparities in coronavirus disease 2019 (COVID-19) prevalence are known, knowledge of the recent surge of COVID-19 in Texas and factors affecting fatality rates is limited. Understanding the health disparities associated with COVID-19 can help healthcare professionals determine the populations that are most in need of COVID-19 preventive care and treatment. The aim of this study was to assess COVID-19-related case and mortality rates. ⋯ This time period represents the highest COVID-19 surge time in Texas. Although our data consist of a short time period of population-level data in an ongoing pandemic and are limited by information reported to the Texas Department of State Health Services, older age, male sex, Hispanics, and Blacks are currently associated with higher infection rates, whereas older age, male sex, and Whites are associated with higher mortality rates. Clinicians and decision makers should be aware of the COVID-19 health disparities and risk factors for mortality to better promote targeted interventions and allocate resources accordingly.
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Southern medical journal · Oct 2021
National Resident Matching Program Rank Order and Performance in an Internal Medicine Residency.
Prospective first-year house staff and residency program leaders spend substantial time, effort, and expense preparing a rank order list for the National Resident Matching Program (NRMP). Previous studies have mostly shown minimal or no relation between rank order and subsequent resident performance, raising questions about the value of this process. Furthermore, no previous studies have been done with Internal Medicine residencies. As such, the purpose of this study was to compare NRMP rank order to multiple objective outcomes of an Internal Medicine residency. ⋯ Higher USMLE score was statistically significantly associated with multiple favorable objective residency outcomes in an Internal Medicine residency. A better NRMP rank was correlated with favorable ACGME milestones in univariate analysis, but USMLE score emerged as the strongest predictor in multivariate analysis.