Southern medical journal
-
Southern medical journal · Mar 2023
Elective Hand Surgery Is Delayed among Private Insurance Holders.
Patients with private healthcare plans often defer nonemergent or elective procedures toward the end of the year once they have met their deductible. No previous studies have evaluated how insurance status and hospital setting may affect surgical timing for upper extremity procedures. Our study aimed to evaluate the influence of insurance and hospital setting on end-of-the-year surgical cases for elective carpometacarpal (CMC) arthroplasty, carpal tunnel, cubital tunnel, and trigger finger release, and nonelective distal radius fixation. ⋯ Privately insured patients underwent elective CMC arthroplasty and carpal tunnel release procedures in Q4 at a significantly greater rate than publicly insured patients. This finding suggests private insurance status, and potentially deductibles, influence surgical decision making and timing. Further work is needed to evaluate the impact of deductibles on surgical planning and the financial and medical impact of delaying elective surgeries.
-
Southern medical journal · Mar 2023
Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina.
Hepatitis C virus (HCV) is an infection of the liver that can lead to significant liver damage and hepatocellular carcinoma. Individuals born between 1945 and 1965 and individuals with intravenous drug use represent the largest HCV demographics and often experience barriers to treatment. In this case series, we discuss a novel partnership between community paramedics (CPs), HCV care coordinators, and an infectious disease physician to provide HCV treatment to individuals with barriers accessing care. ⋯ This case series highlights the barriers experienced by some HCV-positive patients and a distinctive plan to address impediments to access for HCV treatment.
-
Southern medical journal · Mar 2023
Providing Structured Real-Time Feedback on Postdischarge Outcomes Using Electronic Health Record Data.
Most trainees do not receive information about postdischarge outcomes, despite the importance of external feedback for accurate self-assessment and improvement in discharge planning skills. We aimed to design an intervention to foster reflection and self-assessment by trainees regarding how they can improve transitions of care with minimal investment of program resources. ⋯ Meaningful information about postdischarge outcomes from the electronic health record can be used to provide feedback to trainees in a brief, low-resource session during an inpatient rotation. This feedback significantly affects trainee sense of responsibility for and understanding of postdischarge outcomes, which may lead to improved trainee ability to orchestrate transitions of care.
-
Southern medical journal · Mar 2023
A Survey of Louisiana Pediatricians' Approach to Parenting Teens and Adolescent Reproductive Health.
The American Academy of Pediatrics recommends that pediatricians provide a medical home for adolescent parents, and this study sought to determine pediatricians' compliance with this recommendation within the context of other adolescent reproductive health services provided. ⋯ Our study suggests that most Louisiana pediatricians provide care to adolescent mothers; however, knowledge gaps and misconceptions related to adolescent reproductive health persist among pediatricians, including those who refuse care to adolescent mothers. Research into provider-level barriers may inform interventions that improve adolescent parents' access to a pediatric medical home.