Journal of Hospital Medicine : An Official Publication of the Society of Hospital Medicine

BACKGROUND: Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event. METHODS: We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status...

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BACKGROUND: Children with high-intensity neurologic impairment (HINI) have an increased risk of urinary tract infection (UTI) and prolonged intravenous (IV) antibiotic exposure. OBJECTIVE: To determine the association between short (≤3 days) and long (>3 days) IV antibiotic courses and UTI treatment failure in hospitalized children with HINI. METHODS: We performed a retrospective cohort study examining UTI hospitalizations at 49 hospitals in the Pediatric Health Information System from 2016 to 2021 for children (1-18 years) with HINI...

Significant variation in coding intensity among hospitals has been observed and can lead to reimbursement inequities and inadequate risk adjustment for quality measures. Reliable tools to quantify hospital coding intensity are needed. We hypothesized that coded sepsis rates among patients hospitalized with common infections may serve as a useful surrogate for coding intensity and derived a hospital-level sepsis coding intensity measure using prevalence of "sepsis" primary diagnoses among patients hospitalized with urinary tract infection, cellulitis, and pneumonia...

No abstract text is available yet for this article.

BACKGROUND: Patients with limited English proficiency (LEP) may have worse health outcomes and differences in processes of care. Language status may particularly affect situations that depend on communication, such as symptom management or end-of-life (EOL) care. OBJECTIVE: The objective of this study was to assess whether opioid prescribing and administration differs by English proficiency (EP) status among hospitalized patients receiving EOL care. METHODS: This single-center retrospective study identified all adult patients receiving "comfort care" on the general medicine service from January 2013 to September 2021...

IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections RELEASE DATE: October 2, 2023 PRIOR VERSION: March 16, 2020 DEVELOPER: IWGDF Editorial Board FUNDING SOURCE: International Working Group on the Diabetic Foot (IWGDF), Infectious Diseases Society of America (IDSA) TARGET POPULATION: Adults with suspected or confirmed diabetes-related foot infections.

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BACKGROUND: Formulating a thoughtful problem representation (PR) is fundamental to sound clinical reasoning and an essential component of medical education. Aside from basic structural recommendations, little consensus exists on what characterizes high-quality PRs. OBJECTIVES: To elucidate characteristics that distinguish PRs created by experts and novices. METHODS: Early internal medicine residents (novices) and inpatient teaching faculty (experts) from two academic medical centers were given two written clinical vignettes and were instructed to write a PR and three-item differential diagnosis for each...

As medical educators, we have a responsibility to ensure our trainees are exposed to curricula dedicated to Diversity, Equity, and Inclusion (DEI), as illustrated by the Association of American Medical Colleges' recently released DEI Competencies Across the Curriculum. We designed and implemented a curriculum, Social Justice Rounds (SJR), that incorporates teaching on these topics directly into inpatient clinical work. SJR are brief team-based discussions facilitated by Pediatric Hospital Medicine faculty that focus on racism in medicine and other forms of discrimination experienced by patients and the effect it has on their interaction with the healthcare system...

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BACKGROUND: Young adults (YA) with childhood-onset chronic conditions-particularly YA with cystic fibrosis (CF), congenital heart disease (CHD), and sickle cell disease (SCD)-continue to have pediatric hospital admissions. Factors associated with this continued pediatric hospital use remain underexplored. OBJECTIVE: To determine if pediatric hospital use by YA differed (1) across condition and (2) within each condition by sociodemographic factors. METHODS: Conducted a cross-sectional analysis of admissions for YA 22-35 years with CF, CHD, and SCD from 2016 to 2020 in the National Inpatient Sample...

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BACKGROUND: In the United States, there are no federal restrictions on the use of methadone to manage opioid withdrawal symptoms when patients are hospitalized with a medical or surgical condition other than addiction. In contrast, in an outpatient setting, methadone for opioid use disorder (OUD) is highly regulated by federal and state governments and can only be dispensed from an opioid treatment program (OTP). Discrepancies in regulatory requirements across these settings may lead to barriers in care for patients with OUD...

Automated text messaging is a promising approach to monitor patients after hospital discharge and avert readmissions; however, it is not known to what extent patients would engage with this type of program and whether engagement may vary based on patients' characteristics. Using data from a 30-day postdischarge texting program at a large university hospital, we examined engagement over time (operationalized as response rate to text messages) and patient characteristics associated with engagement. Of the 1324 patients in the study sample, 838 (63%) stayed in the program for the full duration...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: In-hospital consultation is essential for patient care. We previously proposed a framework of seven specific consultation types to classify consult requests to improve communication, workflow, and provider satisfaction. METHODS: This multimethods study's aim was to evaluate the applicability of the consult classification framework to real internal medicine (IM) consults. We sought validity evidence using Kane's validity model with focus groups and classifying consult requests from five IM specialties...

BACKGROUND: Respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza virus (PIV) hospitalize many people yearly. Though severe lower respiratory tract disease has been described in children, the elderly, and the immunocompromised, there is a gap in our understanding of RSV, hMPV, and PIV in hospitalized adults. We sought to evaluate the association of RSV, hMPV, and PIV with severe respiratory disease requiring noninvasive or mechanical ventilation and death in hospitalized adults in the United States...