Abstract：
BACKGROUND:Patients with low-risk chest pain are frequently readmitted for evaluation of recurrent chest pain. It is unknown whether stress testing during the first admission for chest pain is a cost-effective means of reducing readmissions. METHODS:Using a hospital administrative database, we conducted a retrospective cohort study of patients aged ≥18 years admitted under "observation status" to Baystate Medical Center between January 2007 and July 2009 for chest pain without acute coronary syndrome. We compared subsequent emergency department (ED) visits, readmissions, and costs within 1 year for patients who had a stress test at index admission to those who did not, adjusting for age, gender, race, insurance, and comorbidities. RESULTS:The cohort included 3315 patients. Most (n = 2376, 71.7%) had a stress test during the index admission. Within 1 year, 256 (7.7%) patients returned to the ED at least once with chest pain. Of these, 112 (43.8%) were admitted during their first return visit. In the multivariable model, return visits for chest pain were negatively associated with previous stress testing (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5 to 0.9). Once in the ED, however, the risk of admission did not vary by stress test during index admission (OR: 0.8, 95% CI: 0.4 to 1.4). Overall costs, including index admission and follow-up visits for chest pain, were higher for patients with stress testing at index admission. CONCLUSION:Inpatient stress testing reduced subsequent resource utilization in terms of ED visits and resultant readmissions, but the savings were not enough to offset the cost of initial testing.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Mallidi J,Penumetsa S,Friderici JL,Saab F,Rothberg MBdoi
10.1002/jhm.2081subject
Has Abstractpub_date
2013-10-01 00:00:00pages
564-8issue
10eissn
1553-5592issn
1553-5606journal_volume
8pub_type
杂志文章abstract：BACKGROUND:Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff and interfere with quality healthcare. OBJECTIVE:The aim of this study was to investigate incidences of workplace violence and the attributes of healthcare staff who are at ...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.976
更新日期：2012-02-01 00:00:00
abstract：:Every year, nearly 5 million adults with cancer are hospitalized. Limited evidence suggests that hospitalization of the cancer patient is associated with adverse morbidity and mortality. Hospitalization of the patient with advanced cancer allows for an intense examination of health status in the face of terminal illne...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
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abstract：BACKGROUND:Individual provider performance drives group metrics, and increasingly, individual providers are held accountable for these metrics. However, appropriate attribution can be challenging, particularly when multiple providers care for a single patient. OBJECTIVE:We sought to develop and operationalize individu...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.2897
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost-related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost-related underuse and its consequences, but have been ...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.948
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:To determine the range and frequency of experiences, clinical and nonclinical roles, training, work expectations, and career plans of practicing pediatric hospitalists. DESIGN:Mail survey study of a national sample of 530 pediatric hospitalists of whom 67% (N = 338) were from teaching hospitals, 71% (N = 374...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.458
更新日期：2009-03-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
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更新日期：2016-10-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.2779
更新日期：2017-08-01 00:00:00
abstract：:Nephrogenic systemic fibrosis (NSF) has now been linked to gadolinium-based contrast (GBC) exposure in those with compromised kidney function, particularly those with end-stage renal disease (ESRD). When ESRD is present, symptoms can be quite devastating for the patient including severe pain and immobility and even de...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
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更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:The National Acute Medicine Programme (NAMP) was established to address the unsatisfactory management of acutely ill medical patients in Ireland. It aimed to improve quality of care and patient safety, streamline access to healthcare, and reduce cost through efficiency gains. METHOD:A model of care was deve...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
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更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS:We conducted a population-based study of Olmsted County, Min...
journal_title：Journal of hospital medicine
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
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更新日期：2013-12-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of hospital medicine
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更新日期：2015-03-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
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更新日期：2011-09-01 00:00:00
abstract：:Dysphagia is associated with aspiration, pneumonia, and malnutrition, but remains challenging to identify at the bedside. A variety of exam protocols and maneuvers are commonly used, but the efficacy of these maneuvers is highly variable. We conducted a comprehensive search of 7 databases, including MEDLINE, Embase, a...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
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journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
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更新日期：2008-11-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.562
更新日期：2010-01-01 00:00:00
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journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
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更新日期：2007-01-01 00:00:00
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journal_title：Journal of hospital medicine
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pub_type： 杂志文章,meta分析
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journal_title：Journal of hospital medicine
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pub_type： 杂志文章,随机对照试验
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更新日期：2016-05-01 00:00:00
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