Abstract:
:Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven achievement and inequalities. Yet, by penalizing the lowest performers, No Child Left Behind's approach to accountability has led to a number of unintended consequences. This article draws lessons from education policy, arguing that financial incentives should be designed to support the lowest performers to improve quality.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Maurer KA,Ryan AMdoi
10.1002/jhm.2483subject
Has Abstractpub_date
2016-01-01 00:00:00pages
62-4issue
1eissn
1553-5592issn
1553-5606journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare utilization patterns following sepsis are poorly understood. OBJECTIVE:To identify patient-level factors that contribute to postsepsis mortality and healthcare utili...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.2197
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Hospital medical groups use various staffing models that may systematically affect care continuity during the admission process. OBJECTIVE:To compare the effect of 2 hospitalist admission service models ("general" and "admitter-rounder") on patient disposition and length of stay. DESIGN:Retrospective obser...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2592
更新日期:2016-10-01 00:00:00
abstract::Physiotherapy delivered in a group setting has been shown to be effective in a variety of populations. However, little is known about the attitudes of older adults toward participating in group physiotherapy. The objectives of this study were to explore older inpatients' perceptions and experiences of group physiother...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.2550
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The theory that posthospitalization stress might increase the risk of postdischarge complications has never been investigated. OBJECTIVE:To assess whether serum levels of stress biomarkers at discharge are associated with readmission and death after an acute-care hospitalization. DESIGN:We prospectively in...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2766
更新日期:2017-07-01 00:00:00
abstract::For generations, American hospitals have been considered recession-proof, but there is reason to believe the current economic crisis is an exception. Hospitals have shown declining financial margins and decreased admissions. The severe recession has adversely affected many hospitals' finances, creating a risk of closu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.654
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:Guidelines recommend pharmacologic prophylaxis for hospitalized medical patients at increased risk of thromboembolism. Despite recommendations, multiple studies demonstrate underutilization. Factors contributing to underutilization include uncertainty that prophylaxis reduces clinically relevant events, as w...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析
doi:10.1002/jhm.450
更新日期:2009-05-01 00:00:00
abstract::Dr. Pham, a practicing general internist and health policy researcher, recalls her experience, as a granddaughter, of how patients, families, and physicians are often complicit in foiling the good coordination of care. ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.410
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Asymptomatic blood pressure elevation is common in the inpatient setting. National guidelines recommend treating with oral agents to slowly decrease blood pressure; however, many clinicians use intravenous antihypertensive medications, which can lead to unpredictable changes in blood pressure. OBJECTIVE:To ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3190
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Hospital-acquired (HA) venous thromboembolism (VTE) is a common source of morbidity/mortality. Prophylactic measures are underutilized. Available risk assessment models/protocols are not prospectively validated. OBJECTIVES:Improve VTE prophylaxis, reduce HA VTE, and prospectively validate a VTE risk-assessm...
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
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
doi:10.1002/jhm.2511
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) is increasingly used to treat children hospitalized with bronchiolitis; however, the best practices for feeding during HFNC and the impact of feeding on time to discharge and adverse events are unknown. The study objective was to assess whether feeding exposure during HFNC was ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3306
更新日期:2019-09-18 00:00:00
abstract::Over the past 10 years, postdischarge clinics have been introduced in response to various health system pressures, including the focus on rehospitalizations and the challenges of primary care access. Often ignored in the discussion are questions of the effect of postdischarge physician visits on readmissions. In addit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.2750
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines. OBJECTIVE:To understand why providers order blood transfusions outside of recommended guidelines...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2236
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The "July phenomenon" refers to a purported worsening of outcomes in teaching-hospital patients with the arrival of new, inexperienced house-staff. Previous quantitative studies of new house-staff and increased mortality have been limited primarily by a focused patient population and the use of limited data ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.917
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. DESIGN, SETTING, PARTICIPANTS:A cross-sectional analysis of patients admitted to an academic medical center. MEASUREMENTS:Nurses administered the Brief Health Lite...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2841
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Computerized clinical knowledge mana-gement systems hold enormous potential for improving quality and efficiency. However, their impact on clinical practice is not well known. OBJECTIVE:To examine the impact of UpToDate on outcomes of care. DESIGN:Retrospective study. SETTING:National sample of US inpatie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.944
更新日期:2012-02-01 00:00:00
abstract::The Centers for Medicare and Medicaid Services awarded Hospital Medicine a Medicare specialty code, "C6", in 2016. We examined the early uptake of C6 code using the 2017 Medicare Part B utilization data. We also compared the actual C6 specialty code usage against estimated rates of overall hospitalist billing using th...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3303
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Serum folate levels are commonly ordered for multiple indications in the inpatient and emergency department settings. Since mandatory folic acid fortification in 1998, there has been a decreasing prevalence of folate deficiency in the United States. OBJECTIVE:Our objective was to determine the indications, ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.1994
更新日期:2013-02-01 00:00:00
abstract::Gallstone ileus is a rare etiology of small bowel obstruction, occurring typically in the elderly population. The delay in diagnosis often results in significant morbidity and mortality. Here, we describe a case of 67 year old woman who presented with non specific abdominal symptoms and on evaluation was found to have...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.582
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Superficial wound cultures are routinely used to guide therapy, despite a lack of clear supporting evidence. PURPOSE:To conduct a systematic review of the correlation between superficial wound cultures and the etiology of skin and soft tissue infections. DATA SOURCES:Medline, EMBASE, CINAHL, Scopus. STUDY...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jhm.688
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Attending rounds at academic medical centers are often disconnected from patients and team members who are not physicians. Regionalization of care teams may facilitate bedside rounding and more frequent interactions among doctors, nurses, and patients. OBJECTIVE:We used time-motion analysis to investigate h...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2696
更新日期:2017-03-01 00:00:00
abstract::Only 1 of 8 stroke patients is managed exclusively by a neurologist. Furthermore, many stroke patients harbor other vascular comorbidities and are also at risk for developing general medical complications that can lead to death following stroke. With the growing hospitalist system, it is quite clear that hospitalists ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.147
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Problems experienced after hospital discharge can result in rehospitalizations and unscheduled urgent and emergent care. OBJECTIVE:To identify opportunities for improving discharge processes by examining calls to an advice line (AL). DESIGN:Prospective cohort. SETTING:A 500-bed, university-affiliated hosp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2252
更新日期:2014-11-01 00:00:00
abstract::Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to g...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2632
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Hospital care on weekends has been associated with reduced quality and poor clinical outcomes, suggesting that decreases in overall intensity of care may have important clinical effects. We describe a new measure of hospital intensity of care based on utilization of the electronic health record (EHR). METHO...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2068
更新日期:2013-09-01 00:00:00
abstract:IMPORTANCE:There is an increasing trend toward designing hospitals with patient-centered features like reduced noise, improved natural light, visitor friendly facilities, well-decorated rooms, and hotel-like amenities. It has also been suggested that because patients cannot reliably distinguish positive experiences wit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2297
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Interhospital transfer is an understudied area within transitions of care. The process by which hospitals accept and transfer patients is not well described. National trends and best practices are unclear. OBJECTIVE:To describe the demographics of large transfer centers, to identify common handoff practices...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2577
更新日期:2016-06-01 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
pub_type: 杂志文章
doi:10.1002/jhm.527
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:There have been no recent studies describing the management and outcomes of patients with infective endocarditis (IE). PATIENTS AND METHODS:We conducted a retrospective cohort study of adult patients admitted to a tertiary medical center from 2007 to 2011 with a Duke criteria consistent discharge diagnosis o...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2746
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Few studies have examined alternative structures for inpatient clerkships. OBJECTIVE:Compare 2 inpatient clerkship structures using multiple outcome variables. DESIGN:Prospective, randomized controlled trial. SETTING:Tertiary-care, freestanding children's hospital. SUBJECTS:All medical students enrolled ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.250
更新日期:2007-11-01 00:00:00