Abstract:
BACKGROUND:Outpatient parenteral antimicrobial therapy (OPAT) is a safe way to administer intravenous (IV) antimicrobial therapy to patients with the potential to decrease hospital length of stay (LOS). Often, homeless patients with complex infections, who could otherwise be treated as an outpatient, remain in the hospital for the duration of IV antibiotic treatment. Injection drug use (IDU) is a barrier to OPAT. OBJECTIVE:To evaluate our experience with administering OPAT to homeless patients at a medical respite facility and determine if patients could complete a successful course of antibiotics. DESIGN:Using retrospective chart review, demographics, diagnosis, and comorbidities including mental illness, current IDU, and remote IDU (>3 months ago) were recorded. Surgical, microbiologic, and antimicrobial therapy including route (IV or oral), duration of therapy, and adverse events were abstracted. PARTICIPANTS:Homeless patients >18 years old who received OPAT at medical respite after discharge, no exclusions. MAIN MEASUREMENTS:Primary outcome was successful completion of OPAT at medical respite. Secondary outcome was successful antimicrobial course completion for a specific diagnosis. RESULTS:Forty-six (87%) patients successfully completed a defined course of antibiotic therapy. Thirty-four (64%) patients were successfully treated with OPAT at medical respite. Readmission rate was 30%. The average length of OPAT was 22 days. The cost savings to our institution (using $1500/day inpatient cost) was $25,000 per episode of OPAT. CONCLUSIONS:OPAT can be successful in a supervised medical respite setting for homeless patients with the help of a multidisciplinary team, and can decrease inpatient LOS resulting in cost savings. Journal of Hospital Medicine 2016;11:531-535. © 2016 Society of Hospital Medicine.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Beieler AM,Dellit TH,Chan JD,Dhanireddy S,Enzian LK,Stone TJ,Dwyer-O'Connor E,Lynch JBdoi
10.1002/jhm.2597subject
Has Abstractpub_date
2016-08-01 00:00:00pages
531-5issue
8eissn
1553-5592issn
1553-5606journal_volume
11pub_type
杂志文章,评审abstract:BACKGROUND:Hospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use. OBJECTIVE:To compare inpatient analgesic prescribing patterns and patients' perception of pain control in the United States and non-US ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
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更新日期:2019-12-01 00:00:00
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abstract::Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-base...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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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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更新日期:2015-04-01 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
abstract:: ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-01-01 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:2012-03-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析
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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
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pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-02-01 00:00:00
abstract::Esophageal variceal bleeding (EVB) is a frequent complication in cirrhotic patients resulting in considerable mortality and morbidity. The aim of this study was to investigate the occurrence, impact, and trends of EVB in hospitalized cirrhotic patients on a nationwide level in the United States. We interrogated data f...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-07-01 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
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更新日期:2010-02-01 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:2015-01-01 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:2008-11-01 00:00:00
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pub_type: 杂志文章
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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
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更新日期:2016-07-01 00:00:00
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更新日期:2015-04-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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