Abstract：
BACKGROUND:A small proportion of patients accounts for a large proportion of hospitalizations. OBJECTIVE:To obtain patients' perspectives of factors associated with the onset and continuation of high hospital use. DESIGN:Qualitative research study where a research coordinator conducted one-on-one semi-structured interviews. A team of researchers performed inductive coding and analysis. SETTING:A single urban academic hospital. PARTICIPANTS:Patients with two-unplanned 30-day readmissions within 12 months and one or more of the following: ≥1 readmission in the last six months, a referral from a clinician, or ≥3 observation visits. RESULTS:Overall, 26 participants completed the interviews. Four main themes emerged. First, major medical problems were universal, but the onset of frequent hospital use varied. Second, participants perceived fluctuations in their course to be related to psychological, social, and economic factors. Social support was perceived as helpful and participants benefited when providing social support to others. Third, episodes of illness varied in onset and generally seemed uncontrollable and often unpredictable to the participants. Fourth, participants strongly desired to avoid hospitalization and typically sought care only after self-management failed. CONCLUSIONS:Emergent themes pointed to factors which influence patients' onset of high hospital use, fluctuations in their illness over time, and triggers to seek care during an episode of illness. These findings enable patients' perspectives to be incorporated into the design of programs serving similar populations of frequently hospitalized patients.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
O'Leary KJ,Chapman MM,Foster S,O'Hara L,Henschen BL,Cameron KAdoi
10.12788/jhm.3175subject
Has Abstractpub_date
2019-03-20 00:00:00pages
E1-E6eissn
1553-5592issn
1553-5606pii
jhm.3175journal_volume
14pub_type
杂志文章abstract：OBJECTIVE:Mortality in hospitalized human immunodeficiency virus (HIV)-infected patients is not well described. We sought to characterize in-hospital deaths among HIV-infected patients in the antiretroviral (ART) era and identify factors associated with mortality. METHODS:We reviewed the medical records of hospitalize...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2409
更新日期：2015-09-01 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 AND OBJECTIVE:Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation rec...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.3275
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Emergency department (ED) ward admissions subsequently transferred to the intensive care unit (ICU) within 24 hours have higher mortality than direct ICU admissions. DESIGN, SETTING, PATIENTS:Describe risk factors for unplanned ICU transfer within 24 hours of ward arrival from the ED. METHODS:Evaluation of...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.1979
更新日期：2013-01-01 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：:As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understa...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.2952
更新日期：2018-09-01 00:00:00
abstract：:Posttraumatic stress disorder (PTSD) is common in the United States, with a prevalence of nearly 8% in the general population and between 10% and 30% in veterans. Despite how common PTSD is, inpatient providers may not be familiar with its manifestations or feel comfortable taking care of patients who may exhibit symp...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
doi：10.12788/jhm.3409
更新日期：2021-01-01 00:00:00
abstract：:Many children's hospitals are actively working to reduce readmissions to improve care and avoid financial penalties. We sought to determine if pediatric readmission rates have changed over time. We used data from 66 hospitals in the Inpatient Essentials Database including index hospitalizations from January, 2010 thro...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.3210
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:The Centers for Disease Control and Prevention recommends routinely offering HIV testing to inpatients at hospitals with an HIV seroprevalence rate of greater than 1% or an AIDS diagnosis rate of greater than 1.0 per 1000 discharges. This recommendation has not been widely adopted, perhaps because of one of ...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
doi：10.1002/jhm.66
更新日期：2006-03-01 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:Warfarin reduces stroke in patients with atrial fibrillation. However, its narrow therapeutic index and need for chronic monitoring are barriers to its optimal utilization in many patients. The recent introduction of 3 novel oral anticoagulants (NOACs), as alternatives to warfarin, may change the eligibility...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
doi：10.1002/jhm.2201
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:Knowing the number of discharges that will occur is important for administrators when hospital occupancy is close to or exceeds 100%. This information will facilitate decision making such as whether to bring in extra staff, cancel planned surgery, or implement measures to increase the number of discharges. W...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.2802
更新日期：2018-03-01 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：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：: ...
journal_title：Journal of hospital medicine
pub_type： 评论,社论
doi：10.12788/jhm.3116
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill. OBJECTIVE:To quantify rates of parenteral administrat...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,多中心研究
doi：10.1002/jhm.2324
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Readmission to a different hospital than the original discharge hospital may result in breakdowns in continuity of care. In different-hospital readmissions (DHRs), continuity can be maintained when hospitals are connected through health information exchange (HIE) systems. OBJECTIVE:To examine whether length...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2535
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Increased recognition of ionizing radiation risks has placed an emphasis on the appropriate use of myocardial perfusion imaging (MPI). Hospitalists frequently order MPI in the evaluation of chest pain and are thus at the forefront of its inpatient utilization. METHODS:We collected baseline figures for a gro...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2288
更新日期：2015-03-01 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：BACKGROUND:Efforts to curb healthcare spending have included interventions that target frequently hospitalized individuals. It is unclear the extent to which the most frequently hospitalized individuals also represent the costliest individuals. OBJECTIVE:To examine the relationship between 2 types of "high users" comm...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2096
更新日期：2013-12-01 00:00:00
abstract：:For more than 20 years, the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) Program has been identifying and synthesizing evidence to inform evidence-based healthcare. Recognizing that many healthcare settings continue to face challenges in disseminating and implementing evidence...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.12788/jhm.3157
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:Little is known about management of hyperglycemia in inpatients. OBJECTIVE:To gain insight into caring for hospitalized patients with hyperglycemia. DESIGN:Retrospective analysis. SETTING:Teaching hospital. PATIENTS:Data on all patients discharged between January 1, 2001, and December 31, 2004 with a dia...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.188
更新日期：2007-07-01 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
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journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.1966
更新日期：2012-11-01 00:00:00
abstract：:Successful secondary prevention of cardiovascular disease relies on medication therapy; thus, minimizing nonadherence is a focus for improving patient outcomes. Receipt of discharge medication counseling has been associated with improved drug knowledge and adherence. We evaluated the prevalence and predictors of postd...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2446
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:Unplanned (unexpected) transfers to the intensive care unit (ICU) are typically preceded by physiologic instability. However, trends toward instability may be subtle and not accurately reflected by changes in vital signs. The shock index (SI) (heart rate/systolic blood pressure as an indicator of left ventri...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.779
更新日期：2010-10-01 00:00:00
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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:Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. OBJECTIVE:To examine gender differences in work characteristics and job satisfaction...
journal_title：Journal of hospital medicine
pub_type： 杂志文章
doi：10.1002/jhm.2400
更新日期：2015-08-01 00:00:00
abstract：BACKGROUND:Half of patients admitted to hospital for reasons unrelated to childbirth are age 65 years or older. Nonetheless, few hospital-based physicians have received training in geriatric medicine, and few geriatricians practice in the hospital. This paper describes the state of the science of hospital care for olde...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
doi：10.1002/jhm.11
更新日期：2006-01-01 00:00:00
abstract：:Clozapine was approved by the US Food and Drug Administration in 1989 for the management of treatment-resistant schizophrenia, and has since proven to reduce symptom burden and suicide risk, increase quality of life, and reduce substance use in individuals with psychotic disorders. Nevertheless, clozapine's psychiatri...
journal_title：Journal of hospital medicine
pub_type： 杂志文章,评审
doi：10.1002/jhm.2345
更新日期：2015-08-01 00:00:00
