Measuring the association between diagnostic errors and neighborhood disadvantage.

Patients who reside in areas of high neighborhood disadvantage have poorer health outcomes; the mechanisms for this disparity are complex. We sought to determine if there was an association between neighborhood disadvantage and diagnostic error among a cohort of adult inpatients who experienced either an ICU transfer or in-hospital death. Using a sample of 527 patients from seven geographically diverse academic medical systems, we compared diagnostic error rates to patients' neighborhood disadvantage levels as measured by the Area Deprivation Index, a validated composite measure of socioeconomic status.

The Impact of Principal Diagnosis on Readmission Risk among Patients Hospitalized for Community-Acquired Pneumonia.

Coding variation distorts performance/outcome statistics not eliminated by risk adjustment. Among 1596 community-acquired pneumonia patients hospitalized from 1998 to 2012 identified using an evidence-based algorithm, the authors measured the association of principal diagnosis (PD) with 30-day readmission, stratified by Pneumonia Severity Index risk class. The 152 readmitted patients were more ill (Pneumonia Severity Index class V 38.

Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients.

Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; = 135) with numerous rehospitalizations ( = 341) from 2017 to 2020 (NIH-funded ACCOuNT project/clinicaltrials.gov#NCT03225820).

Paradoxical doppler echocardiographic parameters during recovery of left atrial contractility after spontaneous conversion from paroxysmal atrial fibrillation to sinus rhythm.

Paroxysmal atrial fibrillation (PAF) reduces atrial contractility due to atrial remodeling, but little is known about the process by which contractile function is reconstituted after spontaneous conversion to sinus rhythm (SR). A 63-year-old healthy man developed PAF. PAF persisted for 2 days before spontaneous conversion to SR.

Association of Preferences for Participation in Decision-making With Care Satisfaction Among Hospitalized Patients.

Importance: The association of patient desire to participate in health care decisions with care satisfaction is poorly understood. The contributions of such desire, expectations of care, and quality of care in assessing patient satisfaction are not known.

Objective: To investigate the association of hospitalized patients' desire to delegate decisions to their physician with care dissatisfaction.

Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers.

Importance: Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units.

Objective: To characterize inpatient adaptations to care for non-ICU COVID-19 patients.

Design: Cross-sectional survey.

The impact of marital status on health care utilization among Medicare beneficiaries.

To explain prior literature showing that married Medicare beneficiaries achieve better health outcomes at half the per person cost of single beneficiaries, we examined different patterns of healthcare utilization as a potential driver.Using the Medicare Current Beneficiary Survey (MCBS) data, we sought to understand utilization patterns in married versus currently-not-married Medicare beneficiaries. We analyzed the relationship between marital status and healthcare utilization (classified based on setting of care utilization into outpatient, inpatient, and skilled nursing facility (SNF) use) using logistic regression modeling.

The Relative Ability of Comorbidity Ascertainment Methodologies to Predict In-Hospital Mortality Among Hospitalized Community-acquired Pneumonia Patients.

Background: Despite widespread use of comorbidities for population health descriptions and risk adjustment, the ideal method for ascertaining comorbidities is not known. We sought to compare the relative value of several methodologies by which comorbidities may be ascertained.

Methods: This is an observational study of 1596 patients admitted to the University of Chicago for community-acquired pneumonia from 1998 to 2012.

Gastric varices and splenic vein obstruction during steroid treatment for autoimmune pancreatitis: A case report and literature review.

Rationale: Few cases of autoimmune pancreatitis (AIP) complicated by gastric varices, in the absence of splenic vein obstruction, have been described in the medical literature. The findings in this case parallel those of 3 previously described cases from Japan and support a pathologic explanation for the evolution of gastric varices in relation to early splenomegaly and the role of steroid therapy for AIP.

Patient Concerns: A 50-year-old male with a history of transfusion-requiring erosive gastritis and recently diagnosed AIP on steroid therapy for 2 weeks presented with a 2-day history of lightheadedness, abdominal pain, and melena.