Appendicitis Hospitalization Care Costs Among Patients With Delayed Diagnosis of Appendicitis.

Importance: Delayed appendicitis diagnosis is associated with worse outcomes. Appendicitis hospital care costs associated with delayed diagnosis are unknown.

Objective: To determine whether delayed appendicitis diagnosis was associated with increased appendicitis hospital care costs.

Statewide Examination of Access to Cancer Surgery During the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic caused interruptions in the delivery of medical care across a wide range of conditions including cancer. Trends in surgical treatment for cancer during the pandemic have not been well described. We sought to characterize associations between the pandemic and access to surgical treatment for breast, colorectal, and lung cancer in Illinois.

Characterizing endovascular aortic intervention outcomes for nonruptured aortic aneurysms by physician specialty.

Background: Evaluate patient outcomes after endovascular aortic interventions performed for nonruptured aortic aneurysms by physician specialties.

Methods: Endovascular aortic repair (EVAR), fenestrated or branched repair (F-BEVAR), and thoracic endovascular aortic repair (TEVAR) procedures were obtained from the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database from 2016 to 2019. Logistic and Poisson regression were used to determine outcomes by patient, physician, and hospital characteristics.

Obstetric Provider Perspectives on Postpartum Patient Navigation for Low-Income Patients.

Background: Patient navigation programs have shown promise for improving health but are not widely used in obstetric care. Our objective was to understand obstetric provider perspectives on how to implement patient navigation to optimize care during the postpartum period for low-income patients.

Method: Focus groups were conducted with obstetric physicians, nurses, and social workers who care for low-income pregnant and postpartum patients in an academic medical center.

Provider Perspectives on Barriers and Facilitators to Postpartum Care for Low-Income Individuals.

Recent paradigm shifts in postpartum care have conceptualized the "fourth trimester" as a critical transitional period requiring tailored, ongoing health care. However, this concept presents challenges for providers, especially in low-resource settings. Our objective was to understand providers' perspectives on challenges in postpartum care to highlight strategies for optimizing care.

Disparities in Hip Arthroplasty Outcomes: Results of a Statewide Hospital Registry From 2016 to 2018.

Background: In November 2019, Centers for Medicare and Medicaid Services announced total hip arthroplasty (THA) will be removed from the inpatient-only list. This may lead to avoidance of patients who have prolonged hospitalizations and discharge to skilled nursing facilities or push providers to unsafely push patients to outpatient surgery centers. Disparities in hip arthroplasty may worsen as patients are "risk stratified" preoperatively to minimize cost outliers.

What Are the Risk Factors for 48 or More-Hour Stay and Nonhome Discharge After Total Knee Arthroplasty? Results From 151 Illinois Hospitals, 2016-2018.

Background: Bundled payment programs and the Centers for Medicare and Medicaid Services removal of total knee arthroplasty (TKA) from the inpatient-only list potentially incentivize avoiding patients with extended length of stay (eLOS) and nonhome discharge (NHD). We aimed to describe which patients are most at risk of eLOS (>2 days), very eLOS (veLOS; >4 days), and NHD.

Methods: Admissions for unilateral TKAs at 151 Illinois nonfederal hospitals from January 2016 to June 2018 were selected from the Illinois Hospital and Health Systems Association COMPdata administrative hospital discharge database.

Simulation-based education leads to decreased use of fluoroscopy in diagnostic coronary angiography.

Objectives: The aim of this study is to determine whether simulation-based education (SBE) translates into reduced procedure time, radiation, and contrast use in actual clinical care.

Background: As a high volume procedure often performed by novice cardiology fellows, diagnostic coronary angiography represents an excellent target for SBE. Reports of SBE in interventional cardiology are limited and there is little understanding of the potential downstream clinical impact of these interventions.

Evaluation of Introduction of a Delayed Cord Clamping Protocol for Premature Neonates in a High-Volume Maternity Center.

Objective: To evaluate adherence to a delayed cord clamping protocol for preterm births in the first 2 years after its introduction, perform a quality improvement assessment, and determine neonatal outcomes associated with protocol implementation and adherence.

Methods: This is a retrospective cohort study of women delivering singleton neonates at 23-32 weeks of gestation in the 2 years before (preprotocol) and 2 years after (postprotocol) introduction of a 30-second delayed cord clamping protocol at a large-volume academic center. This policy was communicated to obstetric and pediatric health care providers and nurses and reinforced with intermittent educational reviews.

National Evaluation of the New Commission on Cancer Quality Measure for Postmastectomy Radiation Treatment for Breast Cancer.

Background: Current guidelines recommend postmastectomy radiotherapy (PMRT) for patients with ≥4 positive lymph nodes and suggest strong consideration of PMRT in those with 1-3 positive nodes. These recommendations were incorporated into a Commission on Cancer quality measure in 2014. However, national adherence with these recommendations is unknown.

Effect of differences in MIC values on clinical outcomes in patients with bloodstream infections caused by gram-negative organisms treated with levofloxacin.

Emerging evidence suggests that current fluoroquinolone dosing strategies may be inadequate to treat bloodstream infections caused by organisms classified as sensitive. This study sought to determine if differences in MICs for levofloxacin-susceptible gram-negative organisms correlate with differences in patient outcomes. A retrospective cohort study evaluated patients treated with levofloxacin for bloodstream infections caused by susceptible gram-negative organisms.

Impact of inactive empiric antimicrobial therapy on inpatient mortality and length of stay.

The consequences of inactive empiric antimicrobial therapy are not well-described and may cause prolonged hospitalization or infection-related mortality. In vitro susceptibility results for 884 patients hospitalized at an academic medical center with gram-negative bloodstream infections (GNBI) from 2001 to 2003 were matched to antimicrobial orders within 24 h of culture. Clinical characteristics, organism, inpatient mortality, and length of stay after culture for patients with GNBI were compared between patients receiving active versus inactive empiric antimicrobial therapy.