Preventive Care Utilization by Patients Who Use Virtual Urgent Care.

The use of direct to patient (DTP) telemedicine for common acute conditions is widespread. It provides certain advantages over in-person visits, but has led to concerns about fragmentation of care. It is unknown whether use of DTP telemedicine decreases use of primary care services in a way that leads to missed preventive screenings and immunizations.

Surgical Outcomes Improvement and Health Inequity in a Regional Quality Collaborative.

Background: Surgical quality improvement initiatives may impact sociodemographic groups differentially. The objective of this analysis was to assess the trajectory of surgical morbidity by race and age over time within a Regional Collaborative Quality Initiative.

Study Design: Adults undergoing eligible general surgery procedures in South Carolina Surgical Quality Collaborative hospitals were analyzed for the presence of at least 1 of 22 morbidities between August 2015 and February 2020.

High-risk opioid analgesic dispensing to adolescents 12-18 years old in South Carolina: 2010-2017.

Purpose: To evaluate "high-risk" opioid dispensing to adolescents, including daily morphine milligram equivalents (MME) above recommended amounts, the percentage of extended-release opioid prescriptions dispensed to opioid-naïve adolescents, and concurrent use of opioids and benzodiazepines, and to evaluate changes in those rates over time.

Methods: Retrospective cohort study of one state's prescription drug monitoring program data (2010-2017), evaluating adolescents 12-18 years old dispensed opioid analgesic prescriptions. Outcomes of interest were the quarterly frequencies of the high-risk measures.

Trends in Dispensed Opioid Analgesic Prescriptions to Children in South Carolina: 2010-2017.

Background And Objectives: Despite published declines in opioid prescribing and dispensing to children in the past decade, in few studies have researchers evaluated all children in 1 state or examined changes in mean daily opioid dispensed. In this study, we evaluated changes in the rate of dispensed opioid analgesics and the mean daily opioid dispensed to persons 0 to 18 years old in 1 state over an 8-year period.

Methods: We identified opioid analgesics dispensed to children 0 to 18 years old between 2010 and 2017 using South Carolina prescription drug monitoring program data.

Facilitated Regional Collaboration and In-Hospital Surgical Complication.

Background: Surgical quality improvement efforts are challenging due to the multidisciplinary nature of care, difficulties obtaining reliable data, and variability in quality metrics. The objective of this analysis was to assess whether participation in a regional collaborative quality initiative was associated with decreased in-hospital surgical complication in South Carolina.

Study Design: In-hospital surgical complication rates were determined using a statewide all-payer claims data set.

Identification of High Utilization Inpatients on Internal Medicine Services.

Background: As healthcare reform moves toward value based care, hospitals must reduce costs. As a first step, here we developed a predictive model to identify high-cost patients on admission.

Methods: We performed a retrospective observational study of 7,571 adults admitted to internal medicine services from July 1, 2013 to June 30, 2014.

Chaos to complexity: leveling the playing field for measuring value in primary care.

Rationale, Aims And Objectives: Develop a risk-stratification model that clusters primary care patients with similar co-morbidities and social determinants and ranks 'within-practice' clusters of complex patients based on likelihood of hospital and emergency department (ED) utilization.

Methods: A retrospective cohort analysis was performed on 10 408 adults who received their primary care at the Medical University of South Carolina University Internal Medicine clinic. A two-part generalized linear regression model was used to fit a predictive model for ED and hospital utilization.

Point of care experience with pneumococcal and influenza vaccine documentation among persons aged ≥65 years: high refusal rates and missing information.

Missed opportunities to vaccinate and refusal of vaccine by patients have hindered the achievement of national health care goals. The meaningful use of electronic medical records should improve vaccination rates, but few studies have examined the content of these records. In our vaccine intervention program using an electronic record with physician prompts, paper prompts, and nursing standing orders, we were unable to achieve national vaccine goals, due in large part to missing information and patient refusal.