Higher 30-day and 60-day readmissions among patients who refuse post acute care services.

Objectives: To compare patients who accepted ("acceptors") post acute care services (PAC) with those who were offered services and refused ("refusers") in terms of their sociodemographic and clinical characteristics, quality of life, health-related problems, and unmet needs; and to examine the association between refusing PAC services and the risk for 30- and 60-day readmission.

Study Design: Secondary data analysis from a cross-sectional study.

Methods: Bivariate analysis and logistic regressions were used to examine the association between refusing PAC services and 30- and 60-day readmission.

Successful electronic implementation of discharge referral decision support has a positive impact on 30- and 60-day readmissions.

In a quasi-experimental study, decision support software was installed in three hospitals to study the ability to scale (spread) its use from one hospital on paper to three hospitals as software, and to examine the effect on 30- and 60-day readmissions. The Discharge Decision Support System (D2S2) software analyzes data collected by nurses on admission with a proprietary risk assessment tool, identifies patients in need of post-acute care, and alerts discharge planners. On six intervention units, with a concurrent comparison group of 76 units, we examined the implementation experience and compared readmission outcomes before and after implementation.

Impact of exhaled nitric oxide measurements on treatment decisions in an asthma specialty clinic.

Background: Asthma management in an outpatient setting is best accomplished by clinical evaluation coupled with spirometry and symptom evaluation, but these assessments do not provide information about airway inflammation. Exhaled nitric oxide (fraction of exhaled nitric oxide [FeNO]) measures T-helper cell type 2-mediated airway inflammation and may be a useful adjunct in asthma management.

Objective: To determine whether the use of FeNO in the specialist management of asthma results in more effective and cost-effective treatment decisions.

Cilomilast for COPD: results of a 6-month, placebo-controlled study of a potent, selective inhibitor of phosphodiesterase 4.

Background: COPD is a relentless, progressive disease. This study evaluated the efficacy of cilomilast, a selective phosphodiesterase (PDE) 4 inhibitor, in the treatment of COPD.

Methods: This was a randomized, double-blind, placebo-controlled, parallel-group, multicenter study in subjects with COPD.