Association between length of stay and readmission for COPD.

Objectives: Recent financial penalties for high risk-adjusted chronic obstructive pulmonary disease (COPD) readmissions are causing hospitals to search for ways to reduce COPD readmissions. Although some have advocated for increasing the length of stay (LOS) as a method to decrease readmissions, the association between LOS and readmission is unclear. Our primary objective was to examine the association between LOS and readmission among patients admitted for COPD.

Utility of Point-of-care Urine Drug Tests in the Treatment of Primary Care Patients With Drug Use Disorders.

Objectives: To determine if urine drug tests (UDTs) can detect under-reporting of drug use (ie, negative self-report, but positive UDT) and identify patient characteristics associated with underreporting when treating substance use disorders in primary care.

Methods: Self-reported use (last 30 d) and UDTs were gathered at baseline, 3, 6, 9, and 12 months from 829 primary care patients participating in a drug use intervention study. Rates of under-reporting were calculated for all drugs, cannabis, stimulants, opioids, and sedatives.

Clinical Needs of Patients with Problem Drug Use.

Introduction: Illicit drug use is a serious public health problem associated with significant co-occurring medical disorders, mental disorders, and social problems. Yet most individuals with drug use disorders have never been treated, though they often seek medical treatment in primary care. The purpose of this study was to examine the baseline characteristics of people presenting in primary care with a range of problem drug use severity to identify their clinical needs.

Promoting Influenza Vaccination to Restaurant Employees.

Purpose: To evaluate an evidence-based workplace approach to increasing adult influenza vaccination levels applied in the restaurant setting

Design: We implemented an intervention and conducted a pre/post analysis to determine effect on vaccination.

Setting: Eleven Seattle-area restaurants.

Subjects: Restaurants with 25+ employees speaking English or Spanish and over 18 years.

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

Introduction: The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users.

Method: Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed.

Results: In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost.

Influenza vaccination status and attitudes among restaurant employees.

Context: Restaurant employees represent a substantial portion of the US workforce, interact closely with the public, and are at risk for contracting influenza, yet their influenza vaccination rates and attitudes are unknown.

Objective: Assess influenza vaccination rates and attitudes among Seattle restaurant employees, to identify factors that could enhance the success of a restaurant-based vaccination program.

Design: In 2012, we invited employees of Seattle restaurants to complete an anonymous paper survey assessing participant demographics, previous influenza vaccination status, and personal attitudes toward influenza vaccination (using a 5-point scale).

Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical trial.

Importance: Although brief intervention is effective for reducing problem alcohol use, few data exist on its effectiveness for reducing problem drug use, a common issue in disadvantaged populations seeking care in safety-net medical settings (hospitals and community health clinics serving low-income patients with limited or no insurance).

Objective: To determine whether brief intervention improves drug use outcomes compared with enhanced care as usual.

Design, Setting, And Participants: A randomized clinical trial with blinded assessments at baseline and at 3, 6, 9, and 12 months conducted in 7 safety-net primary care clinics in Washington State.