Out-of-pocket costs and prescription reversals with oral linezolid.

Objective: To determine the relationship between benefit design, out-of-pocket costs, and prescription reversals, and the impact of reversals on rehospitalizations and total healthcare costs among Medicare members prescribed oral linezolid.

Study Design: Medicare members from a national health plan prescribed oral linezolid posthospitalization for skin and soft tissue infection (SSTI) or pneumonia were followed retrospectively.

Methods: Members were identified by an oral linezolid prescription between June 1, 2007, and April 30, 2011, where the index event was a prescription fill or reversal less than 2 days before or 10 days after discharge.

Application of the combined quality improvement ratio in the evaluation of a quality improvement activity in a managed care organization.

Assessing the impact of clinically relevant quality improvement activities (QIA) is important to managed care organizations; yet, turnover in enrollment can reduce the data available for analyses, thus decreasing the chance that a difference post-QIA will be detected. The Combined Quality Improvement Ratio (CQuIR) uses matching of patients into pairs pre- and post-QIA to systematically and validly increase the data included in the analysis for evaluation of the QIA. Using a paired cohort study design, 456 pairs of patients with diabetes were identified using the Health Plan Employer Data Information Set (HEDIS) specifications.

Postoperative ileus on a gynecologic oncology service--do abdominal X-rays have a role?

Objective: The objective was to estimate the role of abdominal radiographs in the management of the patient with gastrointestinal dysfunction in the early postoperative period following intra-abdominal gynecologic surgery.

Methods: Hospital records were reviewed for 84 patients from the gynecologic oncology service having a clinical diagnosis of either ileus or bowel obstruction immediately after intra-abdominal gynecologic surgery. Patient history, clinical signs and symptoms, findings of plain radiographs, and clinical course were studied to determine whether plain abdominal radiographs were useful in the management of these patients.

Elective induction of labor in multiparous women. Does it increase the risk of cesarean section?

Objective: To determine whether the medical initiation of labor places the multiparous woman at increased risk of cesarean section.

Study Design: This study was a retrospective, case-control assessment of the risk of cesarean section in multiparas with no medical or obstetric complications and vertex presentations whose induction of labor at term was judged to be elective by chart analysis. Case women were matched for age, parity, gestational age and staff obstetrician with controls in spontaneous labor, and the rates of cesarean delivery were compared.