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Pre-to-post COVID-19 pandemic trends in time from emergency department arrival to inpatient floor arrival: Door to floor time.
Am J Emerg Med
December 2024
Department of Internal Medicine (Section of General Internal Medicine, Program for Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA; Department of Pediatrics (Section of Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA.
Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. We find a sustained increase as well as significant seasonal and day-of-the-week variation in DTF times.
View Article and Find Full Text PDFMedicare Advantage and rural hospital profitability.
J Rural Health
January 2025
Department of Health Policy and Management, UNC Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, North Carolina, USA.
Purpose: This study compares 2018-2023 Medicare Advantage (MA) days as a percentage of total Medicare days in rural and urban hospitals, describes 2022-2023 operating profitability of rural and urban hospitals by quartiles of MA days as a percentage of total Medicare days, and explores hospital characteristics that may be important for understanding the relationship between MA and profitability of rural hospitals.
Methods: Financial and hospital data were obtained from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) for the years 2018 to 2023. Hospitals were assigned to quartiles based on MA days as a percentage of total Medicare days.
Cost Shifting for Emergency Care of Veterans With Medicare After MISSION Act Implementation.
JAMA Health Forum
December 2024
Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Guideline Concordant Extended Pharmacologic Venous Thromboembolism Prophylaxis Utilization After Colorectal Cancer Resection Is Low Regardless of Patient Factors or Hospital Characteristics.
Dis Colon Rectum
December 2024
Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Background: Venous thromboembolism after colorectal cancer resection is common and highly morbid. Extended pharmacologic venous thromboembolism prophylaxis after cancer surgery lowers venous thromboembolism risk and is recommended by major professional societies. Adherence is low in contemporary local and regional studies.
View Article and Find Full Text PDFReferral Networks, Racial Inequity, and Hospital Quality for Open Heart Surgery.
Circ Cardiovasc Qual Outcomes
December 2024
RAND Corporation, Santa Monica, CA (C.B.G., C.L.D., S.Z., M.S., L.J.M., I.P.).
Background: Differences in the quality of hospitals where Black and White patients receive coronary artery bypass grafting (CABG) surgery have been documented. We examined the contributions of physician networks to the gap.
Methods: This was a cross-sectional study of all Medicare fee-for-service Black and White patients undergoing elective CABG during 2017 to 2019; the primary care physicians and cardiologists treating them for 12 months before surgery (the patients' physician network); and CABG-performing hospitals within 100 miles of each patient.
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