Objectives: Hospitals are employing more nurse practitioners and physician assistants on inpatient pediatric units. With this study, we compared patient outcomes in high-volume inpatient diagnoses on pediatric hospital medicine services staffed by attending physician hospitalists and residents (hospitalist and resident service [HRS]) with 1 staffed by attending physician hospitalists and advanced practice providers (HAPPS).
Methods: A historical cohort study was implemented by using administrative data for patients admitted to HRS and HAPPS from 2007 to 2011 with asthma, bronchiolitis, cellulitis, and pneumonia with severity levels 1 and 2 for all-patient refined diagnosis-related groups. Length of stay, readmission, ICU transfer, and hospital charges were compared.
Results: After controlling for clinical, demographic, and socioeconomic differences, the average probability of discharge was 10% greater each day (event ratio [ER] = 1.1 [1.06-1.14]) on HAPPS compared with HRS. By diagnosis, this trend persisted with asthma (ER = 1.07 [1.02-1.12]), cellulitis (ER = 1.2 [1.1-1.3]), and pneumonia (ER = 1.17 [1.08-1.28]) but not for bronchiolitis (ER = 0.99 [0.92-1.06]). Both 3- and 30-day readmissions were higher for HRS discharges with bronchiolitis (odds ratio = 5.9 [1.3-28.6] and 2.0 [1.3-3.3], respectively) but not for the other diagnoses. Hospital charges were 13% higher for patients on HRS than HAPPS. ICU transfers did not differ statistically.
Conclusions: Within the limitations of the design, HAPPS performed at least as well as HRS with respect to length of stay, readmissions, ICU transfers, and charges for 4 of the most common inpatient diagnoses with severity levels 1 to 2. Indicated in these results is that in this configuration, advanced practice providers on pediatric hospitalist services represent a viable model for other institutions to consider and test.
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http://dx.doi.org/10.1542/hpeds.2018-0028 | DOI Listing |
BMC Med Educ
December 2024
Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India.
Introduction: This scoping review aimed to review the various challenges facing dental education. Dental education faces multiple institutional, student and faculty-based challenges. Institutional challenges include updating infrastructure resources, recruiting qualified faculty, and implementing administrative policies that enhance dental education.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Orthopaedics and Trauma Unit, University of Modena and Reggio Emilia, Modena, 41125, Italy.
Trigger finger (TF), also known as stenosing flexor tenosynovitis, is a common pathology of the fingers causing functional deficit of the hand. In recent years, new therapeutic approaches such as extracorporeal shock wave therapy (ESWT) and ultrasound-guided (USG) procedures have joined the most traditional conservative treatments as the adaptation of daily activities involving the affected hand and the orthosis. Likewise, the ultrasound (US) examination of the affected finger using modern high-frequency probes has progressively become part of the comprehensive assessment of patients with TF coupled with the medical history, the physical examination, and the functional scales.
View Article and Find Full Text PDFBMC Urol
December 2024
Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
Background: Current treatments for penile erectile structures reconstruction are limited and remain a great challenge in clinical practice. Tissue engineering techniques using different seed cells and scaffolds to construct a neo-tissue open promising avenues for penile erectile structures repair and replacement and show great promise in the restoration of: structure, mechanical property, and function which matches the original tissue.
Methods: A comprehensive literature review was conducted by accessing the NCBI PubMed, Cochrane, and Google Scholar databases from January 1, 1990, to January, 1, 2022 using the search terms "Tissue engineering, Corpus cavernosum (CC), Tunica albuginea (TA), Acellular Matrix, Penile Reconstruction".
Musculoskeletal Care
December 2024
Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Background: Patient and clinician expectations of benefit from recommended management approaches may potentially impact the success of managing musculoskeletal conditions.
Methods: This was a multisite study in an advanced practice musculoskeletal service across Queensland, Australia. Relationships between patient and clinician (advanced physiotherapy practitioner) expectations of benefit, patient characteristics, and clinical outcome recorded 6 months later were explored with regression analysis in 619 patients undergoing non-surgical multidisciplinary care for either knee osteoarthritis (n = 286), low back pain (n = 249) or shoulder impingement syndrome (n = 84).
Sci Rep
December 2024
Agricultural Engineering Department, Faculty of Agriculture and Natural Resources, Aswan University, Aswan, 81528, Egypt.
Efficient cooling systems are critical for maximizing the electrical efficiency of Photovoltaic (PV) solar panels. However, conventional temperature probes often fail to capture the spatial variability in thermal patterns across panels, impeding accurate assessment of cooling system performance. Existing methods for quantifying cooling efficiency lack precision, hindering the optimization of PV system maintenance and renewable energy output.
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