Transitional care management (TCM) services after hospital discharge are critical for continuity of care, and the COVID-19 pandemic accelerated the shift to telehealth modes of delivery. This study examined the shift from face-to-face to telehealth care around the start of the pandemic (April-July 2020) compared with the same months in 2019 and 2021 and the corresponding 30-day readmission rates. We compared the rates of face-to-face and telehealth TCM as well as face-to-face and telehealth non-TCM services and observed a dramatic shift to telehealth in 2020 with a slight drop-off in 2021. For TCM services specifically, face-to-face visits made up nearly 90% of visits in 2019, whereas telehealth made up the vast majority in 2020 and 2021 at 97.5% and 84.9%, respectively. Over the same time periods, 30-day readmission rates remained steady at 10% along with no changes in 30-day mortality. Among those who completed TCM visits, 30-day readmission rates remained between 8% and 9% and 30-day mortality remained below 1%. These data indicate that this dramatic systemwide shift from face-to-face to telehealth TCM was not accompanied by concurrent changes in either 30-day readmission or mortality rates. Although the findings may be subject to ecologic bias, the data at hand did not allow for reliable estimation of differences in effects of patient-level service delivery type on readmission risk or mortality due to the extremely low volume of face-to-face visits during the pandemic periods. Future research would be needed to conduct such comparisons.
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http://dx.doi.org/10.37765/ajmc.2024.89487 | DOI Listing |
J Clin Med
December 2024
Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark.
: A recent retrospective study conducted by our team identified a high percentage of postoperative pneumonia in children with neuromuscular scoliosis. Based on the findings in that study and our clinical experience, we aimed to assess the effectiveness of an optimized perioperative care protocol. : As part of a prospective study, a multidisciplinary team developed a protocol that included preoperative nutritional and respiratory optimization, intra- and postoperative intravenous glucose infusion, early extubation, and postoperative nutritional optimization.
View Article and Find Full Text PDFJ Clin Med
December 2024
AP-HM, Department of Anesthesiology and Critical Care Medicine, University Hospital Timone, Aix Marseille University, 13005 Marseille, France.
: Postoperative delirium (POD) is a common surgical complication that increases hospital stay duration, hospitalization costs, readmission rates and mortality. This study aims to describe the incidence of POD in an elderly patient population and to investigate pain assessment as a risk factor for postoperative confusion. Additionally, we aim to determine a predictive model for POD.
View Article and Find Full Text PDFAntibiotics (Basel)
December 2024
Department of Pharmacy Practice, Auburn University Harrison College of Pharmacy, Auburn, AL 36849, USA.
Methicillin-resistant (MRSA) can cause cases of community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, and nasal colonization with this pathogen increases the risk of infection. Due to its high negative predictive value, multiple studies support using the MRSA nasal polymerase chain reaction (PCR) test to discontinue antimicrobials that target MRSA in the setting of a negative test result. The purpose of this project was to assess the utility of a protocol to allow pharmacists the ability to order MRSA nasal PCR screenings in hospitalized patients with pneumonia.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Hematology, Hospital Clínic Barcelona, 08036 Barcelona, Spain.
Even though venetoclax in combination with azacitidine (VenAza) is considered a low-intensity regimen, its patients present a high incidence of cytopenia and infections during the first courses, making the initial management a challenging phase. This difficulty in our center led to the establishment of an At-Home (AH) program for ramp-up and follow-up patients during the VenAza combination induction phase focused on therapy administration, patient and caregiver education, and management of adverse events (AEs). A total of 70 patients with newly diagnosed acute myeloid leukemia (ND-AML) or relapsed/refractory AML (R/R AML) were treated with VenAza from March 2019 to May 2022.
View Article and Find Full Text PDFCardiovasc Revasc Med
December 2024
Cardiology Division, Hennepin Healthcare, Minneapolis, MN, USA.
Background: There is a growing body of data to support the presence of sex disparities in outcomes of cardiovascular related hospitalizations. Despite this, there remains a paucity of data on relationships between sex and in-hospital outcomes in patients receiving a left atrial appendage occlusion device (LAAOD).
Methods: We examined the 2016-2020 Nationwide Readmission Database to identify patients with Atrial Fibrillation receiving a LAAOD.
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