Poor Surgical Outcomes for Safety-Net Hospitals

NEW YORK – Hospital resources, and not necessarily patient characteristics, may be causing safety-net hospitals to deliver inferior surgical outcomes at increased cost in elective surgical procedures, according to a new study. “Analysis of Medicare Hospital Compare data revealed that safety-net hospitals perform worse on Surgical Care Improvement Project (SCIP) measures and have less efficient emergency departments throughput,” first author Dr…. [Read More]

Dementia Most Costly Terminal Disease, Study Says

Families may spend almost twice as much caring for dementia patients at the end of life than they might if their loved one suffered from a different disease, a U.S. study suggests. Costs paid by Medicare, the U.S. health insurance program for the elderly, were similar over the final five years of life for patients with dementia, heart disease, cancer… [Read More]

Outpatient Care Costly for Hospitals

NEW YORK – Outpatient care may cost more when hospitals own the medical practices or employ the physicians, a U.S. study suggests. Hospital employment of doctors and ownership of physician practices has grown over the past decade as health care providers seek to curb expenses with economies of scale and deliver better-coordinated treatment to patients. Research reported in an article… [Read More]

Younger Type 2 Diabetics Face Greater Mortality Risks

NEW YORK – People with type 2 diabetes are 15 percent more likely to die from any cause and 14 percent more likely to die from a cardiovascular cause than non-diabetics at any given time, according to data from several Swedish registries. The rates are significantly lower than previous estimates. Fifteen years ago, research was suggesting that having diabetes doubled the risk… [Read More]

Drug Treatment Key to Fewer Hospitalizations for Schizophrenic Patients

NEW YORK – Initiation of antipsychotic or antidepressant drug treatment is linked to a reduction in hospitalizations for patients with schizophrenia, according to a new study. “Use of sulpiride, mirtazapine, venlafaxine, and clozapine-aripiprazole and clozapine amisulpride combinations were associated with fewer subsequent admission-days in patients with schizophrenia,” Dr. Rudolf N. Cardinal of the Behavioral and Clinical Neuroscience Institute, University of Cambridge, UK, said by… [Read More]

Younger AF Patients at Higher Risk of Dementia

NEW YORK – Atrial fibrillation (AF) is associated with an increased risk of dementia, especially in younger individuals, according to results from the Rotterdam Study. “When we started this study, we hypothesized that the hazard of atrial fibrillation would be higher with longer exposure, but to find such a strong exposure-time association in younger participants was striking,” said Dr. Frank J…. [Read More]

Risk of Diabetes in Ex-Smokers Decreases

While smoking is linked to an increased risk of developing diabetes, this risk appears to drop over the long term once cigarette use stops, a review of evidence suggests. Researchers analyzed data on almost 5.9 million people in 88 previous studies examining the connection between smoking, second-hand smoke exposure and diabetes. They estimated that roughly 28 million type 2 diabetes cases… [Read More]

Beta-Blockers Increase Mortality in Hypertensive Patients

NEW YORK – Perioperative beta-blocker use in patients with hypertension is associated with increased cardiovascular complications and mortality after noncardiac surgery, researchers from Denmark report. “The consistency of the findings of increased risks associated with beta-blockers across numerous subgroups was an important finding,” Dr. Mads Emil Jorgensen from Gentofte Hospital in Hellerup said by email. “It supports our concern that in a low-risk… [Read More]

Tips for Hospitalists on Improving Diagnostic Skills

Case A 67-year-old man presents to the hospital with persistent, subjective fevers and malaise for one month, subacute onset of dyspnea, and nonproductive cough for the preceding six days. The patient is a nonsmoker, denies sick contacts, and has had no foreign travel. What would be the best approach to making the diagnosis while working… [Read More]

Differences in Care, Outcomes for In-Hospital Versus Community-Onset Stroke

Clinical question: Are there any differences in care and outcomes for in-hospital versus community-onset stroke? Background: In-hospital stroke accounts for 4%-17% of all strokes. Hospitalists and other non-neurological services have to identify and treat subsequent stroke in their patients. There is not much literature detailing the differences between hospitalized stroke patients and those admitted for… [Read More]