Background: Readmission and length of stay are two hospital level metrics commonly used to assess the performance of hospitalist groups. Health care systems implement strategies aimed at reducing both. It is possible however that tactics aimed at improving one measure in individual patients may adversely impact the other. Studies in focused populations of patients hospitalized [...]

Background: The 2016 Surviving Sepsis Campaign guidelines recommend antibiotic administration within 1 hour of emergency department (ED) presentation for patients with sepsis. While early antibiotics are associated with reduced mortality, the 1 hr policy has been criticized for its one-size-fits-all approach and risk for over-diagnosis and treatment. Clinicians and quality leaders have called, instead, for [...]

Background: Health care equity, one of the six domains of high-quality health care as defined by the Institute of Medicine, will only be achieved when health care outcomes do not vary based on patient social characteristics, such as gender, race, ethnicity, geographic location, and socioeconomic status. Readmission is a significant outcome for patients and health [...]

Background: While delirium may affect patients of any age, delirium initiatives have focused mostly on the elderly, as older patients are more vulnerable to developing delirium. Few studies have reported delirium in patients between 18-64 years of age, mostly restricted to patients with advanced cancer or on palliative care units. There is a lack of [...]

Background: Patients with immune-mediated diseases such as rheumatoid arthritis, psoriatic arthritis, or inflammatory bowel disease (IBD) are increasingly being prescribed biologics. While biologics may account for roughly 2% of total prescriptions in the United States, they account for over 35% of net drug spending and for over 80% of the growth in net drug spending.1,2 [...]

Background: Type 2 diabetes (T2DM) is a growing epidemic and now the 7th leading cause of death (1). Despite new advances in medications and technology more than 50% of adults with diabetes in the U.S still don’t achieve the recommended goal of glycated hemoglobin (HbA1c) level of 7.0% or less (2).Local Problem​ : Hispanics with [...]

Background: Pulmonary arterial hypertension (PAH) is a progressively debilitating disorder characterized by sustained increases in pulmonary vascular resistance and pulmonary arterial pressure, which eventually leads to right-sided heart failure. Current therapies for PAH work predominately as vasodilators to target symptoms, rather than focusing on the initial signals that promote disease progression. These therapies have proved [...]

Background: Acute pancreatitis (AP) is a sudden inflammation of the pancreas, and biliary pancreatitis remains the most common cause of AP. Endoscopic retrograde cholangiopancreatography (ERCP) is very commonly used in AP with coexisting acute cholangitis or biliary obstruction. There was a need for a nationwide study to evaluate ERCP utilization trends and healthcare costs amongst [...]

Background: Increased risk of venous thromboembolism (VTE) has been noted among cancer patients as compared to non-cancer. Cancer associated thrombosis caused three folds increased hospitalizations, increased inpatient/outpatient medical and prescription claims, and increased total health care costs per patient. Our objective was to study demographic, clinical and laboratory risk factors for venous thromboembolism (VTE) among [...]

Background: After discharge from an acute care hospitalization, cancer patients may choose to pursue rehabilitative care in a skilled nursing facility (SNF). Our objective was to examine receipt of anti-cancer therapy, death, readmission, and hospice use of cancer patients who discharge to a SNF compared to those who discharge home or home with home health [...]