Background: The prevalence of gout has risen in recent decades despite advancements in therapeutic options due to several reasons, including lack of adherence to treatment guidelines by physicians and patients’ poor perception and adherence to therapy. We aim to assess the beliefs and knowledge of gout management in Internal Medicine residents, to investigate the gaps, [...]

Background: Tissue pathology plays an integral role in the diagnosis of various conditions, especially malignancy. Traditionally biopsy procedures, including core needle biopsy (CNB), have been performed by specialists under imaging guidance. They are traditionally done in special procedure rooms/suites–which come with an added cost of nursing staff, transportation and equipment. Meanwhile hospitalists are increasingly becoming [...]

Background: Cost-related medication non-adherence (CRN) is a persistent and serious challenge among the elderly population in the US. For elderly patients with limited economic means at increased risk of hospitalization, CRN may elevate the risk of repeated hospitalizations and emergency department visits, and lead patients into a downward spiral of worse heath and higher non-adherence. [...]

Background: Alternative payment models have been proposed for lower extremity joint replacement surgeries to deliver well-coordinated and high quality care. It is speculated that while these payment models may lead to more cost effective care, institutions may “cherry pick” less costly and less complex patients to minimize financial risks. In this study, we aim to [...]

Background: Opening new residency programs in community hospitals is one strategy to address physician shortage. Previous reports showed better outcomes in university based hospitals. However, less is known about teaching community hospitals. Disrupting well- established workflows in community hospitals is feared to cause an increased cost and possibly a slide in quality of care. Our [...]

Background: Currently, patients admitted to the hospital are assigned specific levels of care such as intermediate intensive care or acute care. Differences among care at these levels largely differ through nursing ratio as well as frequency of nursing assessment. Costs per day for patients at different levels of care differ significantly as well. Little is [...]

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created the Complex Discharge team to identify and manage patients who may have a long length of stay, a challenging placement [...]

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial access and 2.8% of femoral access PCIs, respectively. While there is a standardized protocol for obtaining a blood type and [...]

Background: As hospitals are increasingly reimbursed for value-based care, quality improvement projects addressing overutilization of routine “daily labs” have become commonplace. Although there are many published studies of daily labs reduction initiatives, there is little consensus on the actual costs of these routine labs to institutions, with most relying on Centers for Medicare & Medicaid [...]

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As an outpatient, right heart catheterization revealed a pulmonary arterial pressure (PAP) of 76/24 mmHg, mean PAP of 41 mmHg, wedge [...]