Background: Availability of acute medical services (e.g., emergency department, intensive care unit) has been associated with adverse clinical outcomes. The association between acute psychiatric inpatient beds and suicide has not been well described. In the Veterans Health Administration (VHA), suicide rates among veterans have increased despite mental health care investments. Our objective was to examine [...]

Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, [...]

Background: Rural areas are disproportionately affected by physician shortages, and small rural hospitals in particular struggle to staff acute medicine services 24/7. Telehospitalist models are emerging as an alternative to provide inpatient medicine services in rural settings. In a 2018 needs assessment of rural Veterans Health Administration (VHA) hospitals, 60% percent reported being short on [...]