Background: Minority and low-income populations are more likely to be hospitalized and/or re-hospitalized for acute asthma, a key indicator of poorly controlled disease. While hospitals have attempted to improve asthma care by implementing individual-level care interventions, inequities persist during inpatient stays and in intervention delivery. Little is known about the impact of “bundled” systems-level interventions [...]

Background: Research and quality improvement programs may differentially reach some population groups and not others, thereby worsening health disparities. RE-AIM is a well-established implementation science framework used to evaluate the impact of interventions across five domains: Reach, Effectiveness, Adoption, Implementation, and Maintenance. This study aimed to summarize past applications of RE-AIM to evaluate for disparities [...]

Background: Against medical advice (AMA) discharges are often emotionally charged for healthcare providers. Complicated capacity assessments, confusion regarding legal and ethical obligations to patients, and limited resources may strain providers. This cross-sectional survey study explored provider perceptions, experiences, and self-assessed competence with AMA discharges at a county hospital with a high AMA rate. Methods: Surveys, [...]

Background: The principle that patients have the right to make choices about their healthcare, including the decision to leave the hospital against the advice of the medical staff, is a foundation of medical ethics.  Consistently, studies have found disproportionately higher rates of readmission and mortality for patients who leave against medical advice (AMA) as compared to patients who are conventionally discharged. This mixed-methods study aimed to: [...]

Background: The year 2020 was pivotal for physician trainees. The harrowing disparities in SARS-CoV-2 infection and deaths left many trainees with a sense of anguish and urgency for working towards health equity. However, surveys of Internal Medicine residents have shown that their knowledge of healthcare disparities is poor, with minimal improvement and exposure during training. [...]

Background: Uncontrolled asthma leading to emergency department (ED) visits and hospitalization causes suffering, disproportionately among underserved patients, and are costly to healthcare systems. Timely treatment and adherence to clinical guidelines via serial monitoring of patients’ reported symptoms, offers the opportunity to improve health outcomes that are important to patients, clinicians, and accountable care organizations (ACO). [...]