Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: Dedicated hospitalists are associated with improvements in healthcare quality and patient outcomes, but are not feasible for small-volume critical access hospitals (CAHs). A telemedicine “virtual hospitalist” model may expand the capabilities of a CAH at a fraction of the cost of an on-site provider. Purpose: Our purpose was to provide hospitalist coverage to remote [...]

Background: Central nervous system medication (CNS med) use among older adults is associated with high morbidity and mortality. This study described patterns of CNS medication use, and identified people most likely to have CNS medications initiated or deprescribed around hospitalization. Methods: Retrospective cohort study using electronic health record data from 3-hospitals. Patients aged 65 years [...]

Background: Cardiovascular disease remains the leading cause of death in the United States. Approximately every 40 seconds, an American will have a myocardial infarction. The aim of this project is to assess the progress of the prevention and management of myocardial infarction by using the National Inpatient Sample (NIS) data. Methods: This is a retrospective [...]

Background: Limited hospital capacity continues to be one of the major challenges to health care in hospitals in the US and the developed word. This problem manifests in a variety of ways in multiple settings starting with prolonged emergency room wait times and left without being seen rates, prolonged ED boarding time, and elective surgery [...]

Background: Regionalization of pediatric healthcare has led to an increased proportion of hospitalizations at tertiary care centers and freestanding children’s hospitals. For some of these patients, transfer from another hospital is required to access inpatient care. There are known disparities in access to care for historically marginalized races/ethnicities, but it is unclear if these disparities [...]

Background: The Hospital Readmissions Reduction Program (HRRP) incentivizes acute care hospitals to decrease their preventable readmissions by putting hospitals at risk of reduced Medicare reimbursements. There exist many sources of heterogeneity in the actual incentives individual hospitals face each year. The HRRP applies the same methodology to hospitals regardless of their share of Medicare patients, [...]

Background: Current staffing models cannot deliver the benefits of hospital medicine to the 1300 critical access hospitals (CAHs) located throughout the rural United States.   Staffing each CAH with local hospitalists would require at least 5500 hospitalists (more than 10% of the workforce), to cover less than 2% of the hospitalized population.   A “virtual hospitalist” program [...]

Background:   The overall national patient satisfaction scores have improved since the HCAHPS reporting began. However, it is unknown whether the improvement trends are different between teaching and non-teaching hospitals. Therefore, our objective was to compare long-term changes in patient satisfaction between teaching and non-teaching hospitals. Methods:   We used three datasets; HCAHPS data (2008 [...]