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Phosphorus sources, forms, and abundance as a function of streamflow and field conditions in a Maumee River tributary, 2016-2019.

J Environ Qual 2021 Sep 20. Epub 2021 Sep 20.

U.S. Geological Survey, Upper Midwest Environmental Sciences Center, 2630 Fanta Reed Road, La Crosse, WI, 54603.

Total phosphorus (TP), dissolved P (DP), and suspended sediment (SS) were sampled in Black Creek, Indiana, monthly during base flow and for 100 storm events during water years 2016-2019, enabling analysis of how each of these varied as a function of streamflow and field conditions at nested edge-of-field sites. Particulate P was normalized by SS (P = [TP-DP]/SS). Streamflow events were differentiated by maximum TP concentrations co-occurring with maximum SS ("SED") or DP ("SOL"). Read More

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September 2021

Racial Disparities in Triage of Adolescent Patients After Bullet Injury.

J Trauma Acute Care Surg 2021 Sep 14. Epub 2021 Sep 14.

Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO President of Power4STL.

Introduction: While pediatric trauma centers (PTCs) and adult trauma centers (ATCs) exhibit equivalent trauma mortality, the optimal care environment for traumatically injured adolescents remains controversial. Race has been shown to effect triage within emergency departments (EDs) with people of color receiving lower acuity triage scores. We hypothesized that African-American adolescents were more likely triaged to an ATC than a PTC compared to their Caucasian peers. Read More

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September 2021

Pulmonary hypertension among children with in-hospital cardiac arrest: a multicenter study.

Resuscitation 2021 Sep 15. Epub 2021 Sep 15.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Aims: To determine the prevalence of pulmonary hypertension (PH) among children with in-hospital cardiac arrest (IHCA) and its association with survival.

Methods: Children (<18 years) admitted to ICUs participating in the Virtual Pediatric Systems multicenter registry between January 2011 and December 2017 who had an IHCA during their hospitalization were included. Patients were classified by whether they had a documented diagnosis of PH at the time of IHCA. Read More

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September 2021

Trichomonas Infection Rates in Males Presenting to the Emergency Department for Sexually Transmitted Infections.

J Emerg Med 2021 Sep 14. Epub 2021 Sep 14.

University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; John R. Oishei Children's Hospital, Buffalo, New York; Erie County Department of Health, Buffalo, New York.

Background: Trichomonas vaginalis (TV) is one of the most common sexually transmitted infections (STIs). Overall prevalence is reported to be 3.1%, with rates approaching 12. Read More

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September 2021

Racial and Ethnic Disparities in Hip Fracture Surgery Care in the United States From 2006 to 2015: A Nationwide Trends Study.

J Am Acad Orthop Surg 2021 Sep 13. Epub 2021 Sep 13.

From the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY (Amen, Varady); Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Chen); Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Shannon); and Department of Orthopaedic Surgery (Rajaee), Cedar-Sinai Medical Center, Los Angeles, CA.

Background: Racial and ethnic disparities in the surgical treatment of hip fractures have been previously reported, demonstrating delayed time to surgery and worse perioperative outcomes for minority patients. However, data are lacking on how these disparities have trended over time and whether national efforts have succeeded in reducing them. The aim of this study was to investigate temporal trends in racial and ethnic disparities in perioperative metrics for patients undergoing hip fracture surgery in the United States from 2006 to 2015. Read More

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September 2021

Development and Validation of a Risk Prediction Model for 1-Year Readmission Among Young Adults Hospitalized for Acute Myocardial Infarction.

J Am Heart Assoc 2021 Sep 13:e021047. Epub 2021 Sep 13.

Program on Aging Department of Internal Medicine Yale School of Medicine New Haven CT.

Background Readmission over the first year following hospitalization for acute myocardial infarction (AMI) is common among younger adults (≤55 years). Our aim was to develop/validate a risk prediction model that considered a broad range of factors for readmission within 1 year. Methods and Results We used data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which enrolled young adults aged 18 to 55 years hospitalized with AMI across 103 US hospitals (N=2979). Read More

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September 2021

Rhinocerebral Mucormycosis in a COVID-19 Patient from Nepal: A Case Report.

JNMA J Nepal Med Assoc 2021 Jul 30;59(239):703-705. Epub 2021 Jul 30.

Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

With the surge of cases during the second wave of COVID-19 in Nepal, a number of mucormycosis coinfection cases have also come to our attention. We present a case of a 65-year-old female who was admitted to our emergency department with complaints of pain, swelling, and tingling sensation of the left side of the face along with blood-tinged nasal discharge for 20 days. She had been tested positive for COVID-19 a month back and managed with oxygen support and corticosteroids. Read More

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Association of Social Isolation With Disability Burden and 1-Year Mortality Among Older Adults With Critical Illness.

JAMA Intern Med 2021 Sep 7. Epub 2021 Sep 7.

Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut.

Importance: Disability and mortality are common among older adults with critical illness. Older adults who are socially isolated may be more vulnerable to adverse outcomes for various reasons, including fewer supports to access services needed for optimal recovery; however, whether social isolation is associated with post-intensive care unit (ICU) disability and mortality is not known.

Objectives: To evaluate whether social isolation is associated with disability and with 1-year mortality after critical illness. Read More

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September 2021

Association Between Racial Disparities in Hospital Length of Stay and the Hospital Readmission Reduction Program.

Health Serv Res Manag Epidemiol 2021 Jan-Dec;8:23333928211042454. Epub 2021 Aug 31.

Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, NY, USA.

Background: On average Black patients have longer LOS than comparable White patients. Longer hospital length of stay (LOS) may be associated with higher readmission risk. However, evidence suggests that the Hospital Readmission Reduction Program (HRRP) reduced overall racial differences in 30-day adjusted readmission risk. Read More

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Bounce-Back: Predicting Acute Readmission from Inpatient Rehabilitation for Patients with Stroke.

Am J Phys Med Rehabil 2021 Sep 2. Epub 2021 Sep 2.

Cedars-Sinai, Department of Physical Medicine and Rehabilitation, Los Angeles, California Cedars-Sinai, Department of Biomedical Sciences Cedars-Sinai, Department of Nursing Research, Los Angeles, California Casa Colina Hospital and Centers for Healthcare, Pomona, California Health Department, State University of New York at Cortland, Cortland, New York Corresponding Author.

Abstract: Objective: To identify demographic, medical and functional risk factors for discharge to an acute hospital before completion of an inpatient rehabilitation program and 7-day and 30-day readmissions after completion of an inpatient rehabilitation program.Design: Cohort study included 138,063 fee-for-service Medicare beneficiaries with a primary diagnosis of new onset stroke discharged from an inpatient rehabilitation facility (IRF) from June 2009-December 2011. Multivariate models examined readmission outcomes and included data from six months prior to onset of the stroke to thirty days after discharge from the inpatient rehabilitation facility (IRF). Read More

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September 2021

Patient- and hospital-related risk factors for non-routine discharge after lumbar decompression and fusion for spondylolisthesis.

Clin Neurol Neurosurg 2021 Aug 21;209:106902. Epub 2021 Aug 21.

Department of Neurosurgery, John Hopkins School of Medicine, Baltimore, MD, USA; Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY 11030, USA.

Objective: In various spinal surgeries, non-routine discharges have been associated with inferior outcomes. However, there exists a paucity of data regarding the relationship between non-routine discharge and quality of care among patients with spondylolisthesis. The aim of this study was to identify independent predictors for non-routine discharge following spinal decompression and fusion for lumbar spondylolisthesis. Read More

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Clinical and Echocardiographic Characteristics of Patients Hospitalized With Acute Versus Chronic Heart Failure With Preserved Ejection Fraction (From the ARIC Study).

Am J Cardiol 2021 Aug 30. Epub 2021 Aug 30.

Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina. Electronic address:

An expanding number of therapies are now indicated for comorbidity management in heart failure with preserved ejection fraction (HFpEF). Whether comorbidity burdens differ for patients with HFpEF who are hospitalized for acute decompensated heart failure (ADHF) versus those with chronic stable heart failure (CSHF) who are hospitalized for other causes is uncertain. Since 2005, the Atherosclerosis Risk in Communities (ARIC) study has conducted adjudicated community surveillance of hospitalized heart failure. Read More

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Predictors of Nonelective Surgery for Spinal Metastases: Insights from a National Database.

Spine (Phila Pa 1976) 2021 May 11. Epub 2021 May 11.

Case Western Reserve University School of Medicine, Cleveland, OH, USA. Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.

Study Design: Secondary analysis of a national all-payer database.

Objective: Our objectives were to (1) identify patient- and hospital-level factors independently associated with the receipt of non-elective surgery and (2) determine whether non-elective surgery portends differences in perioperative outcomes compared to elective surgery for spinal metastases.

Summary Of Background Data: Spinal metastases may progress to symptomatic epidural spinal cord compression that warrants urgent surgical intervention. Read More

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Preservation of Cardiac Reserve and Cardiorespiratory Fitness in Patients With Acute De Novo Versus Acute on Chronic Heart Failure With Reduced Ejection Fraction.

Am J Cardiol 2021 Aug 28. Epub 2021 Aug 28.

VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.

There is limited understanding on the potential differences in the pathophysiology between de novo heart failure with reduced ejection fraction (HFrEF) and acute on chronic HFrEF. The aim of this study was to assess differences in cardiorespiratory fitness (CRF) parameters between de novo heart failure and acute on chronic HFrEF using cardiopulmonary exercise testing (CPX). We retrospectively analyzed CPX data measured within 2 weeks of discharge following acute hospitalization for HFrEF. Read More

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Atypical idiopathic intracranial hypertension presenting as cyclic vomiting syndrome: a case report.

J Med Case Rep 2021 Aug 31;15(1):440. Epub 2021 Aug 31.

Department of Neurology, Children's Memorial Hermann Hospital, 6410 Fannin St., Ste 1014, Houston, TX, 77030, USA.

Background: Idiopathic intracranial hypertension is a disorder of increased intracranial pressure in the absence of cerebrospinal outflow obstruction, mass lesion, or other underlying cause. It is a rare phenomenon in prepubertal children and is most typically found in women of childbearing age. The classic presentation consists of headaches, nausea, vomiting, and visual changes; however, children present more atypically. Read More

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Approach and avoidant coping among black transgender women who have experienced violence: A qualitative analysis.

Psychol Serv 2021 Aug 30. Epub 2021 Aug 30.

The Nell Hodgson Woodruff School of Nursing, Emory University.

Black transgender women face nearly universal exposure to violence. Coping behaviors among cisgender women who have survived violence are well delineated; however, there are relatively few studies examining coping strategies for transgender women. The purpose of this qualitative study was to identify and characterize coping behaviors employed by Black transgender women (from Baltimore, MD and Washington, DC metropolitan areas) following an experience of violence. Read More

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Incidence and Diagnostic Challenges of Bowel Ischemia after Continuous-flow Left Ventricular Assist Device Therapy.

ASAIO J 2021 Aug 24. Epub 2021 Aug 24.

From the School of Medicine, Duke University, Durham, North Carolina Department of Surgery, Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina Division of Cardiothoracic Surgery, Department of Surgery, Emory University, Atlanta, Georgia Division of Trauma and Critical Care Surgery, Department of Surgery, Duke University, Durham, North Carolina.

Long-term continuous-flow left ventricular assist device (CFLVAD) therapy is limited by complications. Compared with stroke and renal dysfunction, post-CFLVAD bowel ischemia is poorly characterized. Adult patients who underwent first-time durable CFLVAD implantation at our institution between 2008 and 2018 were identified and screened for bowel ischemia using Current Procedural Terminology codes for abdominal surgical exploration and International Classification of Disease codes for intestinal vascular insufficiency. Read More

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Race Differences in Interventions and Survival After Out-of-Hospital Cardiac Arrest in North Carolina, 2010 to 2014.

J Am Heart Assoc 2021 Sep 25;10(17):e019082. Epub 2021 Aug 25.

Duke Clinical Research Institute Durham NC.

Background Following the implementation of the HeartRescue project, with interventions in the community, emergency medical services, and hospitals to improve care and outcomes for out-of-hospital cardiac arrests (OHCA) in North Carolina, improved bystander and first responder treatments as well as survival were observed. This study aimed to determine whether these improvements were consistent across Black versus White individuals. Methods and Results Using the Cardiac Arrest Registry to Enhance Survival (CARES), we identified OHCA from 16 counties in North Carolina (population 3 million) from 2010 to 2014. Read More

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September 2021

Association Between Black Race, Clinical Severity, and Management of Acute Pulmonary Embolism: A Retrospective Cohort Study.

J Am Heart Assoc 2021 Sep 25;10(17):e021818. Epub 2021 Aug 25.

Division of Vascular Surgery University of Pittsburgh Pittsburgh PA.

Background Existing evidence indicates Black patients have higher incidence of pulmonary embolism (PE) and PE-related mortality compared with other races/ethnicities, yet disparities in presenting severity and treatment remain incompletely understood. Methods and Results We retrospectively queried a multihospital healthcare system for all hospitalizations for acute PE (2012-2019). Of 10 329 hospitalizations, 8743 met inclusion criteria. Read More

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September 2021

Hospital Quality of Care and Racial and Ethnic Disparities in Unexpected Newborn Complications.

Pediatrics 2021 Sep;148(3)

Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Objectives: To investigate racial and ethnic differences in unexpected, term newborn morbidity and the influence of hospital quality on disparities.

Methods: We used 2010-2014 birth certificate and discharge abstract data from 40 New York City hospitals in a retrospective cohort study of 483 834 low-risk (term, singleton, birth weight ≥2500 g, without preexisting fetal conditions) neonates. We classified morbidity according to The Joint Commission's unexpected newborn complications metric and used multivariable logistic regression to compare morbidity risk among racial and ethnic groups. Read More

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September 2021

Diagnostic tool for the diagnosis of physiological and pathological conditions of the uterus in cows postpartum.

Tierarztl Prax Ausg G Grosstiere Nutztiere 2021 Aug 23;49(4):229-233. Epub 2021 Aug 23.

Department of Veterinary Medicine, Faculty of Veterinary Medicine and Technology of Animal Husbandry, S. Seifullin Kazakh Agro Technical University.

Objective: An important task of veterinarians in cattle husbandry is the early diagnosis of postpartum complications that can lead to infertility. The aim of the study was the evaluation of a new device to distinguish between physiological and pathological conditions of the uterus based on the determination of the time of uterine involution and the physicochemical properties of the vaginal discharge (lochia) during the first weeks after parturition.

Material And Methods: A total of 173 black-and-white Holstein-Friesian dairy cows were examined for any pathological alteration of the uterine involution on days 1-2, 6-8, 11-14 postpartum and, in case of pathological findings, additionally on days 18-22, 23-27 and 28-30 after parturition. Read More

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Continuing Cardiopulmonary Symptoms, Disability, and Financial Toxicity 1 Month After Hospitalization for Third-Wave COVID-19: Early Results From a US Nationwide Cohort.

J Hosp Med 2021 Aug 18. Epub 2021 Aug 18.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University School of Medicine, Portland, Oregon.

Background: Patients discharged after COVID-19 report ongoing needs.

Objectives: To measure incident symptoms after COVID-19 hospitalization.

Design, Setting, And Participants: Preplanned early look at 1-month follow-up surveys from patients hospitalized August 2020 to January 2021 in NHLBI PETAL Network's Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. Read More

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A protocol for the first episode psychosis outcome study (FEPOS): ≥15 year follow-up after treatment at the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia.

Early Interv Psychiatry 2021 Aug 20. Epub 2021 Aug 20.

Orygen, Parkville, Victoria, Australia.

Background: Specialist early intervention (SEI) service models are designed to treat symptoms, promote social and vocational recovery, prevent relapse, and resource and up-skill patients and their families. The benefits of SEI over the first few years have been demonstrated. While early recovery can be expected to translate to better long-term outcomes by analogy with other illnesses, there is limited evidence to support this from follow-up studies. Read More

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Racial/Ethnic Disparities in Use of High-Quality Hospitals Among Oral Cancer Patients in California.

Laryngoscope 2021 Aug 18. Epub 2021 Aug 18.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.

Objectives/hypothesis: To examine racial/ethnic differences in use of high-quality hospitals in patients treated for oral cancer in California.

Study Design: Retrospective cancer database cohort study.

Methods: Data were extracted from the California Cancer Registry data set linked with discharge records and hospital characteristics from the California Office of Statewide Health Planning and Development, and with neighborhood characteristics from the California Neighborhoods Data System. Read More

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Old Is (Not) Gold: Midazolam Monotherapy versus Midazolam Plus Fentanyl for Sedation during Cardiac Catheterization.

J Interv Cardiol 2021 2;2021:9932171. Epub 2021 Aug 2.

Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA.

Objective: We aimed to study the differences in perception of pain during cardiac catheterization with midazolam monotherapy compared to the current standard of midazolam plus fentanyl.

Background: Procedural sedation is important to ensure comfort and safety in patients undergoing left heart catheterization. Despite the widespread use of midazolam and fentanyl for procedural sedation, the effectiveness of this dual agent approach to sedation has never been studied in comparison to midazolam monotherapy. Read More

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Race, language, and neighborhood predict high-risk preterm Infant Follow Up Program participation.

J Perinatol 2021 Aug 17. Epub 2021 Aug 17.

Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Objectives: Infant Follow Up Programs (IFUPs) provide developmental surveillance for preterm infants after hospital discharge but participation is variable. We hypothesized that infants born to Black mothers, non-English speaking mothers, and mothers who live in "Very Low" Child Opportunity Index (COI) neighborhoods would have decreased odds of IFUP participation.

Study Design: There were 477 infants eligible for IFUP between 1/1/2015 and 6/6/2017 from a single large academic Level III NICU. Read More

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Merging Two Hospitals: The Effects on Pediatric Extracorporeal Cardiopulmonary Resuscitation Outcomes.

J Pediatr Intensive Care 2021 Sep 31;10(3):202-209. Epub 2020 Aug 31.

Pediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia.

In this article, a retrospective study was performed to describe the impact of merging two pediatric intensive care units on the overall and neurocognitive outcomes of children who required extracorporeal cardiopulmonary resuscitation (ECPR). Results from three cohorts were compared: 2008 to 2014: premerge, 2014 to 2017: initial time period postmerge, and 2018 to 2019: established merge. Survival to hospital discharge (and with good neurological outcome) was of 68% (61%), 46% (36%), and 79% (71%), respectively, for the three time periods. Read More

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September 2021

How patients describe their diagnosis compared to clinical documentation.

Diagnosis (Berl) 2021 Aug 16. Epub 2021 Aug 16.

Institute for Communication in Health Care, Australian National University, Canberra, ACT, Australia.

Objectives: To explore how patients describe their diagnoses following Emergency Department (ED) discharge, and how this compares to electronic medical record (EMR) documentation.

Methods: We conducted a cohort study of patients discharged from three EDs. Patients completed questionnaires regarding their understanding of their diagnosis. Read More

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Rescan Time Delays in Ischemic Stroke Imaging: A Retrospective Observation and Analysis of Causes and Clinical Impact.

AJNR Am J Neuroradiol 2021 Aug 12. Epub 2021 Aug 12.

Radiology (J.M.K., A.T.B., G.M., P.C.S.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

Background And Purpose: Delays to reperfusion negatively impact outcomes of patients with ischemic stroke, yet current guidelines recommend selective sequential imaging for thrombectomy candidates. We aimed to quantify and analyze time delays associated with rescanning in sequential acute stroke imaging.

Materials And Methods: This was a retrospective cohort study of consecutive patients with acute ischemic stroke who underwent imaging for treatment decision-making from January 1, 2017, to June 30, 2020. Read More

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Trends in Medical and Surgical Admission Length of Stay by Race/Ethnicity and Socioeconomic Status: A Time Series Analysis.

Health Serv Res Manag Epidemiol 2021 Jan-Dec;8:23333928211035581. Epub 2021 Jul 29.

Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA.

Background: Length of stay (LOS), a metric of hospital efficiency, differs by race/ethnicity and socioeconomic status (SES) and longer LOS is associated with adverse health outcomes. Historically, projects to improve LOS efficiency have yielded LOS reductions by 0.3 to 0. Read More

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