Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Hospitalists working outside the Veterans Affairs (VA) system frequently will serve Veterans receiving care for acute conditions and/or awaiting transfer to VA facilities. ⋯ Most studied health conditions among Veterans of post-9/11 conflicts have focused on areas of particular importance to the VA. However, significant gaps remain, particularly in understanding the correlation between specific exposures and clinical outcomes currently observed and to be anticipated in the future in this population.
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Prior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326). ⋯ The literature is mixed on the impact of efforts to improve handoffs, though there are few randomized trials. Few studies reported patient experiential or cost/utilization outcomes, or involved hospitalist physicians, which represent potential areas for future research.
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Review
Effect of neighborhood socioeconomic disadvantage on 30-day readmissions: A systematic review.
The area deprivation index (ADI) is a measure of neighborhood disadvantage. It uses census-level information to quantify a person's neighborhood deprivation level based on their address. Recent studies have used ADI to examine the relationship between a patient's address and various health outcomes, including 30-day readmissions. ⋯ Living in a high ADI area moderately impacts 30-day readmissions, particularly for patients who have undergone surgery or have undifferentiated problems.
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"Decision Fatigue" (DF) describes the impaired ability to make decisions because of repeated acts of decision-making. ⋯ The role of clinician, patient, and work environment attributes in mediating DF is understudied. Similarly, the context surrounding the decision under study require further explication and when assessing resource use and decision quality, adjudication should be made against prespecified standards.
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Review
Association of physical function with hospital readmissions among older adults: A systematic review.
Hospital readmissions pose significant burdens on healthcare systems, particularly among older adults. While efforts to reduce readmissions have historically focused on medical management, emerging evidence suggests physical function may also play a role in successful care transitions. However, there is a limited understanding of the relationship between functional measures and readmission risk. This systematic review aims to assess the association between physical function impairments and hospital readmissions. ⋯ Functional impairments are robust predictors of hospital readmissions in older adults. Routine assessment of physical function during hospitalization can improve risk stratification and may support successful care transitions, particularly in older adults.