Journal of general internal medicine
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Review Meta Analysis
Patient Outcomes Following Interhospital Care Fragmentation: A Systematic Review.
Interhospital fragmentation of care occurs when patients are admitted to different, disconnected hospitals. It has been hypothesized that this type of care fragmentation decreases the quality of care received and increases hospital costs and healthcare utilization. This systematic review aims to synthesize the existing literature exploring the association between interhospital fragmentation of care and patient outcomes. ⋯ Our review suggests that fragmented hospital readmissions contribute to increased mortality, longer length-of-stay, and increased risk of readmission to the hospital.
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Review Meta Analysis
Patient Outcomes Following Interhospital Care Fragmentation: A Systematic Review.
Interhospital fragmentation of care occurs when patients are admitted to different, disconnected hospitals. It has been hypothesized that this type of care fragmentation decreases the quality of care received and increases hospital costs and healthcare utilization. This systematic review aims to synthesize the existing literature exploring the association between interhospital fragmentation of care and patient outcomes. ⋯ Our review suggests that fragmented hospital readmissions contribute to increased mortality, longer length-of-stay, and increased risk of readmission to the hospital.
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Observational analysis methods can be refined by benchmarking against randomized trials. We reviewed studies systematically comparing observational analyses using propensity score methods against randomized trials to explore whether intervention or outcome characteristics predict agreement between designs. ⋯ Disagreements between observational studies using propensity score methods and randomized trials can occur for many reasons and the available data cannot be used to discern the reasons behind specific disagreements. Better benchmarking of observational analyses using propensity scores (and other causal inference methods) is possible using observational studies that explicitly attempt to emulate target trials.
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The specific phrase "goals of care" (GOC) is pervasive in the discourse about serious illness care. Yet, the meaning of this phrase is ambiguous. We sought to characterize the use and meaning of the phrase GOC within the healthcare literature to improve communication among patients, families, clinicians, and researchers. ⋯ The use of the phrase "goals of care" within the healthcare literature is increasingly common. We identified a consensus, operational definition that can facilitate communication about serious illness among patients, families, and clinicians and provide a framework for researchers developing interventions to improve goal-concordant care.
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The specific phrase "goals of care" (GOC) is pervasive in the discourse about serious illness care. Yet, the meaning of this phrase is ambiguous. We sought to characterize the use and meaning of the phrase GOC within the healthcare literature to improve communication among patients, families, clinicians, and researchers. ⋯ The use of the phrase "goals of care" within the healthcare literature is increasingly common. We identified a consensus, operational definition that can facilitate communication about serious illness among patients, families, and clinicians and provide a framework for researchers developing interventions to improve goal-concordant care.