Journal of general internal medicine
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"Before medically advised" (BMA) discharges are rising among hospitalized people with opioid use disorder (OUD) and associated with worse outcomes. However, little is known about BMA discharge among the growing share of U.S. Medicare beneficiaries with OUD. ⋯ BMA discharge among Medicare beneficiaries with OUD is associated with fragmented patterns of post-discharge care, and increased readmissions and deaths relative to home discharges. Efforts are needed to address the drivers and consequences of BMA discharge among individuals with OUD in Medicare.
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Language barriers can impact pharmaceutical disease management leading to potential health disparities among limited English proficiency (LEP) people with diabetes mellitus (DM) in the United States (US). ⋯ Our findings indicate that the differences in DM outcomes among LEP people are likely attributed to factors other than medication prescription. These might include cultural beliefs, dietary adjustments, and communication barriers in healthcare. Enhanced patient education, acknowledgment of cultural practices, and improved language services could potentially mitigate these disparities.
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Over 60 million patients in the USA have limited English proficiency (LEP) and experience barriers in care. Still, there exists no standardized method of monitoring the utilization of language interpreting services (LIS). ⋯ The study provides vital insights into language service preferences, frequency, and duration. These findings emphasize the need for standard methods in monitoring LIS usage to enhance patient outcomes for LEP patients.
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Quality of care can be measured in several dimensions: different clinical disciplines, structures/processes/outcomes of care (SPO), and also different domains of quality (effectiveness, safety, care coordination, patient-centeredness, efficiency, timeliness, and community/population health). To our knowledge, no previous study has compared different sets of performance measures in terms of how well they cover these different aspects of quality. ⋯ The measure sets we examined, which overwhelmingly measure processes of care, should be encouraged to add structure and outcomes measures. All three measure sets under-emphasize certain aspects of quality such as timeliness, care coordination, efficiency, and patient-centeredness. Finally, and most importantly, all three measure sets focused overwhelmingly on measuring the activities of family physicians; attention should be given to building measures that will examine the activities of other clinicians.