Journal of general internal medicine
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External incentives increasingly encourage hospitals to address health-related social needs, yet limited evidence exists about whether social needs interventions are associated with quality indicators like potentially preventable admissions. ⋯ Hospital meal delivery was associated with significantly lower probability of potentially preventable hospitalizations, with larger effects for Medicaid beneficiaries. Meal delivery may support hospital quality. More nuanced understanding about the reach of social needs interventions is needed to further examine the impact of these hospital-based services on patient outcomes.
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COVID-19 increased the burden of childcare on parents, leaving women vulnerable to increased disparities in the division of domestic labor. Women healthcare workers may be at heightened risk of worsening gender parity in the workplace as a result. ⋯ We observed significant gender-based disparities in the division of household labor among healthcare workers, with negative impacts on work performance, focus, and academic productivity. Our results support the notion that the COVID-19 pandemic worsened gender parity in the homes of healthcare workers, thus negatively affecting gender parity in the medical workplace.
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Gulf War illness (GWI) is characterized by multiple, persistent symptoms (e.g., fatigue, musculoskeletal pain, concentration problems, and gastrointestinal disorders) across more than one body system that are severe enough to interfere with daily functioning. For Veterans in rural areas, the confluence of geographic barriers and GWI may create unique challenges when navigating health care, given the range of specialty care needed to support GWI. However, little is known about how rural Veterans manage their GWI symptoms and navigate health care systems. ⋯ Our findings suggest that rurality intersects with GWI management in ways that compound barriers to health care access for Veterans. VA can address time and distance barriers by continuing to expand specialty telehealth services and telehealth training for providers and patients. VA could also incorporate recommendations from the VA/DoD clinical practice guidelines into point-of-care decision support to enhance recognition of GWI and improve consistency of treatment, which may contribute to trust-building among GW Veterans.
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Trainees frequently present data, including vital signs, laboratory test results, and imaging results, just after the history or presenting illness in a section labeled "ED Course." This practice distracts from the history and physical and decenters the patient as the most valuable source of diagnostic data. Reformatting presentations to appropriately present objective data after the complete history may improve diagnosis and refocuses attention on the patient.