Journal of general internal medicine
-
Oropharyngeal dysphagia (dysphagia) is a common (up to 86%) and devastating syndrome in hospitalized older adults with dementia. ⋯ Our study highlights the need for standardizing dysphagia management best practices in hospitalized patients with dementia, the importance of addressing goals of care, and provider education on the risks and benefits of dysphagia diets and artificial nutrition via PEG tube.
-
Moral injury affects a variety of populations who make ethically complex decisions involving their own and others' well-being, including combat veterans, healthcare workers, and first responders. Yet little is known about occupational differences in the prevalence of morally injurious exposures and outcomes in nationally representative samples of such populations. ⋯ Results from these nationally representative samples of three high-risk populations suggest that exposure to PMIEs is common and a sizable minority report clinically meaningful moral injury.
-
Increasingly, health systems are collecting and using social needs data, yet there is limited information about individuals' preferences for how social needs information is shared among providers for treatment purposes. ⋯ Individuals' preferences regarding social needs information sharing for treatment purposes, as well as experience of discrimination, trust in healthcare, quality of care, and patient-provider communication, should be considered in health system efforts to capture social needs information.
-
"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.
-
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.