Arch Intern Med
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Comparative Study
Impact of marital status on outcomes in hospitalized patients. Evidence from an academic medical center.
Prior studies have described the importance of social support on long-term patient outcomes. Few studies have investigated the impact of social support on outcomes in hospitalized patients. ⋯ The findings suggest that marital status was an independent risk factor for several important hospital outcomes. This adds to our understanding of the importance of social support and other nonbiological factors on outcomes in hospitalized patients. This also has implications for the design of hospital-based interventions to improve patient outcomes and for the development of equitable prospective and capitated hospital payment formulas.
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Delirium, a common and often overlooked syndrome in acutely ill elderly patients, may present with signs and symptoms of depression. ⋯ Health care providers should consider the diagnosis of delirium in hospitalized elderly patients who appear to be depressed.
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Because the incidence rates of treated end-stage renal disease are much lower in Canada than in the United States, we hypothesized that decisions, made by family physicians and community internists, not to refer certain patients to nephrologists might explain this difference. ⋯ These results suggest that nonreferral for dialysis occurs in Ontario and that the act of referral, or nonreferral as the case may be, is influenced by both age and coexisting disease. The patterns of nonreferral reported raise a concern that patients who might benefit are not being referred to dialysis centers.
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Complementary (or alternative) medicine has become a prevalent phenomenon in most industrialized countries. At present the evidence from randomized controlled trials investigating its effectiveness is fragmentary and therefore inconclusive. ⋯ Complementary medicine may be useful; however, the notion urgently needs to be tested in randomized controlled trials.