Postgraduate medicine
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Postgraduate medicine · May 2009
Multicenter Study Comparative StudyAntidiabetic therapy before and 1 year after discharge for patients manifesting in-hospital hyperglycemia.
While studies have evaluated the impact of hyperglycemia during hospitalization, little is known about its management before and after admission. ⋯ Hyperglycemia management was intensified for all DM+ patients, primarily with insulin in the hospital and both insulin and OHAs PD. A better understanding of this natural history and antidiabetic transitional care could facilitate better discharge planning and thus improve diabetes care.
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Postgraduate medicine · May 2009
Multicenter Study Comparative StudyImpact of an intensive care unit telemedicine program on a rural health care system.
We evaluated the impact of a 15-hospital, rural, multi-state intensive care unit (ICU) telemedicine program. Acute Physiology, Age, and Chronic Health Evaluation (APACHE III) scores, raw mortality rates, and actual-to-predicted length of stay (LOS) ratios and mortality ratios were used. Surveys evaluated program impact in smaller facilities and satisfaction of the physicians staffing the remote center. ⋯ In regional hospitals, acuity scores increased (retention of sicker patients) while raw mortality was the same or lower. Length of stay ratios were reduced in these hospitals. In the tertiary hospital, actual-to-predicted ICU and hospital mortality and LOS ratios decreased.