Southern medical journal
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Southern medical journal · Sep 2023
Effect of Integrase Strand Transfer Inhibitor Use on Time to HIV Viral Suppression before Delivery.
We sought to determine whether pregnant individuals with human immunodeficiency virus (HIV) prescribed integrase strand transfer inhibitor (INSTI) antiretrovirals (ARVs) achieve viral suppression faster than individuals taking non-INSTI regimens and to determine whether there were differences in viral suppression at delivery among INSTI ARVs. ⋯ Despite recommendations to prescribe INSTI in pregnancy for rapid viral suppression, we did not find a significant difference in time to viral suppression when pregnant individuals were taking non-INSTI ARVs. We did not find that one INSTI ARV was superior for viral suppression.
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Southern medical journal · Sep 2023
Chargemaster Pricing Variation for Commonly Billed Procedures in Interventional Cardiology.
A chargemaster is a database of all of the billable items offered by a hospital with their base price listings. A 2018 executive order required all American hospitals to publish their chargemasters to increase price transparency and reduce healthcare expenditures. Chargemaster listings, however, demonstrate marked variability and inconsistency and have not been associated with consumer benefit. The objective of this study was to analyze chargemasters for commonly billed interventional cardiology procedures across five diverse states to explore relationships between price listings and hospital characteristics, ownership, location, and hospital quality. ⋯ Chargemaster price listings for common interventional cardiology procedures varied significantly across these five states. Urban and metropolitan hospital location, hospital type, and hospital ownership could be factors driving increased chargemaster procedure prices. Prices were highest at hospitals with the highest quality rating.
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Southern medical journal · Sep 2023
Community Socioeconomic and Urban-Rural Disparities in Prehospital Notification of Stroke by Emergency Medical Services in North Carolina.
Notification by emergency medical services (EMS) to the destination hospital of an incoming suspected stroke patient is associated with timelier in-hospital evaluation and treatment. Current data on adherence to this evidence-based best practice are limited, however. We examined the frequency of EMS stroke prenotification in North Carolina by community socioeconomic status (SES) and rurality. ⋯ Across a large, diverse population, EMS prenotification occurred in only one-third of suspected stroke patients. Furthermore, low SES and rural tracts were independently associated with a lower likelihood of prehospital notification. These findings suggest the need for education and quality improvement initiatives to increase EMS stroke prenotification, particularly in underserved communities.
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Southern medical journal · Sep 2023
Impact of COVID-19 Policies on Hospitalists' Psychological Safety.
The coronavirus disease 2019 pandemic brought about many changes in work environment and interpersonal interactions to prevent the spread of infection. Policies such as ubiquitous masking, virtual meetings, physician distancing, and decreased communal eating changed the inpatient work environment. This study aims to look at the impact of these changes on hospitalists' psychological safety. ⋯ This study highlights the importance of finding ways to foster connection and decrease burnout while continuing to prevent the spread of infection.
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Southern medical journal · Sep 2023
Patient Acceptance of Primary Care Behavioral Health in a Resident Obstetrics and Gynecology Clinic.
Primary care behavioral health (PCBH) is a patient care model in which a behavioral health consultant (BHC) works alongside the primary care provider to address behavioral components of health conditions. PCBH is well received in the primary care setting; however, little is known about acceptability of the service among prenatal patients. The study was designed to explore the acceptability of PCBH among pregnant patients in a resident obstetrics and gynecology clinic. ⋯ Overall, the PCBH model had high acceptability among a prenatal care population in a resident obstetrics and gynecology clinic and offers potential to improve prenatal outcomes.