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Shan X, Zheng X, Wang H, Kong L, Shan Y, Dong J, Gou J, Huang G, Xi X, Du Q. Cost-benefit analysis of pharmacist early active consultation in patients with multidrug-resistant bacteria in China. Int J Clin Pharm 2025; 47:863-872. [PMID: 40111584 DOI: 10.1007/s11096-025-01889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 02/18/2025] [Indexed: 03/22/2025]
Abstract
BACKGROUND Although Pharmacist Early Active Consultation (PEAC) has demonstrated clinical benefits in patients with multidrug-resistant organisms (MDROs), its cost-effectiveness in China remains insufficiently studied. AIM This study aimed to evaluate the cost-effectiveness of PEAC in patients with MDROs from the perspective of the Chinese healthcare system. METHOD A historically controlled study was conducted on 100 MDRO-infected patients, including 37 who received PEAC and 63 who did not. The effective treatment rate and duration of the symptoms were assessed. A decision tree model was developed using model inputs derived from the study. The primary endpoints included incremental cost per MDRO treatment and incremental cost-effectiveness ratio (ICER). Uncertainty was evaluated using one-way and probabilistic sensitivity analysis. RESULTS The effective treatment rate increased to 89.1% in the PEAC group compared with 62.1% in the no-consultation group. Patients in the PEAC group experienced a 2.1-day shorter duration of symptoms than those without consultation (15.5 days vs. 17.6 days, P = 0.04). The base case analysis estimated that the PEAC group gained 0.189 quality-adjusted life years (QALYs) at a cost of $18,209.7, while the no-consultation group gained 0.177 QALYs at a cost of $23,831.1. The PEAC group was more cost-effective, yielding an ICER of - $475,499.0 per QALY gained. Probabilistic sensitivity analysis indicated that PEAC was cost-effective in 60.1% of cases, with costs remaining below the willingness-to-pay (WTP) threshold, supporting PEAC as a cost-effective strategy for managing MDRO infections. CONCLUSION Pharmacist Early Active Consultation was a more cost-effective strategy than no consultation for treating MDRO infections in patients in China.
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Affiliation(s)
- Xuefeng Shan
- Department of Pharmacy, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People's Republic of China
| | - Xiaoying Zheng
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Hongmei Wang
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lingxi Kong
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Youlan Shan
- Department of Infectious Disease, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Jie Dong
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Branch Rd, Yubei District, Chongqing, 401120, People's Republic of China
| | - Jinghui Gou
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Branch Rd, Yubei District, Chongqing, 401120, People's Republic of China
| | - Guili Huang
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Branch Rd, Yubei District, Chongqing, 401120, People's Republic of China
| | - Xin Xi
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Branch Rd, Yubei District, Chongqing, 401120, People's Republic of China
| | - Qian Du
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Branch Rd, Yubei District, Chongqing, 401120, People's Republic of China.
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Chong C, Watai T, Lachar J, Nishimura Y. Impact of a multidisciplinary team model on discharge efficiency and accuracy in internal medicine resident teams. Intern Med J 2025; 55:833-838. [PMID: 40119664 DOI: 10.1111/imj.70033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Accepted: 02/24/2025] [Indexed: 03/24/2025]
Abstract
BACKGROUND Efficient discharge planning is crucial for improving hospital capacity and patient care. Multidisciplinary rounds (MDRs) have been shown to enhance communication and coordination, yet their impact on resident teaching teams' discharge efficiency is less studied. AIMS To examine how embedding dedicated case managers (CMs) and social workers (SWs) into internal medicine (IM) resident teams impacts discharge efficiency. METHODS We conducted a retrospective cross-sectional study at The Queen's Medical Center comparing two resident multidisciplinary teaching (MDT) teams that included dedicated CMs and SWs with two resident standard care teams over an 8-month period (October 18 2023-June 25 2024). The outcomes assessed included length of stay (LOS), expected discharge date (EDD) accuracy, readmission rates and the rate of conditional discharge orders placed. RESULTS A total of 1944 patients were included. The MDT teams showed significantly improved EDD accuracy (72.0% vs 66.7%, P = 0.0120) and more frequently placed conditional discharge orders (61.7% vs 43.8%, P < 0.0001) compared to standard care teams. No significant difference was observed in LOS or readmission rates. CONCLUSION Embedding dedicated CMs and SWs within resident teams improved EDD accuracy and the rate of conditional discharge orders placed, suggesting an opportunity to integrate MDRs as a standard within IM residency training to enhance discharge planning efficiency.
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Affiliation(s)
- Christina Chong
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Travis Watai
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Jatinder Lachar
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Yoshito Nishimura
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
- Division of Hematology and Oncology, Mayo Clinic, Rochester, USA
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Suzuki T, Katayama K, Houchens N, Hartley S, Tokuda Y, Watari T. The Future of Hospital Medicine in Japan: Lessons From the United States Hospital Medicine System. Int J Gen Med 2025; 18:2379-2390. [PMID: 40329999 PMCID: PMC12052002 DOI: 10.2147/ijgm.s520518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 04/29/2025] [Indexed: 05/08/2025] Open
Abstract
Purpose To compare hospitalist roles and training systems between the United States (US) and Japan, identifying strengths and challenges to guide development of Japan's emerging hospital medicine program. Methods A qualitative, descriptive narrative study was conducted during a 10-day observational site visit to the Veterans Affairs Ann Arbor Healthcare System and University of Michigan Hospital in October 2022. Two experienced Japanese hospitalist authors independently observed clinical rounds, interprofessional meetings, and educational sessions. Data were collected through direct observation and structured discussions focusing on care-team structures, workflows, multidisciplinary collaboration, educational approaches, and quality improvement activities. The authors subsequently developed a comparative analysis report of Japan-US differences. Guided discussions based on this report were conducted with experienced US hospitalists and a pioneer physician of General Medicine in Japan to obtain expert commentary on the analyses. No quantitative data analysis or specific analytical software was utilized for this narrative comparison. Results The US hospitalist model demonstrated group practice approaches with shift-based schedules supporting work-life balance. Multidisciplinary teams actively incorporated residents and students in patient care, quality improvement, and teaching. Japan's traditional attending physician model emphasized continuity of care but showed high workloads and limited multidisciplinary integration. Japanese hospitalists faced challenges including extensive work hours, fewer specialized training opportunities in quality improvement and patient safety, and less robust team-based learning environments. Conclusion Incorporating elements from the US model-such as group practice with shift-based systems, enhanced multidisciplinary collaboration, and structured educational and quality improvement initiatives-could address workload issues and foster professional development in Japan's hospital medicine system while preserving valued aspects of continuity of care. These findings provide specific actionable guidance for healthcare administrators, medical education directors, and policymakers involved in developing Japan's hospitalist system, as well as to practicing Japanese hospitalists seeking to enhance their professional practice environments and educational frameworks.
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Affiliation(s)
- Tomoharu Suzuki
- Department of Hospital Medicine, Urasoe General Hospital, Urasoe, Okinawa, Japan
| | - Kohta Katayama
- Department of General Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sarah Hartley
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Urasoe, Okinawa, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Takashi Watari
- Kyoto University Hospital, Integrated Clinical Education Center, Kyoto, Japan
- General Medicine Center, Shimane University Hospital, Shimane, Japan
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Pradelli L, Risoli C, Summer E, Bellini G, Mozzarelli F, Anderson G, Guasconi M, Artioli G, Bonacaro A, Sarli L. Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis. BMJ Open 2025; 15:e087268. [PMID: 40118478 PMCID: PMC11931918 DOI: 10.1136/bmjopen-2024-087268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 02/28/2025] [Indexed: 03/23/2025] Open
Abstract
OBJECTIVE A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings. DESIGN A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski et al. DATA SOURCE Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme. DATA EXTRACTION AND SYNTHESIS The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden. RESULTS Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context. CONCLUSIONS This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings. PROSPERO REGISTRATION NUMBER CRD42022297395.
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Affiliation(s)
| | | | - Elena Summer
- Fondazione Madonna della Bomba Scalabrini ETS, Piacenza, Italy
| | | | - Fabio Mozzarelli
- Azienda USL di Piacenza, Piacenza, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gloria Anderson
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Massimo Guasconi
- Azienda USL di Piacenza, Piacenza, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonio Bonacaro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Masiano SP, Rose S, Wolfe J, Albert NM, Milinovich A, Jurecko L, Ridgeway B, Kattan MW, Misra-Hebert AD. Plan of Care Visits: Implementation During Hospitalization and Association With 30-Day Readmissions in a Large, Integrated Health Care System. Med Care 2025; 63:52-61. [PMID: 39419822 DOI: 10.1097/mlr.0000000000002081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
BACKGROUND Plan of Care of Visits (POCV), including the patient, nurse, and hospital provider were implemented across an integrated health system to improve provider-patient communication during hospitalization and patient outcomes. OBJECTIVES To assess POCV adoption after implementation, patient characteristics assosites were classified as teachsites were classified as teachsites were classified as teachsites were classified as ciated with POCV completion, and association of POCV with 30-day readmissions. METHODS This retrospective cohort study utilized electronic medical record (EMR) data of 237,430 adult patients discharged to home from 11 hospitals from January 2020 to December 2022. POCV completion was a discrete EMR variable. POCV adoption was estimated monthly by hospital as proportion of patients with at least 1 POCV during hospitalization, with variation among hospitals measured using the Variance Partition Coefficient (VPC). Multivariable logistic regressions assessed factors associated with POCV completion and POCV association with 30-day readmission. RESULTS POCV adoption increased from 69% to 94% (2020-2022) and varied by 50% across hospitals (VPC 0.50, 95% CI: 0.29-0.70). Odds of a discharge-day POCV were lower among older patients (≥65 vs. 18-34 y, OR 0.81, CI: 0.79-0.83), and higher among female (OR 1.06; CI: 1.04-1.07), Asian (vs. White, OR 1.13; CI: 1.06-1.21), Hispanic (OR 1.09; CI: 1.05-1.13), and surgical patients (vs. medical, OR 1.33; CI: 1.30-1.35). Patients completing discharge-day POCV had lower 30-day readmission odds (2022 OR 0.76, CI: 0.73-0.79). Patients with POCV on ≥75% of hospital days had similar readmission odds trends. CONCLUSIONS POCV implementation was successful, and POCV completion was associated with fewer 30-day readmissions. Future work should focus on increasing POCV adoption while reducing hospital variation.
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Affiliation(s)
- Steven P Masiano
- Healthcare Delivery and Implementation Science Center, Cleveland Clinic, Cleveland, OH
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Susannah Rose
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Center for Biomedical Ethics and Society, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Judith Wolfe
- University Hospitals St. John Medical Center, Westlake, OH
- Center for Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Nancy M Albert
- Zelony Nursing Institute, Cleveland Clinic, Cleveland, OH
- Linda H. Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Alex Milinovich
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Leslie Jurecko
- Safety, Quality, and Patient Experience, Clinical Transformation Office, Cleveland Clinic, Cleveland, OH
| | - Beri Ridgeway
- Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH
| | - Michael W Kattan
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Anita D Misra-Hebert
- Healthcare Delivery and Implementation Science Center, Cleveland Clinic, Cleveland, OH
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
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Lowell ER, Macpherson C, Villarreal-Cavazos K, Chandrana A, Sevitz JS, Veit K, Dakin A, Quinn L, Troche MS. An interdisciplinary approach to rehabilitation in Parkinson's disease: case series. Neurodegener Dis Manag 2024; 14:217-226. [PMID: 39540543 PMCID: PMC11703373 DOI: 10.1080/17582024.2024.2421736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 10/23/2024] [Indexed: 11/16/2024] Open
Abstract
Interdisciplinary care is increasingly promoted to enhance satisfaction and outcomes for individuals with complex medical conditions, such as Parkinson's disease (PD). However, there is little research on the feasibility or efficacy of interdisciplinary care in clinical settings. And, while the use of an integrated team of allied health professionals has the potential to provide significant health benefits to individuals with PD, there are educational and logistical barriers to the use of interdisciplinary care in clinical settings. An interdisciplinary care model was described that aimed to facilitate these benefits and alleviate some of these known clinical feasibility challenges. Three cases are also provided to exemplify how this approach to collaborative care was used to address individual needs and to highlight some of the successes and challenges associated with the implementation of an interdisciplinary and person-centered care model via telehealth. These cases may help clinicians adopt techniques to facilitate greater collaboration across disciplines or aid in the development of a feasible interdisciplinary program in their own clinics. Further research is needed to further enhance individual outcomes and integrate other disciplines into the care team.
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Affiliation(s)
- Emilie R Lowell
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
| | - Chelsea Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY10027, USA
| | - Katya Villarreal-Cavazos
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
| | - Anuja Chandrana
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY10027, USA
| | - Jordanna S Sevitz
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
| | - Kelly Veit
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
| | - Avery Dakin
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY10027, USA
- Department of Rehabilitation & Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, NY10032, USA
| | - Michelle S Troche
- Laboratory for the Study of Upper Airway Dysfunction, Teachers College, Columbia University, New York, NY10027, USA
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY10027, USA
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Lidin M, Michelsen HÖ, Hag E, Stomby A, Schlyter M, Bäck M, Hagström E, Leosdottir M. The Nurses' Role in the Cardiac Rehabilitation Team: Data From the Perfect-CR Study. J Cardiovasc Nurs 2024:00005082-990000000-00201. [PMID: 38912908 DOI: 10.1097/jcn.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
BACKGROUND Nurses constitute a central profession in the cardiac rehabilitation (CR) team delivering comprehensive CR to individuals with cardiovascular disease. We aimed to identify specific components reflecting the nurses' role in the CR team associated with attainment of risk factor targets post myocardial infarction. METHODS Center-level data (n = 78) was used from the Perfect-CR study, in which structure and processes applied at CR centers in Sweden (including details on the nurses' role) were surveyed. Patient-level data (n = 6755) was retrieved from the SWEDEHEART registry. Associations between structure/processes and target achievement for systolic blood pressure (BP) (<140 mm Hg) and low-density lipoprotein cholesterol (LDL-C, <1.8 mmol/L) at 1 year post myocardial infarction were assessed using logistic regression. RESULTS Structure and processes reflecting nurses' autonomy and role in the CR team associated with patients achieving systolic BP and/or LDL-C targets included the following: nurses having treatment algorithms to adjust BP medication (odds ratio [95% confidence interval]: systolic BP, 1.22 [1.05-1.42]; LDL-C, 1.17 [1.03-1.34]) and lipid-lowering medication (systolic BP, 1.14 [1.00-1.29]; LDL-C, 1.17 [1.05-1.30]), patients having the same nurse throughout follow-up (systolic BP, 1.07 [1.03-1.11]; LDL-C, 1.10 [1.06-1.14]), number of follow-up hours with a nurse (systolic BP, 1.13 [1.07-1.19]), having regular case rounds to discuss patient cases during follow-up (LDL-C, 1.22 [1.09-1.35]), and nurses having training in counseling methods (systolic BP, 1.06 [1.03-1.10]). CONCLUSION Components reflecting CR nurses' autonomy and role in the team are of importance for patients attaining risk factor targets post myocardial infarction. The results could provide guidance for optimizing nurses' competence and responsibilities within the CR team to improve patient care.
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Aguirre AO, Lim J, Kuo CC, Ruggiero N, Siddiqi M, Monteiro A, Baig AA, Housley SB, Recker MJ, Li V, Reynolds RM. Social Determinants of Health and Associations With Outcomes in Pediatric Patients With Brain Tumors. Neurosurgery 2024; 94:108-116. [PMID: 37526439 DOI: 10.1227/neu.0000000000002624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/25/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Social determinants of health (SDOH) are nonmedical factors that affect health outcomes. Limited investigation has been completed on the potential association of these factors to adverse outcomes in pediatric populations. In this study, the authors aimed to analyze the effects of SDOH disparities and their relationship with outcomes after brain tumor resection or biopsy in children. METHODS The authors retrospectively reviewed the records of their center's pediatric patients with brain tumor. Black race, public insurance, median household income, and distance to hospital were the investigated SDOH factors. Univariate analysis was completed between number of SDOH factors and patient demographics. Multivariate linear regression models were created to identify coassociated determinants and outcomes. RESULTS A total of 272 patients were identified and included in the final analysis. Among these patients, 81 (29.8%) had no SDOH disparities, 103 (37.9%) had 1, 71 (26.1%) had 2, and 17 (6.2%) had 3. An increased number of SDOH disparities was associated with increased percentage of missed appointments ( P = .002) and emergency room visits ( P = .004). Univariate analysis demonstrated increased missed appointments ( P = .01), number of postoperative imaging ( P = .005), and number of emergency room visits ( P = .003). In multivariate analysis, decreased median household income was independently associated with increased length of hospital stay ( P = .02). CONCLUSION The SDOH disparities are prevalent and impactful in this vulnerable population. This study demonstrates the need for a shift in research focus toward identifying the full extent of the impact of these factors on postoperative outcomes in pediatric patients with brain tumor.
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Affiliation(s)
- Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Jaims Lim
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Manhal Siddiqi
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Andre Monteiro
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Ammad A Baig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Steven B Housley
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Matthew J Recker
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Veetai Li
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Pediatric Neurosurgery, John R. Oishei Children's Hospital, Buffalo , New York , USA
| | - Renée M Reynolds
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Pediatric Neurosurgery, John R. Oishei Children's Hospital, Buffalo , New York , USA
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Srinivas V, Choubey U, Motwani J, Anamika F, Chennupati C, Garg N, Gupta V, Jain R. Synergistic strategies: Optimizing outcomes through a multidisciplinary approach to clinical rounds. Proc AMIA Symp 2023; 37:144-150. [PMID: 38174031 PMCID: PMC10761132 DOI: 10.1080/08998280.2023.2274230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/12/2023] [Indexed: 01/05/2024] Open
Abstract
Multidisciplinary rounds (MDR) constitute a patient-centered care model wherein professionals from diverse disciplines collaborate in real time to provide specialized expertise. The MDR team, encompassing care partners, hospitalists, nurses, pharmacists, and more, employs a collaborative approach that optimizes patient care through shared goals, electronic record access, regular reviews, and patient involvement. MDRs have evolved to reduce patient mortality, complications, length of stay, and readmissions, and they enhance patient satisfaction and utilization of ancillary services. Family engagement in MDRs further transforms relationships from adversarial to collaborative, leading to improved comprehension of treatment strategies and smoother navigation of challenging conversations. Despite challenges such as time constraints, limited patient coverage, and hierarchical barriers, MDRs are being increasingly conducted across healthcare settings, with positive outcomes.
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Affiliation(s)
- Varsha Srinivas
- PES Institute of Medical Sciences and Research, Kuppam, India
| | | | - Jatin Motwani
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Fnu Anamika
- University College of Medical Sciences, New Delhi, India
| | | | - Nikita Garg
- Children’s Hospital of Michigan, Detroit, Michigan, USA
| | - Vasu Gupta
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, Ohio, USA
| | - Rohit Jain
- Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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