Emergency Department Return Visits as a Quality Metric

A recent JAMA publication lead-authored by Dr. Amber Sabbatini examined the scientific soundness of emergency department (ED) return visits as a measure of the ED’s quality of care. Emergency department return visits have been considered for wider adoption as a quality metric, especially for those patients who are hospitalized during the return ED visit. The “quality”Continue reading “Emergency Department Return Visits as a Quality Metric”

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Twenty year trends in female first authorship in medical journals

A study in the British Medical Journal examined the sex of first authors in six of the highest impact medical journals (Annals of Internal Medicine, Archives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM)) and found that the proportion of research article first authors who are women rose from 27% in 1994 to 37% in 2014.Continue reading “Twenty year trends in female first authorship in medical journals”

Avoid peanut allergy by early introduction of peanuts

A study released today in the New England Journal of Medicine showed that giving infants small amounts of peanut butter in their first year of life substantially reduced the prevalence of peanut allergy when compared to infants who avoided peanuts for their first year. The investigators found that the safeguard lasted for a year after the children stoppedContinue reading “Avoid peanut allergy by early introduction of peanuts”

Robots vs. doctors?

Although I agree with the basic premise of this week’s Washington Post article “The Robot Doctor Will See You Now“–namely, that computers can augment medical care–the article misses the art-science balance so central to physician’s practice.  He states: If you’ve ever gone to a doctor with an odd set of symptoms and realized that your doctor has no clue what theyContinue reading “Robots vs. doctors?”

Coffee: to drink or not to drink

According to the U.S. Food and Drug Administration, 90% of people worldwide, and 80% in the US, consume caffeine in some form every day. The average adult has an intake of about 200 milligrams, or roughly one cup of coffee per day. As one of those few non-coffee-drinking adults–probably rarer still among emergency medicine providers–I was intrigued by  today’s New YorkContinue reading “Coffee: to drink or not to drink”

Social determinants of health and pay-for-performance readmissions measures

In an article released by JAMA Pediatrics today, my co-authors and I show that social determinants of health (patient factors such as health insurance, poverty and other sociodemographic measures) are risk factors for readmissions-related penalties for children’s hospitals. Without adjusting pay-for-performance (P4P) measures for social determinants of health (SDH), hospitals may receive penalties partially related to patient SDH factors beyondContinue reading “Social determinants of health and pay-for-performance readmissions measures”

Readmissions revisited

I am reposting  a post by Garret Johnson and Zoe Lyon, both research assistants for Dr. Ashish Jha at the Harvard T.H. Chan School of Public Health (who also has a great post on risk-adjustment for readmissions.  The post eloquently explores an issue I’ve visited in a recent post: the importance of understanding the diverseContinue reading “Readmissions revisited”

Guns, Drugs and Cars

This week’s JAMA released a comparison of major causes of injury death and how they contribute to the gap in life expectancy between the US and other high-income countries. Here are their findings: Men in the comparison countries had a life expectancy advantage of 2.2 years over US men (78.6 years vs 76.4 years), asContinue reading “Guns, Drugs and Cars”

Is it ethical to incentivize “wellness”?

In an essay on medical ethics, Harald Schmidt explores the question: is it right for employers and health plans to offer incentives to employees/members to pursue health care that is not informed by evidence?  He uses as his example several large insurers paying young (younger than 50, even younger than 40 years), low-risk women to obtain mammograms.  The evidenceContinue reading “Is it ethical to incentivize “wellness”?”

Can U pls look @ this?

The pediatrician-author-mom Perri Klass wrote a piece in this week’s Well column that will bring knowing smiles to many providers and parents reading this post. She writes about how many unofficial telemedicine consults she fields involving photos of various rashes, injuries and other physical findings taken by parents and/or teens with their mobile devices. She usesContinue reading “Can U pls look @ this?”