This large systematic review of 61 studies evaluating the association between quality and cost found ~1/3 with a positive association, ~1/3 with a negative association, and ~1/3 with no association. There is still not good evidence of the direction or magnitude of the association between health care quality and health care cost (abstract).
In my last post, I promised – just in time for the New Year – to describe my fail-safe method for tackling overwhelmingly large projects. Please, please don’t waste this method on cleaning out a closet or writing an abstract. That would be like using a flamethrower to light a holiday candle. Rather, consider it […]
This large systematic review of patients with AMI found blood transfusions were associated with higher risk of mortality and subsequent AMI compared to no transfusion, regardless of baseline, nadir, or change in hemoglobin. As with many other conditions, the use of blood transfusions should be minimized in patients with AMI (abstract).
This large retrospective database analysis of patients with non-variceal UGI bleed found, after adjusting for confounders, that those who received transfusions were significantly more likely to rebleed than those that did not receive transfusions (odds ratio 1.8, CI 1.2 to 2.8). As with other conditions, RBC transfusions should only be administered when absolutely necessary, but […]
The FDA has issued a safety alert to avoid the use of dabigatran in patients with mechanical heart valves; a randomized trial was stopped early, as patients with mechanical heart valves were more likely to experience heart attack, stroke, or valve clot while on dabigatran compared to warfarin (FDA site).
There is a longstanding but unproven belief that shortening LOS will lead to higher readmission rates. This study of 129 VA hospitals over 14 years found significant decreases in both LOS and readmissions among 5 diagnoses; hospitals with shorter LOS did have higher readmission rates, with ~ a 6% increase in readmissions for every day […]