background :impact of substance abuse on outcome of hospitalized patients with acute myocardial infarction (mi) is a frequent question. available studies show disagreements over its impact, thus we performed this study to find a clear answer.   methods : in a cross sectional study, 304 patients (include 152 consecutive opium dependents and equal number of independents) with acute mi admitted to...

UNLABELLED This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospit...

OBJECTIVE The objective of this study was to assess the external validity of hospitalization as an outcome measure for first-episode psychosis services. METHODS A two-year, prospective cohort design was used to examine the associations between hospitalization, general psychopathology, and quality of life in a cohort of 606 participants treated for a first episode of psychosis. RESULTS In bi...

BACKGROUND Some patients experience a delayed discharge from the intensive care unit (ICU) where the intended and actual discharge times do not coincide. The clinical implications of this remain unclear. OBJECTIVE To determine the incidence and duration of delayed ICU discharge, identify the reasons for delay and evaluate the clinical consequences. METHODS Prospective multi-centre observati...

BACKGROUND Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap. OBJECTIVES The primary objectives of this study were, first, to examine whether there were significant differences in terms o...

BACKGROUND During 2006, Israeli hospitals faced a clonal outbreak of carbapenem-resistant Klebsiella pneumoniae that was not controlled by local measures. A nationwide intervention was launched to contain the outbreak and to introduce a strategy to control future dissemination of antibiotic-resistant bacteria in hospitals. METHODS In March 2007, the Ministry of Health issued guidelines mandat...

Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mor...

STUDY OBJECTIVE Massachusetts became the first state in the nation to ban ambulance diversion in 2009. It was feared that the diversion ban would lead to increased emergency department (ED) crowding and ambulance turnaround time. We seek to characterize the effect of a statewide ambulance diversion ban on ED length of stay and ambulance turnaround time at Boston-area EDs. METHODS We conducted...