Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1001
K. Rendle, C. Saia, A. Vachani, A. Burnett-Hartman, V. P. Doria-Rose, C. Neslund-Dudas, C. Oshiro, R. Kim, J. Lafata, S. Honda, J. Wainwright, N. Mitra, R. Greenlee
{"title":"Incremental Rates of Imaging and Diagnostic Procedures Attributed to Lung Cancer Screening in Community Practice","authors":"K. Rendle, C. Saia, A. Vachani, A. Burnett-Hartman, V. P. Doria-Rose, C. Neslund-Dudas, C. Oshiro, R. Kim, J. Lafata, S. Honda, J. Wainwright, N. Mitra, R. Greenlee","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1001","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1001","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128211263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1002
E. Núñez, T. Caverly, S. Zhang, M. Glickman, S. Qian, J. Boudreau, D. Miller, C. Slatore, R. Wiener
{"title":"Timely Receipt of Guideline Recommended Annual Lung Cancer Screening Across Three Rounds Among US Veterans","authors":"E. Núñez, T. Caverly, S. Zhang, M. Glickman, S. Qian, J. Boudreau, D. Miller, C. Slatore, R. Wiener","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1002","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1002","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127053042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1004
A. Dedent, H. Collard, N. Thakur
{"title":"Indicators of Neighborhood Health Disparities in Idiopathic Pulmonary Fibrosis","authors":"A. Dedent, H. Collard, N. Thakur","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1004","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1004","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123165236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1003
M. Seedahmed, J. Chen, J. Potter, C. Mcculloch, M. Whooley, L. Koth, M. Arjomandi
{"title":"The Epidemiology of Sarcoidosis Among U.S. Veterans, 2000-2020","authors":"M. Seedahmed, J. Chen, J. Potter, C. Mcculloch, M. Whooley, L. Koth, M. Arjomandi","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1003","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1003","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"199 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128887740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1009
C. Ghiathi, A. Lanfranco, M. Kreider, J. Heath
{"title":"Fellows’ Experience and Perceptions of Airway Management Training Within Pulmonary and Critical Care Fellowship","authors":"C. Ghiathi, A. Lanfranco, M. Kreider, J. Heath","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1009","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1009","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129944989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1005
C. Hernández, H. Mitchell, N. A. Rosario, D. Levine
Rationale “Home hospital” is hospital-level substitutive care delivered at home for acutely ill patients who would traditionally be cared for in the hospital. Despite years of successful operations and evidence from randomized controlled trials, to our knowledge outcomes in the U.S. specifically for patients with respiratory disease have not been evaluated. Methods We performed a retrospective evaluation of all patients who were cared for in our home hospital program between 2016 and 2021. We compared patients requiring admission with respiratory disease (asthma exacerbation, COPD exacerbation, and any non-COVID pneumonia) to all other patients who received home hospital care (other general medical conditions such as heart failure and infectious processes). Patients entered the program either from the emergency department after it was determined they required admission or from the general medical ward after it was determined they required additional days of acute care. Patients were risk-stratified using peak flow (asthma), BAP-65 (COPD), and CURB- 65 (pneumonia), among other scores to prognosticate against the ICU. Upon admission at home, patients received 2 nurse/paramedic visits daily, 1 physician visit daily, IV medications, advanced respiratory therapies, continuous heart and respiratory rate monitoring, and other hospital-level treatments/diagnostics as needed. Results Among 1,166 admissions, 25% were for respiratory disease (38% COPD, 38% pneumonia, and 24% asthma) and 75% were for non-respiratory disease (48% infection, 27% heart failure). Both groups had similar sociodemographic characteristics: mean age 72 years (SD, 17), 63% female, 44% White, 39% partnered, 71% English-speaking, 52% Medicare beneficiary, and 58% retired. Groups differed by education, with less attainment in the respiratory group (34% high school vs 29%;p=0.034), smoking status (20% active smoker vs 9%;p<0.001), and more outpatient medications (median number, 10 vs 8;p<0.001). During home hospital, respiratory patients had less utilization: length of stay (mean days, 3.4 vs 4.8;p<0.001), laboratory orders (median, 0 vs 2;p<0.001), consultations (1% vs 7%;p=0.004), and physical/occupational therapy (2% vs 7%;p=0.032). Both groups had a similar escalation rate (i.e., requiring transfer back to the hospital) of 4% and no mortality during home hospital. Within 30-days of discharge, both groups were similar: 14% readmission, 9% ED presentation, and 4% mortality. Conclusions Home hospital care is safe and effective for patients with acute respiratory illness compared to other general medical conditions. If scaled, it can serve to generate significant high-value capacity creation for health systems and communities, with opportunities to advance the complexity of care delivered.
"家庭医院"是医院级别的替代护理，为传统上在医院接受治疗的急性病人提供家庭护理。尽管多年来成功的手术和随机对照试验的证据，据我们所知，美国呼吸道疾病患者的结果尚未得到评估。方法:我们对2016年至2021年间在我们的家庭医院项目中接受治疗的所有患者进行了回顾性评估。我们比较了因呼吸系统疾病(哮喘加重、慢性阻塞性肺病加重和任何非covid - 19肺炎)需要入院的患者与接受家庭医院护理的所有其他患者(其他一般医疗状况，如心力衰竭和感染过程)。病人要么在确定他们需要住院后从急诊科进入这个项目，要么在确定他们需要额外几天的急性护理后从普通病房进入这个项目。使用血流量峰值(哮喘)、BAP-65 (COPD)和CURB- 65(肺炎)等评分对患者进行风险分层，以预测ICU预后。入院后，患者每天接受2次护士/护理人员访问，每天接受1次医生访问，静脉注射药物，高级呼吸治疗，持续心脏和呼吸频率监测，并根据需要进行其他医院级别的治疗/诊断。结果1166例入院患者中，呼吸道疾病占25% (COPD占38%，肺炎占38%，哮喘占24%)，非呼吸道疾病占75%(感染占48%，心力衰竭占27%)。两组具有相似的社会人口学特征:平均年龄72岁(SD, 17)， 63%为女性，44%为白人，39%为伴侣，71%为英语，52%为医疗保险受益人，58%为退休人员。各组受教育程度不同，呼吸系统组受教育程度较低(34%高中对29%，p=0.034)，吸烟状况(20%活跃吸烟者对9%，p<0.001)，门诊用药较多(中位数，10对8,p<0.001)。在家庭医院期间，呼吸系统患者的使用率较低:住院时间(平均天数，3.4 vs 4.8;p<0.001)、实验室订单(中位数，0 vs 2;p<0.001)、咨询(1% vs 7%;p=0.004)和物理/职业治疗(2% vs 7%;p=0.032)。两组的升级率(即需要转回医院)相似，均为4%，在家庭医院期间无死亡。出院30天内，两组相似:14%再次入院，9%出现ED, 4%死亡。结论对急性呼吸系统疾病患者进行家庭医院护理是安全有效的。如果扩大规模，它可以为卫生系统和社区创造重要的高价值能力，并有机会提高所提供护理的复杂性。
{"title":"Hospital-Level Care at Home for Adults with Acute Respiratory Illness: A Descriptive Analysis","authors":"C. Hernández, H. Mitchell, N. A. Rosario, D. Levine","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1005","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1005","url":null,"abstract":"Rationale “Home hospital” is hospital-level substitutive care delivered at home for acutely ill patients who would traditionally be cared for in the hospital. Despite years of successful operations and evidence from randomized controlled trials, to our knowledge outcomes in the U.S. specifically for patients with respiratory disease have not been evaluated. Methods We performed a retrospective evaluation of all patients who were cared for in our home hospital program between 2016 and 2021. We compared patients requiring admission with respiratory disease (asthma exacerbation, COPD exacerbation, and any non-COVID pneumonia) to all other patients who received home hospital care (other general medical conditions such as heart failure and infectious processes). Patients entered the program either from the emergency department after it was determined they required admission or from the general medical ward after it was determined they required additional days of acute care. Patients were risk-stratified using peak flow (asthma), BAP-65 (COPD), and CURB- 65 (pneumonia), among other scores to prognosticate against the ICU. Upon admission at home, patients received 2 nurse/paramedic visits daily, 1 physician visit daily, IV medications, advanced respiratory therapies, continuous heart and respiratory rate monitoring, and other hospital-level treatments/diagnostics as needed. Results Among 1,166 admissions, 25% were for respiratory disease (38% COPD, 38% pneumonia, and 24% asthma) and 75% were for non-respiratory disease (48% infection, 27% heart failure). Both groups had similar sociodemographic characteristics: mean age 72 years (SD, 17), 63% female, 44% White, 39% partnered, 71% English-speaking, 52% Medicare beneficiary, and 58% retired. Groups differed by education, with less attainment in the respiratory group (34% high school vs 29%;p=0.034), smoking status (20% active smoker vs 9%;p<0.001), and more outpatient medications (median number, 10 vs 8;p<0.001). During home hospital, respiratory patients had less utilization: length of stay (mean days, 3.4 vs 4.8;p<0.001), laboratory orders (median, 0 vs 2;p<0.001), consultations (1% vs 7%;p=0.004), and physical/occupational therapy (2% vs 7%;p=0.032). Both groups had a similar escalation rate (i.e., requiring transfer back to the hospital) of 4% and no mortality during home hospital. Within 30-days of discharge, both groups were similar: 14% readmission, 9% ED presentation, and 4% mortality. Conclusions Home hospital care is safe and effective for patients with acute respiratory illness compared to other general medical conditions. If scaled, it can serve to generate significant high-value capacity creation for health systems and communities, with opportunities to advance the complexity of care delivered.","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125271764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1007
A. Admon, S. Cohen-Mekelburg, J. Denson, H. Gershengorn, C. Cooke
{"title":"Fragmented Care Is Associated with Greater Mortality and Increased Costs Among Patients Hospitalized for Respiratory Failure","authors":"A. Admon, S. Cohen-Mekelburg, J. Denson, H. Gershengorn, C. Cooke","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1007","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1007","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116078011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1008
N. Held, A. Neumeier, T. Amass, R. Pomponio, R. Peterson, T. Huie, M. Moss
{"title":"Length of Rounds, Patient Census, and Patient Acuity Correlate with Increased Cognitive Load Amongst Multidisciplinary Providers in an ICU Learning Environment","authors":"N. Held, A. Neumeier, T. Amass, R. Pomponio, R. Peterson, T. Huie, M. Moss","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1008","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1008","url":null,"abstract":"","PeriodicalId":118386,"journal":{"name":"A13. IMPROVING CARE FOR PATIENTS WITH LUNG DISEASE OR CRITICAL ILLNESS THROUGH TRAINING AND EVALUATION","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127676801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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