Elizabeth Fowler, Purva Rawal, Dilipan W. Sundaramoorthy, Michael de La Guardia
This Viewpoint discusses a Centers for Medicare and Medicaid Innovation volunteer greenhouse gas emissions reporting and technical assistance program for hospitals and hospital systems.
本观点讨论了医疗保险和医疗补助创新中心为医院和医院系统提供的自愿温室气体排放报告和技术援助计划。
{"title":"The CMS Innovation Center’s Role in Addressing Greenhouse Gas Emissions","authors":"Elizabeth Fowler, Purva Rawal, Dilipan W. Sundaramoorthy, Michael de La Guardia","doi":"10.1001/jama.2025.0197","DOIUrl":"https://doi.org/10.1001/jama.2025.0197","url":null,"abstract":"This Viewpoint discusses a Centers for Medicare and Medicaid Innovation volunteer greenhouse gas emissions reporting and technical assistance program for hospitals and hospital systems.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987965","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}
This Viewpoint discusses Tennessee’s ban on gender-affirming care for transgender youth and how the US Supreme Court’s decision on the constitutionality of this law could have potential implications for state regulation of medical practice.
{"title":"United States v Skrmetti—Testing the Transition to Politicized Regulation of Medicine","authors":"Nicole Huberfeld, Michael R. Ulrich","doi":"10.1001/jama.2024.28537","DOIUrl":"https://doi.org/10.1001/jama.2024.28537","url":null,"abstract":"This Viewpoint discusses Tennessee’s ban on gender-affirming care for transgender youth and how the US Supreme Court’s decision on the constitutionality of this law could have potential implications for state regulation of medical practice.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967912","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}
This Viewpoint discusses the need for clinicians to conduct thorough research on the risks and benefits of gender-affirming care so that lawmakers and judges do not make decisions on such care without evidence.
{"title":"Toward Evidence-Based and Ethical Pediatric Gender Medicine","authors":"Moti Gorin, Jilles Smids, John Lantos","doi":"10.1001/jama.2024.28203","DOIUrl":"https://doi.org/10.1001/jama.2024.28203","url":null,"abstract":"This Viewpoint discusses the need for clinicians to conduct thorough research on the risks and benefits of gender-affirming care so that lawmakers and judges do not make decisions on such care without evidence.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967911","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}
This Medical News article is an interview with Emily E. Haroz, PhD, an associate professor at the Johns Hopkins Bloomberg School of Public Health’s Center for Indigenous Health, about an observational study that compared suicide risk machine learning models with a non–artificial intelligence screening method in a large group of Indian Health Service patients.
这篇医学新闻文章是对Emily E. Haroz博士的采访，她是约翰霍普金斯大学彭博公共卫生学院土著健康中心的副教授，关于一项观察性研究，该研究将自杀风险机器学习模型与非人工智能筛查方法在一大群印第安健康服务患者中进行了比较。
{"title":"How AI Could Help Clinicians Identify American Indian Patients at Risk for Suicide","authors":"Yulin Hswen, Jennifer Abbasi","doi":"10.1001/jama.2024.24063","DOIUrl":"https://doi.org/10.1001/jama.2024.24063","url":null,"abstract":"This Medical News article is an interview with Emily E. Haroz, PhD, an associate professor at the Johns Hopkins Bloomberg School of Public Health’s Center for Indigenous Health, about an observational study that compared suicide risk machine learning models with a non–artificial intelligence screening method in a large group of Indian Health Service patients.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940364","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}
This Medical News article discusses the emerging Oropouche virus, which recently has been associated with deaths and vertical transmission in the Americas.
这篇医学新闻文章讨论了新出现的Oropouche病毒，该病毒最近与美洲的死亡和垂直传播有关。
{"title":"Little-Known Oropouche Virus Is Spreading: What Clinicians Need to Know About the Insect-Borne Illness","authors":"Kate Schweitzer","doi":"10.1001/jama.2024.28216","DOIUrl":"https://doi.org/10.1001/jama.2024.28216","url":null,"abstract":"This Medical News article discusses the emerging Oropouche virus, which recently has been associated with deaths and vertical transmission in the Americas.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"38 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940362","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}
This JAMA Patient Page explains the origins and transmissibility of bird flu, along with prevention, diagnosis, symptoms, potential complications, and management in humans.
这个JAMA患者页面解释了禽流感的起源和传播能力，以及预防、诊断、症状、潜在并发症和人类管理。
{"title":"What Is Bird Flu?","authors":"Louis D. Saravolatz, Preeti N. Malani","doi":"10.1001/jama.2025.0065","DOIUrl":"https://doi.org/10.1001/jama.2025.0065","url":null,"abstract":"This JAMA Patient Page explains the origins and transmissibility of bird flu, along with prevention, diagnosis, symptoms, potential complications, and management in humans.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961684","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}
This JAMA Insights explores the prevalence of episodic and chronic migraine in adults and acute and preventive treatments for migraine, such as novel calcitonin gene-related peptide receptor antagonists.
{"title":"Chronic Migraine in Adults","authors":"Rebecca Burch","doi":"10.1001/jama.2024.26818","DOIUrl":"https://doi.org/10.1001/jama.2024.26818","url":null,"abstract":"This JAMA Insights explores the prevalence of episodic and chronic migraine in adults and acute and preventive treatments for migraine, such as novel calcitonin gene-related peptide receptor antagonists.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939948","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}
Anjali Bhatla, Victoria L. Bartlett, Michael Liu, ZhaoNian Zheng, Rishi K. Wadhera
ImportancePrivate equity acquisitions of health care facilities have rapidly increased over the past decade. However, little is known about the effects of private equity acquisitions of US hospitals on patient care experience.ObjectiveTo evaluate whether the acquisition of hospitals by private equity firms was associated with changes in measures of patient-reported experience compared with matched control hospitals from 2008 through 2019.Design, Settings, and ParticipantsThis cohort study identified 73 US hospitals newly acquired by private equity firms and 293 matched control (nonacquired) US hospitals from 2008 through 2019. An event study, difference-in-differences design was used to evaluate changes in patient experiences measures from 3 years before to 3 years after private equity acquisition.Main Outcomes and MeasuresThe primary outcomes were 2 global measures of patient-reported care experience from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which included patients’ overall hospital rating and willingness to recommend the hospital. Secondary outcomes included the 7 other HCAHPS measures encompassing clinical process, communication, and environmental measures.ResultsThere were 73 private equity–acquired hospitals and 293 matched control hospitals. The percentage of patients rating hospitals as a 9 or 10, on a scale of 0 to 10, decreased at private equity–acquired hospitals (65.0% before acquisition and 65.2% after acquisition) when compared with control hospitals (66.2% to 69.2%) during the postacquisition period relative to the preacquisition period with a difference-in-differences estimate of −2.4 percentage points (95% CI, −3.9 to −0.9). In addition, the percentage of patients who would definitely recommend the hospital also decreased at private equity–acquired hospitals (66.9% before acquisition and 65.5% after acquisition) compared with control hospitals (68.2% to 69.3%) with a difference-in-difference estimate of −2.1 percentage points (95% CI, −3.6 to −0.7). For both of these global measures of patient experience, the difference between private equity–acquired and control hospitals increased over time and was largest in year 3 after acquisition (−5.2 percentage points [95% CI, −8.8 to −1.5] and −4.4 percentage points [95% CI, −8.0 to −0.70] for each measure, respectively). For secondary measures of patient care experience, there was a decrease in patient-reported responsiveness of hospital staff at private equity–acquired hospitals compared with control hospitals (−1.3 percentage points [95% CI, −2.4 to −0.2]), but no differential change across other measures of clinical process, communication, and environment.Conclusions and RelevancePatient care experience worsened after private equity acquisition of hospitals. These findings raise concern about the implications of private equity acquisitions on patient care experience at US hospitals.
{"title":"Changes in Patient Care Experience After Private Equity Acquisition of US Hospitals","authors":"Anjali Bhatla, Victoria L. Bartlett, Michael Liu, ZhaoNian Zheng, Rishi K. Wadhera","doi":"10.1001/jama.2024.23450","DOIUrl":"https://doi.org/10.1001/jama.2024.23450","url":null,"abstract":"ImportancePrivate equity acquisitions of health care facilities have rapidly increased over the past decade. However, little is known about the effects of private equity acquisitions of US hospitals on patient care experience.ObjectiveTo evaluate whether the acquisition of hospitals by private equity firms was associated with changes in measures of patient-reported experience compared with matched control hospitals from 2008 through 2019.Design, Settings, and ParticipantsThis cohort study identified 73 US hospitals newly acquired by private equity firms and 293 matched control (nonacquired) US hospitals from 2008 through 2019. An event study, difference-in-differences design was used to evaluate changes in patient experiences measures from 3 years before to 3 years after private equity acquisition.Main Outcomes and MeasuresThe primary outcomes were 2 global measures of patient-reported care experience from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which included patients’ overall hospital rating and willingness to recommend the hospital. Secondary outcomes included the 7 other HCAHPS measures encompassing clinical process, communication, and environmental measures.ResultsThere were 73 private equity–acquired hospitals and 293 matched control hospitals. The percentage of patients rating hospitals as a 9 or 10, on a scale of 0 to 10, decreased at private equity–acquired hospitals (65.0% before acquisition and 65.2% after acquisition) when compared with control hospitals (66.2% to 69.2%) during the postacquisition period relative to the preacquisition period with a difference-in-differences estimate of −2.4 percentage points (95% CI, −3.9 to −0.9). In addition, the percentage of patients who would definitely recommend the hospital also decreased at private equity–acquired hospitals (66.9% before acquisition and 65.5% after acquisition) compared with control hospitals (68.2% to 69.3%) with a difference-in-difference estimate of −2.1 percentage points (95% CI, −3.6 to −0.7). For both of these global measures of patient experience, the difference between private equity–acquired and control hospitals increased over time and was largest in year 3 after acquisition (−5.2 percentage points [95% CI, −8.8 to −1.5] and −4.4 percentage points [95% CI, −8.0 to −0.70] for each measure, respectively). For secondary measures of patient care experience, there was a decrease in patient-reported responsiveness of hospital staff at private equity–acquired hospitals compared with control hospitals (−1.3 percentage points [95% CI, −2.4 to −0.2]), but no differential change across other measures of clinical process, communication, and environment.Conclusions and RelevancePatient care experience worsened after private equity acquisition of hospitals. These findings raise concern about the implications of private equity acquisitions on patient care experience at US hospitals.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939950","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}
In this narrative medicine essay, an infectious diseases physician who is immunocompromised laments the disdain she felt while continuing to wear a mask after vaccinations allowed most people to shed them.
{"title":"Invisible Me","authors":"Jeannina A. Smith","doi":"10.1001/jama.2024.26725","DOIUrl":"https://doi.org/10.1001/jama.2024.26725","url":null,"abstract":"In this narrative medicine essay, an infectious diseases physician who is immunocompromised laments the disdain she felt while continuing to wear a mask after vaccinations allowed most people to shed them.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939949","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}
This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia.
{"title":"Corticosteroids for Sepsis, Acute Respiratory Distress Syndrome, or Community-Acquired Pneumonia","authors":"Peggy B. Leung, Andrew M. Davis, Joshua Davis","doi":"10.1001/jama.2024.24537","DOIUrl":"https://doi.org/10.1001/jama.2024.24537","url":null,"abstract":"This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936194","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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