Top 10 List of Social Admits Defined!

What is a social admit to the hospital?   A social admission is generally accepted by healthcare professionals to be a patient with no acute medical needs that is brought into a hospital because no safe discharge arrangements could be made at the time they presented. Most social admits involve elderly patients who present to an emergency room with weakness, have a thorough negative workup and are too weak to go home but have no where else to go. They might have a non surgical fracture limiting their mobility or a family refusing to take them home. Most social admissions occur after-hours when community services are unavailable to assist with a safe discharge.  Most patients are admitted through the ER by a Hospitalist to observation status, which often causes the patient to be readmitted a month later with a stroke or a heart attack when they get a bill for thousands of dollars in uncovered Medicare services. Most of the time, a social admit can be safely discharged within the next 48 hours, which happens to be the time Medicare will pay for observation status.  Occasionally, a weekend or a holiday throws a wrench in the plan and hospitals become default nursing homes until discharge can be arranged.On rare occasion, social admits stay weeks, sometimes months, in a hospital because no long term care facility will accept them.  Some patients, and their families in particular, have burned all the bridges in their community nursing homes and patients have no ...
Source: The Happy Hospitalist - Category: Internists and Doctors of Medicine Authors: Source Type: blogs

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Background and Objectives: The benefit of tissue plasminogen activator (tPA) in acute ischemic stroke is time dependent. A 15-minute decrease in door-to-needle (DTN) time has been associated with increased odds of ambulating independently, faster discharge, and decreased odds of death. We investigated common causes of delay in DTN times in a community hospital setting in order to identify areas for improvement. Methods: A retrospective medical record review was conducted at a 574-bed community hospital. This included 100 patients who received tPA from 2016 to 2019. Time segments were classified a priori to reflect key...
Source: Quality Management in Healthcare - Category: Health Management Tags: Original Research Source Type: research
BACKGROUND:Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS).OBJECTIVE:To examine the association between adolescent concussions and future MS diagnosis....
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
OBJECTIVES: Investigate the relationship between maternal alcohol-use disorder and multiple biological and social child outcomes, including birth outcomes, child protection, justice contact, and academic outcomes for both Indigenous and non-Indigenous chil...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
BACKGROUND: Drug abuse and interpersonal violence are strongly linked to one another. The person's addiction to drugs increases the chances of being a perpetrator of violence or a victim to it. Illicit drugs use is recognized as a contributing factor to ne...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
OBJECTIVES: Suicidal and accidental poisoning due to drug overdose is one of the common reason of morbidity and mortality all over the world. Considering such statement, toxicological analysis becomes imperative in suicidal, accidental and also in homicida...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Background and Rationale: From the medicolegal point of view, long term systemic consequences of scald injury should be identified for proper compensation and legal action, especially for scald injury involving skin full-thickness in 20% of total body surf...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Burns, Electricity, Explosions, Fire, Scalds Source Type: news
CONCLUSION Survival and complication rates of pediatric trauma patients on ECMO are comparable to those reported for other indications. Trauma should not be considered a contraindication for ECMO. LEVEL OF EVIDENCE Therapeutic, level V.
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: PTS 2019—ORAL Source Type: research
BACKGROUND Shock Index Pediatric-Adjusted (SIPA) has been used to predict injury severity and outcomes after civilian pediatric trauma. We hypothesize that SIPA can predict the need for blood transfusion and emergent surgery among pediatric patients injured in warzones, where resources are limited and accurate triage is essential. METHODS Retrospective review of the DoD Trauma Registry for all patients 17 years or younger, from 2008 to 2015. Shock Index Pediatric-Adjusted was determined using vital signs recorded upon arrival to the initial level of care. Patients were classified into two groups (normal vs. elevated S...
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: PTS 2019—ORAL Source Type: research
INTRODUCTION Impaired intestinal microvascular perfusion following resuscitated hemorrhagic shock (HS) leads to ischemia-reperfusion injury, microvascular dysfunction, and intestinal epithelial injury, which contribute to the development of multiple organ dysfunction syndrome in some trauma patients. Restoration of central hemodynamics with traditional methods alone often fails to fully restore microvascular perfusion and does not protect against ischemia-reperfusion injury. We hypothesized that resuscitation (RES) with fresh frozen plasma (FFP) alone or combined with direct peritoneal resuscitation (DPR) with 2.5% Delfl...
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: 2019 AAST PODIUM Source Type: research
CONCLUSION Patients with bicortically displaced rib fractures are more likely to develop pneumonia, ARDS, and need for tracheostomy even when controlling for flail chest. Future studies should investigate the utility of flail chest management algorithms in patients with bicortically displaced fractures. LEVEL OF EVIDENCE Prognostic and epidemiological study, level III.
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: AAST 2018 PODIUM PAPER Source Type: research
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