Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center

Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center.Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012.Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28–4.37,p=0.006), age > 70 years (OR = 3.88, CI = 1.13–11.48,p=0.014), and AJCC stage IV (OR = 171.81, CI = 59.99–492.06,p<0.0001).Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

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Patching the Safety Net: Establishing a Free Specialty Care Clinic in an Academic Medical Center

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2014.0173 ◽

2014 ◽

Vol 25 (4) ◽

pp. 1810-1820 ◽

Cited By ~ 4

Author(s):

Andrew G. Shuman ◽

Oluseyi Aliu ◽

Katherine Simpson ◽

Paul Salow ◽

Kara Morgenstern ◽

...

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Safety Net ◽

Specialty Care ◽

Care Clinic ◽

Academic Medical

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Factors Affecting Compliance With Myringotomy Tube Follow-up Care

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211072293 ◽

2022 ◽

pp. 000348942110722

Author(s):

Helen H. Soh ◽

Katherine R. Keefe ◽

Madhav Sambhu ◽

Tithi D. Baul ◽

Dillon B. Karst ◽

...

Keyword(s):

Medical Center ◽

Private Insurance ◽

Academic Medical Center ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Safety Net ◽

Tube Placement ◽

Factors Affecting ◽

Urban Safety

Objective: Myringotomy and tube insertion is a commonly practiced procedure within pediatric otolaryngology. Though relatively safe, follow-up appointments are critical in preventing further complications and monitoring for improvement. This study sought to evaluate the factors associated with compliance of post-myringotomy follow-up visits in an urban safety-net tertiary care setting. Methods: This study is a retrospective chart review conducted in outpatient otolaryngology clinic at an urban, safety-net, tertiary-care, academic medical center. All patients from ages 0 to 18 who received myringotomy and tube placement between February 3, 2012, to May 30, 2018 at the aforementioned clinic were included. Results: A total of 806 patients had myringotomy tubes placed during this period; 190 patients were excluded due to no visits being scheduled within 1 and 6 month visit windows post-operatively, leaving 616 patients included for analysis. Of 616 patients, 574 patients were seen for the 1-month visit, (42 patients did not have follow-up visits within the 1-month window), and 356 patients were examined for the 6-month visit (260 patients did not schedule follow-up visits within the 6-month window). For the 1-month follow-up visits post-procedure, only race/ethnicity type “Other” was associated with lower no-show rates (OR = 0.330, 95% CI: 0.093-0.968). With the 6-month follow-up visits, having private insurance (OR = 0.446, 95% CI: 0.229-0.867) and not having a 1-month visit scheduled (OR = 0.404, 95% CI: 0.174-0.937) predicted lower no-show rates. Conclusion: No meaningful factors studied were significantly associated with compliance of short-term, 1-month visits post-myringotomy. Compliance of longer-term, 6-month post-operative visits was associated with insurance type and previous visit status.

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Prioritizing cervical cancer screening services during the COVID-19 pandemic: Response of an academic medical center and a public safety net hospital in California

Preventive Medicine ◽

10.1016/j.ypmed.2021.106569 ◽

2021 ◽

Vol 151 ◽

pp. 106569

Author(s):

George F. Sawaya ◽

Hunter K. Holt ◽

Robyn Lamar ◽

Misa Perron-Burdick ◽

Karen Smith-McCune

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Medical Center ◽

Academic Medical Center ◽

Safety Net ◽

Academic Medical ◽

Safety Net Hospital ◽

Screening Services ◽

Pandemic Response

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Collaborative Comanagement Between Neurohospitalists and Internal Medicine Hospitalists Decreases Provider Costs and Enhances Satisfaction With Neurology Care at an Academic Medical Center

The Neurohospitalist ◽

10.1177/1941874417735173 ◽

2017 ◽

Vol 8 (2) ◽

pp. 74-81

Author(s):

James G. Greene

Keyword(s):

Positive Impact ◽

Medical Center ◽

Academic Medical Center ◽

Hospital Medicine ◽

Professional Services ◽

Care Model ◽

Future Health ◽

Medical Centers ◽

Academic Medical ◽

Potential Benefits

Background and Purpose: The majority of academic medical centers are moving to a neurohospitalist model of care for hospital neurology coverage. Potential benefits over a more traditional academic model of patient care include greater expertise in acute neurologic disease, increased efficiency, and improved availability to patients, providers, and learners. Despite these perceived advantages, switching to a neurohospitalist model can come at substantial financial cost, so finding ways to maximize the positive impact of a limited number of neurohospitalists is very important to the future health of academic neurology departments. Over the past 7 years, we have implemented a model for inpatient neurological care based on an intimate collaborative relationship between the neurology and hospital medicine services at our main academic hospital. Our goal was to optimize the value of care by decreasing cost while improving quality. Methods: Cost and revenue associated with professional services was evaluated on a yearly basis. As part of ongoing quality improvement efforts, yearly surveys were administered to referring providers during the transition to a collaborative care model in which NHs and medicine hospitalists comanage neurology inpatients. Results: Net operating loss was dramatically decreased upon transition to the new care model. Concomitantly, there was a robust positive impact on perception of overall quality, timeliness, and communication skills of neurology services. Conclusions: Collaborative comanagement is an effective strategy to improve overall satisfaction with neurology services at a tertiary academic medical center while maintaining financial viability.

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