Israel De Alba

Pneumonia continues to be a severe health problem in the United States, responsible for close to 1 million hospital admissions and nearly 140,000 hospital readmissions per year. The literature on this topic suggests that approximately 1 in 5 patients with pneumonia is readmitted to the hospital within 30 days of discharge and that most readmissions are not because of pneumonia-related causes. Although many pneumonia readmissions may not be preventable, reducing readmissions is feasible, as shown by recent trends in Centers for Medicare & Medicaid Services data. Modifiable patient-, physician-, and system-related factors can be targeted for intervention. Many interventions aimed at reducing hospital readmissions targeting transitional care, care coordination, and postdischarge care have shown potential for reducing readmission rates.

Background: The aim of the study was (a) to assess sensitivity and specificity of self-sampling in a community setting for identifying high-risk human papillomavirus (HPV) infection and abnormal Papanicolaou (Pap) smears and (b) to assess satisfaction with this collection method among Hispanic women.

OBJECTIVE: We evaluated the relationship between U.S. citizenship status and the receipt of Pap smears and mammograms among immigrant women in California.

Our aim was to assess the impact of English language proficiency on Pap smear use among Hispanics. We performed a cross-sectional study using 2000 National Health Interview Survey data and included 2,331 Hispanic women, age ≥18 without a hysterectomy. After adjusting for sociodemographic and access factors, highly proficient English speakers were more likely to report a Pap smear in the past 3 years as compared to low proficient (adjusted prevalence ratio, 1.16; 95% confidence interval, 1.08 to 1.22). Also associated with Pap smear use were income, usual source of care, and health insurance. Our finding suggests that low English language proficiency is a barrier to receiving recent Pap smears among Hispanics.

Little is known about the frequency, severity, and risk factors for disease in drug‐ and alcohol‐dependent persons without primary medical care. Our aims are to assess the burden of medical illness, identify patient and substance dependence characteristics associated with worse physical health, and compare measures of illness burden in this population. This was accomplished through a cross‐sectional study among alcohol‐, heroin‐ or cocaine‐dependent persons without primary medical care who were admitted to an urban inpatient detoxification unit. The mean age of these patients was 35.7 (SD 7.8) years; 76% were male and 46% were Black. Forty‐five percent reported being diagnosed with a chronic illness, and 80% had prior medical hospitalizations. The mean age‐adjusted SF‐36 Physical Component Summary (PCS) score was lower than the general U.S. population norm (44.1 vs 50.1; p < 0.001). In multivariable analysis, female gender (adjusted mean change in PCS score: −3.71 points, p = .002), problem use of hallucinogens (−3.51, p = 0.013), heroin (−2.94, p = 0.008), other opiates (−3.20, p = .045), living alone (−3.15, p = .023), having medical insurance (−2.26, p = 0.014) and older age (−.22 points per year, p = 0.001) were associated with worse health. From these data, it seems that alcohol‐ and drug‐dependent persons without primary medical care have a substantial burden of medical illness compared to age‐ and gender‐matched U.S. population controls. While the optimal measure of medical illness burden in this population is unclear, a variety of health measures document this medical illness burden in addicted persons.