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CONTEXT Hip fracture is a common clinical problem that leads to considerable mortality and disability. A need exists for a practical means to monitor and improve outcomes, including function, for patients with hip fracture. OBJECTIVES To identify and compare the importance of significant prefracture predictors of functional status and mortality at 6(More)
OBJECTIVE To characterize the symptom experience of a cohort of intensive care unit (ICU) patients at high risk for hospital death. DESIGN Prospective analysis of patients with a present or past diagnosis of cancer who were consecutively admitted to a medical ICU during an 8-month period. SETTING Academic, university-affiliated, tertiary-care, urban(More)
Seriously ill persons are emotionally vulnerable during the typically protracted course of an illness. Physicians respond to such patients' needs and emotions with emotions of their own, which may reflect a need to rescue the patient, a sense of failure and frustration when the patient's illness progresses, feelings of powerlessness against illness and its(More)
CONTEXT Previous studies of surgical timing in patients with hip fracture have yielded conflicting findings on mortality and have not focused on functional outcomes. OBJECTIVE To examine the association of timing of surgical repair of hip fracture with function and other outcomes. DESIGN Prospective cohort study including analyses matching cases of(More)
BACKGROUND Hip fracture patients are at increased risk of confusion or delirium due to the trauma associated with the injury and the rapid progression to hospitalization and surgery, in addition to the pain and loss of function experienced. Hip fracture patients who develop delirium may require longer hospital stays, are more often discharged to long-term(More)
BACKGROUND We have observed that many black and Hispanic patients receiving palliative care at a major urban teaching hospital are unable to obtain prescribed opioids from their neighborhood pharmacies. In this study, we investigated the availability of commonly prescribed opioids in New York City pharmacies. METHODS We surveyed a randomly selected sample(More)
BACKGROUND Delirium and pain are common following hip fracture. Untreated pain has been shown to increase the risk of delirium in older adults undergoing elective surgery. This study was performed to examine the relationship among pain, analgesics, and other factors on delirium in hip fracture patients. METHODS We conducted a prospective cohort study at(More)
BACKGROUND Palliative care programs are becoming increasingly common in U.S. hospitals. OBJECTIVE To quantify the growth of hospital based palliative care programs from 2000-2003 and identify hospital characteristics associated with the development of a palliative care program. DESIGN AND MEASUREMENTS Data were obtained from the 2001-2004 American(More)
BACKGROUND Hospital palliative care programs provide high-quality, comprehensive care for seriously ill patients and their families. OBJECTIVE To examine geographic variation in patient and medical trainee access to hospital palliative care and to examine predictors of these programs. METHODS Primary and secondary analyses of national survey and census(More)