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Background: The gender gap in physician compensation has persisted for decades. Little is known about how differences in use of the electronic health record (EHR) may contribute. Objective: To characterize how time on clinical activities, time on the EHR, and clinical productivity vary by physician gender and to identify factors associated with physician productivity. Design, Setting, and Participants: This longitudinal study included general internal medicine physicians employed by a large ambulatory practice network in the Northeastern United States from August 2018 to June 2021. Main Measures: Monthly data on physician work relative value units (wRVUs), physician and practice characteristics, metrics of EHR use and note content, and temporal trend variables. Key Results: The analysis included 3227 physician-months of data for 108 physicians (44% women). Compared with men physicians, women physicians generated 23.8% fewer wRVUs per month, completed 22.1% fewer visits per month, spent 4.0 more minutes/visit and 8.72 more minutes on the EHR per hour worked (all p < 0.001), and typed or dictated 36.4% more note characters per note (p = 0.006). With multivariable adjustment for physician age, practice characteristics, EHR use, and temporal trends, physician gender was no longer associated with productivity (men 4.20 vs. women 3.88 wRVUs/hour, p = 0.31). Typing/dictating fewer characters per note, relying on greater teamwork to manage orders, and spending less time on documentation were associated with higher wRVUs/hour. The 2021 E/M code change was associated with higher wRVUs/hour for all physicians: 10% higher for men physicians and 18% higher for women physicians (p < 0.001 and p = 0.009, respectively). Conclusions: Increased team support, briefer documentation, and the 2021 E/M code change were associated with higher physician productivity. The E/M code change may have preferentially benefited women physicians by incentivizing time-intensive activities such as medical decision-making, preventive care discussion, and patient counseling that women physicians have historically spent more time performing. [ABSTRACT FROM AUTHOR]

Diabetes and its comorbidities are risk factors for severe, including fatal, COVID-19 disease.[1] Diabetes also requires regular monitoring, pharmacologic treatment, and access to medical care, all of which may have been disrupted during the COVID-19 pandemic. There is risk for misclassification of causes of death and underascertainment of diabetes when using causes of death to identify people with diabetes. However, all-cause mortality among people with diabetes increased 30% in 2020 compared to prior years, an excess of 438 deaths per 100,000 people with diabetes. [Extracted from the article]

Background: Hospital readmission is common among patients with diabetes. Some readmissions, particularly for hypoglycemia and hyperglycemia, may be avoidable with better care transitions and post-discharge management.Objective: To ascertain the most common reasons and risk factors for readmission among adults with diabetes, with specific consideration of severe dysglycemia.Design: Retrospective analysis of data from the OptumLabs Data Warehouse, an administrative data set of commercially insured and Medicare Advantage beneficiaries across the U.S.Participants: Adults ≥18 years of age with diabetes, discharged from a hospital between January 1, 2009, and December 31, 2014 (N = 342,186).Main Measures: Principal diagnoses and risk factors for 30-day unplanned readmissions, subset as being for severe dysglycemia vs. all other causes.Key Results: We analyzed 594,146 index hospitalizations among adults with diabetes: mean age 68.2 years (SD, 13.0), 52.9% female, and 67.8% white. The all-cause 30-day readmission rate was 10.8%. Heart failure was the most common cause for index hospitalization (5.5%) and readmission (8.9%). Severe dysglycemia accounted for 2.6% of index hospitalizations (48.1% hyperglycemia, 50.4% hypoglycemia, 1.5% unspecified) and 2.5% of readmissions (38.3% hyperglycemia, 61.0% hypoglycemia, 0.7% unspecified). Younger patient age, severe dysglycemia at index or prior hospitalization, and the Diabetes Complications Severity Index (DCSI) were the strongest risk factors predisposing patients to severe dysglycemia vs. other readmissions. Prior episodes of severe dysglycemia and the DCSI were also independent risk factors for other-cause readmissions, irrespective of the cause of the index hospitalization.Conclusions: Adults with diabetes are hospitalized and readmitted for a wide range of health conditions, and hospitalizations for severe hypoglycemia and hyperglycemia remain common, with high rates of recurrence. Severe dysglycemia is most likely to occur among younger patients with multiple diabetes complications and prior history of such events. [ABSTRACT FROM AUTHOR]

The article focuses on the rules introduced in medicaid coverage and the restrictions regarding opioid use. It talks about the risks associated with growing use of opioid in older adults in the population. It tells about the increase in the risks involved on the consumption of opioid with potentiators or drugs like benzodiazepines, gabapentinoids and non-benzodiazepine sedative hypnotics.