Differences In Care Of Patients Research Articles

Impacts of health insurance on tympanostomy tube outcomes in the pediatric population.

Tympanostomy tube (TT) placement is a common surgical procedure for treating pediatric patients with chronic otitis media with effusion (COME) with or without recurrent acute otitis media (rAOM). Prior work suggests children from low-income families face significant disparities in access to care for rAOM or COME. The impact of these health disparities in the care of children with rAOM or COME has yet to be investigated in a state with an expanded public health insurance model. We seek to examine differences in care for patients with rAOM and COME based on insurance status and socioeconomic status (SES) in Massachusetts. Retrospective review of 560 pediatric patients referred for TT insertion at a tertiary academic medical center between 2017 and 2019. Demographic data collected included age, ethnicity, insurance type (public, private, none) and zip code. Otologic history collected included prior AOM episodes, time to postoperative follow-up, postoperative "no-show" appointments, and number of postoperative audiograms. Multinomial logistic regression was used to isolate the effects of race and ethnicity. We found no major differences in preoperative outcome measures between cohorts. Postoperatively, public insurance was independently associated with decreased odds of undergoing an audiogram (OR 0.35, 95% Cl 0.16-0.76) and increased odds of "no-showing" for an appointment (OR 3.1, 95% CI 1.8-5.3). SES was not independently associated with differences in postoperative outcomes. In a state with an early expanded public health insurance model, access to care for rAOM and COME is comparable despite differences in insurance type and SES. However, enrollment in public health insurance is associated with worse measures of follow up care. Despite improvements in access to care with expanded health insurance models, retention continues to be a challenge for vulnerable populations.

Primary Care Delivery Perceptions and Their Associations with Physician and Patient Gender.

We aim to survey patients' opinions on perceived differences in patient care delivered by male and female physicians. Patients of primary care practices at Mayo Clinic, Arizona completed a survey sent through the electronic health record. The survey evaluated opinion regarding their primary care physician (PCP)'s overall healthcare provision capabilities and any perceived differences based on gender. 4983 patients' responses were included in final analysis. Compared to male patients, most female patients preferred to have a female PCP (78.1% vs. 32.7%, p < 0.01). Having a preference for female physicians was correlated with higher overall opinion of female physicians. The majority of male patients did not hold a difference in opinion regarding male versus female physicians (p < 0.01). Male patients were half as likely to have a better opinion and nearly 2.5 times more likely to have a worse opinion of female physicians (p < 0.01) compared to female patients. Patients preferring female physicians were nearly 3 times more likely to have a better opinion of female physicians compared to patients with no preference (p < 0.01). In a primary care setting, majority of female patients compared to male patients preferred female physicians as their PCP and had higher opinion of the care delivery of female physicians. These findings may influence how practices should assign primary care physicians to new patients and add underlying context to patient satisfaction ratings.

Analysis of Care and Outcomes for Epistaxis Weekend Admissions

To study differences in care of patients admitted for epistaxis during the weekend compared to the weekday. Retrospective database review. 2003 to 2014 National Inpatient Sample. Patients admitted for a primary diagnosis of epistaxis were extracted from the National Inpatient Sample from 2003 to 2014. Univariate and multivariate analyses were applied to assess differences in patient demographics, clinical characteristics, treatment, and outcomes between weekend and weekday admissions. A total of 39,329 cases were included in our study cohort, with 28,458 weekday admissions and 10,892 weekend admissions. There was no significant difference in patient race, gender, insurance status, hospital ownership status, or location between weekend and weekday admissions (p > .05). Most weekend admissions were emergent (82.2%) and were treated with packing (51.8%). Upon performing logistic regression, the likelihood of emergent admission (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.32-1.51, p < .001) and prolonged length of stay (OR 1.11, 95% CI 1.05-1.17, p < .001) was higher for weekend admissions versus weekday admissions. Moreover, odds of packing for epistaxis were significantly higher (OR 1.14, 95% CI 1.09-1.19, p < .001) on the weekend, while odds of ligation (OR 0.88, 95% CI 0.80-0.97, p = .013) and endovascular arterial embolization (OR 0.74, 95% CI 0.65-0.84, p < .001) were lower. There were no significant differences in in-hospital mortality, patient discharge disposition, and total hospital charges (p > .05). Patients primarily admitted for epistaxis over the weekend were more likely to be emergent, experienced prolonged length of stay, and be treated nonoperatively with packing, than weekday admissions. No significant differences in patient insurance or hospital ownership were identified.

EPH202 Use of National Healthcare Information Databases to Assess Sex Differences in Patient Care in Spain: The Case of Asthma (2017-2020)

EPH202 Use of National Healthcare Information Databases to Assess Sex Differences in Patient Care in Spain: The Case of Asthma (2017-2020)

Correction to: Sex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination Therapy

HomeJournal of the American Heart AssociationVol. 11, No. 19Correction to: Sex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination Therapy Open AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toOpen AccessCorrectionPDF/EPUBCorrection to: Sex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination Therapy Originally published29 Sep 2022https://doi.org/10.1161/JAHA.121.020788Journal of the American Heart Association. 2022;11:e020788This article corrects the followingSex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination TherapyOther version(s) of this articleYou are viewing the most recent version of this article. Previous versions: September 29, 2022: Ahead of Print In the article by Maukel et al, “Sex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination Therapy” which published online February 22, 2022 (J Am Heart Assoc. 2022;11:e023294. DOI: 10.1161/JAHA.121.023294) and was included in the March 1, 2022 issue of the journal, corrections were needed.In the HTML and ePub versions of the article, in the 9th paragraph of the Discussion section, the 2nd sentence read: “Apparently, the focus should shift to sex and sex differences in patient care after implant.” The sentence has been corrected to read: “Apparently, the focus should shift to sex and gender differences in patient care after implant.” The last sentence of that paragraph read “The impact of traditional sex roles and the perceived social support on outcomes after LVAD implant needs to be further investigated.” This has now been corrected to “The impact of traditional gender roles and the perceived social support on outcomes after LVAD implant needs to be further investigated.” These sentences were correct in the PDF version of the article.Additionally, there were errors in alignment in the stub columns of Tables 1 and 2. These alignment errors have now been corrected.The publisher regrets the errors.The online version of the article has been updated and is available here: https://www.ahajournals.org/doi/10.1161/JAHA.121.023294. Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesSex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination TherapyLisa‐Marie Maukel, et al. Journal of the American Heart Association. 2022;11 October 4, 2022Vol 11, Issue 19Article InformationMetrics Copyright © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley BlackwellThis is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.https://doi.org/10.1161/JAHA.121.020788PMID: 36172963 Originally publishedSeptember 29, 2022 PDF download

Leveraging Clerkship Experiences to Address Segregated Care: A Survey-Based Approach to Student-Led Advocacy

Phenomenon: Many academic medical centers (AMCs) have a history of separating patients on the basis of insurance status. In New York State, where Black and Latino patients are more than twice as likely to have Medicaid as white patients, this practice leads to de facto racial segregation in healthcare. Emerging evidence suggests that this segregation of care is detrimental to both patient care and medical education. Medical students are uniquely positioned to be change makers in this space but face significant barriers to speaking out about these disparities and successfully advocating for institutional change. Approach: The authors designed, piloted, and distributed a 16-item survey on segregated care to third-year medical students at a large academic medical center in New York City. Students were asked both open- and close-ended questions about witnessing separation and differences in patient care on the basis of insurance during their clinical rotations. The survey was shared with 140 students in March 2019 with a response rate of 46.4% (n = 65). Preliminary findings were presented to school and hospital administrators. Findings: More than half of survey respondents reported witnessing separation of patient care or differences in patient care on the basis of insurance (56.3%, n = 36 and 51.6%, n = 33 respectively). Many students reported that these experiences contributed to cynicism and burnout. The authors leveraged these results to advocate for quality improvement measures. In Ob-Gyn, department leadership launched a clinical transformation taskforce and recruited a new Vice Chair of Clinical Transformation/Chief Patient Experience Officer, whose role includes addressing segregated care and disparities in health outcomes. The hospital committed to establishing integrated practices in new clinical spaces and launching a similar survey among house staff. Insights: Many medical students experience and participate in segregated care during their clerkships and this has the potential to impact their education. Medical students are well-positioned to recognize segregated care across health systems and leverage their experiences for advocacy. A survey-based approach can be a powerful tool enabling students to collect these experiences to address segregated care and other health equity issues.

Advanced cancer and concomitant dementia: access to specialized palliative care, emergency room, hospital care, and place of death

Background Dementia and advanced cancer are complex, life-limiting conditions that benefit from specialized palliative care (SPC) interventions at the end of life. The objective was to study possible differences in care for patients with concomitant advanced cancer and dementia (CA-DEM) or cancer only (CA) regarding access to SPC, acute hospital care, and place of death. Materials and methods A retrospective observational registry study on health care consumption data from the Stockholm Regional Council involving logistic regression analyses of age, sex, living arrangements, comorbidities, dementia diagnosis, and socio-economic status. Results Of the 12,667 persons aged ≥65 years who died from advanced cancer between 2015 and 2019, 605 had concomitant dementia. Of these, 76% of patients with CA and 42% of patients with CA-DEM had access to SPC (p<.0001). There were more admissions to palliative care for persons not living in nursing homes (p<.0001), women (p<.0001), socioeconomically privileged patients (p<.05), those with fewer comorbidities (p<.0001), and younger patients (<85 years) (p<.0001). Access to SPC reduced ER visits, hospitalizations, and acute hospital deaths for CA, whereas access to SPC only reduced hospital deaths in the CA-DEM group. Conclusions The probability of being admitted to SPC was lower in cancer patients with known dementia. Access to SPC reduced emergency room visits and acute admissions to hospitals for the whole group, and hospital deaths both for CA and CA-DEM.

P-L16 The Impact of Covid-19 on the Management of Primary and Metastatic Liver Cancers; A Single Centre Experience

BackgroundThe Covid-19 pandemic has impacted on all aspects of health care. Surgical specialties have been affected by the impact on theatre time and space, staff re-deployments, reduced ICU capacity for non-Covid patients, and in some cases this has had a significant impact on wait time for surgery and overall surgical capacity. In our tertiary referral HPB unit, the service has been relocated to two different sites throughout the pandemic. We aimed to assess the impact of this on patients undergoing liver resectionMethodsWe examined patient data for all patients undergoing liver resection in the 15 month period prior to the introduction of national lockdown, and compared this with all patients who have undergone liver resection since. We looked at total number of cases, ICU admission rates (planned vs unplanned), length of stay, case mix, histology, rates of laparoscopic vs open surgery, and length of time from completing neoadjuvant chemotherapy to surgery. Data were obtained from electronic care records and patient notes.ResultsThe overall number of cases was similar (84 pre-covid vs 86 since) and basic patient demographics were unaffected. Median length of stay was the same for both groups (7 days). Colorectal metastases were the underlying pathology in the majority of cases (56/84 pre Covid, 56/86 post). Numbers of laparoscopic and laparoscopic converted to open cases were reduced in the post-Covid era, 12 prior versus four since. The median time from completion of neo-adjuvant chemotherapy to surgery was also affected, increasing from 46 to 62 days.ConclusionsThese data show some differences in patient care in the pre and post-Covid eras, in particular a lower rate of laparoscopic surgery and longer period of time between neo-adjuvant treatment and surgery. Longer follow up is required to see if these trends persist and their effect on long term survival and recurrence rates. However, despite the strains on the system there were similar numbers of patients pre and post Covid, indicating that patients are still presenting and being treated. This showed that staff responded well to the pressures of Covid, and trainee experience would have been similar

P55.01 Standard of Care Disparity in a Global Cancer Support Group: Examining an Advocate Survey to Inspire Change.

Advocates from patient support groups offer valuable insights into perceived standard of care around the world. We investigated the disparities that ALK Positive cancer patients face in 22 countries around the world. We presented patient advocates with a 10 question survey, asking them to provide answers around the quality of care they receive. Advocates were volunteers from the largest patient support group for ALK Positive cancer globally. 51 surveys were analysed and results were arranged by country to show differences in patient care globally and inconsistencies within a country. While over half (26) of responders rated their care “Very good” or “Excellent”, twenty answered “OK”, four “Very bad” and 1 “Unacceptable”, highlighting the need for improvements in a mainly European and North American patient group. Nine of the eleven countries with more than one representative had two or more different answers; eight of which contained a rating of “OK” or lower. Advocates deemed the three most important areas for improvement as access to clinical trials, access to targeted therapies and research. Access to Trials and Medication each featured in ten different countries answers. Six advocates from different countries stated they do not believe ALK patients have appropriate access to targeted therapies; three of which were from countries that also gave positive answers. When asked what prevents patients accessing medication, the three largest number of responses were for government funding, drug approval and patient cost. Government funding featured in eleven countries responses, followed by four and five for drug approval and patient cost respectively. Over 85% (41/47) of advocates stated they receive routine scans (CT/MRI/PET) in line with their expectations, but some stated MRI’s were only performed if patients had prior metastases or were symptomatic. The same percentage, 85%, of advocates answered that they do receive NGS testing, in the form of either tissue or liquid biopsy. Nearly 90% of advocates believe their country's oncologists are experienced with ALK Positive cancer. The negative responses for this question were all from different countries, three of which also had positive responses. By exploring our advocates' responses, we discovered areas where standard of care differs both by, and within, countries. Using this information, our advocates know where to focus their efforts to improve care for themselves and others.

A minute with …

A minute with …

Understanding Opioid Actions, Pain and Analgesia: A Tribute to Dr. Gavril Pasternak.

This special issue is a tribute to our mentor, colleague and friend, Gavril W. Pasternak, MD, PhD. Homage to the breadth and depth of his work (~ 450 publications) over a 40 career in pharmacology and medicine cannot be captured fully in one special issue, but the 22 papers collected herein represent seven of the topics near and dear to Gav's heart, and the colleagues, friends and mentees who held him near to theirs. The seven themes include: (1) sites and mechanisms of opioid actions in vivo; (2) development of novel analgesic agents; (3) opioid tolerance, withdrawal and addiction: mechanisms and treatment; (4) opioid receptor splice variants; (5) novel research tools and approaches; (6) receptor signaling and crosstalk in vitro; and (7) mentorship. This introduction to the issue summarizes contributions and includes formal and personal remembrances of Gav that illustrate his personality, warmth, and dedication to making a difference in patient care and people's lives.

Differences in Hospital-Based Care for Patients With Intellectual and Developmental Disabilities.

The number of adults with intellectual and developmental disabilities (IDD) seeking treatment in non-IDD-specific health care settings is growing. Little is known about how adults with IDD use health care services in specialty settings, including occupational therapy services. To describe adults with IDD in hospitals and identify differences in utilization patterns compared with patients without IDD. Descriptive and correlational designs were used. Data were obtained from Vizient (Clinical Data Base/Resource Manager™), a national database of administrative discharge abstracts for adults admitted to hospitals for an orthopedic procedure. From this sample, subsamples of (1) patients diagnosed with IDD and (2) an age- and gender-matched sample of patients without IDD were identified. The study cohort with IDD experienced longer lengths of stay, t(2821.5) = -14.2, p < .001; were more likely to have Medicare coverage, χ2(3, N = 8,472) = 1,170.38, p < .001; and were more commonly discharged to subacute or skilled nursing facilities, χ2(5, N = 8,472) = 1,033.60, p < .001. Differences in occupational therapy services were also noted. Despite similarities in orthopedic procedures, participants with IDD had different use patterns than those without IDD. Differences may be attributed to varying client factors and contexts. The results also indicate that practitioners in non-IDD-specific settings should expect to encounter clients with IDD. Occupational therapy practitioners have an opportunity to be leaders in adapting treatment protocols and providing education to caregivers and health care providers on behalf of people with IDD. What This Article Adds: This article provides novel information about a population that is known to experience disparities in health outcomes. It offers a basis on which future research can build to improve health care delivery and occupational therapy interventions to improve outcomes.

Inpatient falls prevention: state-wide survey to identify variability in Western Australian hospitals

Objective: A point prevalence survey was conducted across Western Australia to monitor adherence to evidence-based practices to prevent falls in hospitals. Study design and methods: A state-wide point prevalence survey of patients and their medical records was conducted across 20 hospitals, over 17 days during May 2014. The survey determined rates of: provision of verbal information to patients; completion of a falls risk screening tool and age based cognitive testing. Univariate and multivariate logistic regression was utilised to determine key risks and opportunities to improve. Results: Information was collected from 2,720 patients. The provision of verbal information to prevent falls, as recalled by patients was 60% (hospital range 35–88%). This was significantly higher for patients with a stay of six or more days or involved in rehabilitation care. Perinatal women were three times less likely to be provided with verbal falls prevention information. A falls risk screening tool was completed for 82% of patients (range 28–98%). Perinatal women, and both adult and paediatric patients compared to older adults, were significantly less likely to have a complete falls risk screening tool. Thirty seven percent of patients within the recommended age ranges had cognitive testing (range 0–87%). Short-term patients and those not involved in rehabilitation, were significantly less likely to have been tested. Discussion: The survey identified differences in patient care and supporting processes across all hospitals. The results have highlighted areas for improvement. Conclusion: There were wide variations across all the hospitals in the provision of falls information, completion of falls risk screening tools and cognitive testing. At significant risk of missing out on falls prevention strategies were short stay patients and perinatal women. Five hospitals had significantly low rates of cognitive testing, indicating a hospitalwide issue rather than specific patient cohorts. Subsequently, the importance of ensuring that falls prevention strategies are conducted is vital to reduce preventable inpatient falls in all care settings. Implications for research, policy and practice: This was the first state-wide point prevalence study in WA and it has informed the need for further research into the implication of falls risk inpatients. It was found that falls risk assessment was not conducted for each patient who met the screening criteria. A review of the criteria, and practicability to carry out the assessment may need to be further investigated to determine if the practice should be refined. What is already known about the topic? Falls in hospitals are a frequent and largely considered preventable health concern. Falls that occur in hospitals are associated with an increased length of stay and use of health resources. What this paper adds: This paper offers a comprehensive insight into the variation in hospital falls prevention strategies, from a state-wide perspective. It also identifies perinatal women as a high-risk group who are missing out on falls prevention strategies despite having the potential to fall. It also gives an insight to health services that not all at risk patients are being screened and those screened are not screened early in their inpatient stay which can be a risk to both patient and staff.

Azithromycin for severe COVID-19

Azithromycin for severe COVID-19

The Case for Changing the Narrative in Health &amp; Social Care

Given our current challenges, how can we contribute to making a difference in patient care and service efficiencies? In other words, how can we all work towards changing the narrative and acting in different ways to make a difference to our patients, colleagues, and organisations alike. Whilst not overstating the case, our NHS is being challenged from several angles. Many colleagues are under serious work pressures, are stressed, suffer from low morale, some are voting with their feet and many more are reporting burnout. And yes, some of our patients are not having the timely care that they deserve? Many of our organisations are in financial distress; many are in special measures and Turnaround Regimes.

Can community and hospital medicine meet? A novel integrative care experience at Assuta University Medical Center.

The ageing of the population, along with the rise in chronic complex illnesses, requires extensive interprofessional, individualized care, mainly in the community, but also in hospitals. Fragmentation results in suboptimal care, higher cost due to duplication and poor quality of care. Hence, collaboration between health systems is essential to prevent further complications and provide enhanced medical care to patients. Integrative care creates bridges between community and hospital health. Integration should be pursued at different levels within a system to facilitate the continuous, comprehensive, and coordinated delivery of services to individuals and populations. To be applied and to make a difference in patient care and outcome, its significance needs to be understood and embedded at the management level. Health systems should abandon familiar paradigms and collaborate with other health systems on the macro level. Several studies describe integrative care from its different aspects. Division of integration into levels: systemic to clinical, horizontal vs longitudinal and according to the degree of integration (from linkage to full integration). Maccabi Health Services is the first Israeli health organization to place an integrative care team at Assuta Hospital in Ashdod. The multiprofessional team, situated in the hospital, sees every Maccabi patient in the hospital. Through close communication and collaborative work with the hospital team – a shared continuity of the care plan is prepared. The team coordinates future care in the community from the hospital to ease the release process and improve outcomes.

Diagnosis-Related Group in Colon Surgery: Identifying Areas of Improvement to Drive High-Value Care

Diagnosis-related group (DRG) migration is defined as the reassignment of colectomy patients from DRG 331 to 330 based exclusively on postoperative complications. Strategic and comparative application of this metric has the potential to demonstrate baseline and excessive rates of complications related directly to patient care differences across institutions. The aim of this study was to report the variability of DRG migration across United States hospitals and its impact on overall cost and length of stay (LOS). This study investigated the variability of DRG migration rates across United States hospitals polling 5 per cent of the national Medicare data. The study endpoints were total cost, LOS, and DRG migration rate. Hospitals were classified into tertiles for low (0.1-16.6%), moderate (16.7-23.0%), and high (23.1-83.3%) DRG migration rates. The study included 5120 patients from 615 hospitals. DRG migration rates for hospitals ranged from 0.1 per cent to 83.3 per cent, with 157 in the low, 183 in the moderate, and 364 in the high tertile. DRG migration resulted in a progressively increased LOS and hospital costs from the lowest to highest tertile. Several diagnoses were identified which are suggestive of failure to integrate evidence-based processes of care across the tertiles. The data confirm a wide variation in DRG migration rates from DRG 331 to 330 based only on postoperative complications. These ranges allow for the potential definition of both best practice, and opportunities for quality improvement with respect to postoperative complications, identification of hospital outliers, and the economics of care as part of a value-based care program.

Shifting Gears from Transplant to CAR T: Creating a Cell Therapy Nurse Coordinator Role

Topic Significance & Study Purpose/Background/Rationale With the advent of novel cell therapies such as chimeric antigen receptor (CAR)-T, blood and marrow transplant (BMT) programs find themselves in uncharted territory. While CAR-T shares some aspects with BMT, differences in patient care and program needs warrant the creation of a cellular therapy coordinator (CTC) role. This presentation aims to explore the unique development of the CTC role in an intermediate size transplant program providing commercial CAR-T therapy. Methods, Intervention, & Analysis The CTC role resulted from extensive work by a multidisciplinary cell therapy team. The team created CAR-T focused standard operating procedures, and the CTC then translated these policies into direct patient care. While BMT policies have been long established, little precedent exists for CAR-T therapy. The CTC, in collaboration with the cell therapy team, created program-specific patient education publications, set documentation standards, and developed discharge planning tools. The CTC also created an adverse event reporting system as required by the FDA. In a variation from BMT, the CTC assumed responsibility for patient care coordination from the time of consent through the time of program discharge. This allowed for monitoring at all stages, and allowed the CTC to understand the nuances of each patient's CAR-T experience. Findings & Interpretation The program administered CAR-T cells to 17 patients over six months. Retrospective evaluation demonstrated several factors that differentiate the CTC role. Unlike BMT, manufactured CAR-T cells require oversight from pharmaceutical companies, insurance, and the FDA. The CTC maintains a relationship with the pharmaceutical companies through patient registration, event reporting, and facility audits. Since official billing codes do not exist, the CTC has an increased responsibility in the insurance approval process, working closely with financial coordinators and hospital administrators. The CTC also experiences challenges due to an acutely ill patient population. While most BMT patients are in remission, the relapsed/refractory CAR-T patients often require urgent treatment, adding additional time sensitivity to care coordination. Discussion & Implications As new trials and commercial products become available, cancer centers interested in pursuing cellular therapies should consider early implementation of cell therapy nurse coordinators. By understanding the nuances of cell therapy, a designated CTC ensures patient safety and enhance program development.

Abstract 242: Can Belief Enhance Relief? A Multicenter Study

Purpose: While caring for patients, it is important to recognize more than just the apparent physical symptoms. Their emotional well-being, level of comfort, and spiritual concerns are relevant and should be taken into consideration. We aimed to identify if a greater commitment to spiritual belief systems by healthcare providers could have an effect on the patient care they provided. Methods: The Ethics in Intensive Care Study (ETHICS) was conducted in multiple centers all over the world utilizing a confidential survey. Questions were related to personal opinions on ethical issues, including personal beliefs, and patient care. We hypothesized that the personal beliefs of the healthcare providers should not affect the quality of care provided. Pearson’s correlation was used to ascertain statistical significance. Results: A total of 9,720 healthcare providers rated their level of spirituality from 1 (least) to 10 (greatest), and answered whether their beliefs affected their patient care. The majority of the people surveyed (65.6%; n=6,378) assessed themselves between 5 and 8 out of 10. In each individual level, most physicians felt patient care was not affected. However, on closer inspection and analysis, an interesting trend emerged. Only 11.4% (n=45) of those who rated themselves in level 1 of spirituality (n=394) stated their patient care was affected by their personal beliefs. Of people in level 5 (n=1,300), 13.3% (n=173) felt their beliefs affect the quality of care provided, and surprisingly, that number increased to 21.4% (n=193) among those healthcare provider rated in level 10 (n=899) [ p &lt;0.001, Pearson’s R correlation 0.94]. Conclusions: A significant number of physicians identify themselves as religious, whether by belief in God, or based on a level of spirituality. We found a strong correlation between the level of spirituality a provider feels and the perception of how much his/her patient care is affected. We are not aware if this translates into real differences in patient care.

Challenging Conventions to Make a Difference in Patient Care: The 2017 Gaston Labat Award Lecture.

Challenging Conventions to Make a Difference in Patient Care: The 2017 Gaston Labat Award Lecture.