all CXR images were urgently acquired, and their average time was 43 minutes from order to availability. Before intervention, the median number of CXRs per patient per day was 0.38 (0.36 -0.40). After, this amount decreased to 0.30 (0.28 -0.32) [p= 0.0013], representing a 22% reduction on CXR request. Mean length of ICU stay before and after campaign was, respectively, 8.14 (7.79 -8.71) and 8.45 (8.24 -9.74) days [p= 0.35]. Mean mortality rate before and after intervention was, respectively, 18.45% (6 3.87%) and 21.58% (6 2.23%) [p = 0.12]. Conclusions: This was the first report of a Choosing Wisely initiative in a Brazilian ICU of a public hospital. Transition to a high value on-demand CXR strategy in ICUs is safe and particularly noteworthy in a low resource public health system.
with a disease combination for a subpopulation was computed by taking the difference between LHC for members of that subpopulation without disease and LHC for members of that subpopulation who had that disease combination. Racial differences were measured in the absolute differences in LHC and LCD between black women/men and white women/men. Results: Our sample comprised of 53,035 individuals ages 40-79 years with a weighted population of 104 million. Higher percentage of blacks in comparison to whites were obese (44.3% vs. 33.4%) and reported OCC (21.7% vs. 14.1%). Overall, black women, ages 70-79 years, paid $9,003 higher than white women with cost difference highest for the population with at least CHD. Racial difference in LCD was higher for women for all OCC's for all age cohorts, but not for age cohort 70-79 years. The LCD was highest for black women ages 60-69 years for stroke, with black women incurring $42,286 higher costs than white women. Conclusions: Racial differences in LCD associated with all OCC's are wide in women ages 40-69. Policies addressing obesity prevention may help reduce the economic burden of OCC's among this subpopulation.
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