TY - JOUR
T1 - Repeated hospitalization for diabetic ketoacidosis. The game of "sartoris"
AU - Flexner, Charles W.
AU - Weiner, Jonathan P.
AU - Saudek, Christopher D.
AU - Dans, Peter E.
N1 - Funding Information:
From the School of Medicine, Johns Hopkins University, and the Office of Medical Practice Evaluation, Johns Hopkins Hospital, Baltimore, Maryland. At the time of the research, Dr. Flexner was a medical student at Johns Hopkins. He is currently a resident in internal medicine at the Stanford University Hospital. This work was supported in part by a grant from the W. K. Kellogg Foundation, Battle Creek, Michigan. Requests for reprints should be addressed to Dr. Peter E. Dans, Johns Hopkins Hospital, Osler 624, 600 North Wolfe Street, Baltimore, Maryland 21205. Manuscript accepted April 13, 1983.
PY - 1984/4
Y1 - 1984/4
N2 - Repeated hospital admission is a serious problem for both the patient and the health care system. The life story of a patient repeatedly admitted for treatment of exacerbations of a chronic disease, such as diabetic ketoacidosis, can often be compared to Faulkner's family Sartoris. The Sartoris characters were wholly occupied in the pursuit of their painful decline and eventual demise. At the Johns Hopkins Hospital, 45 persons were identified who were repeatedly admitted to the medical service for diabetic ketoacidosis. Forty-two charts of "recidivist" patients and "non-recidivist" control patients matched for age and severity of disease were reviewed to determine factors that, if corrected, would prevent repeated admission. Case reports of three patients who were admitted an average of 11 times annually for several years are presented. Implications of the "Game of Sartoris" for the American teaching hospital are discussed.
AB - Repeated hospital admission is a serious problem for both the patient and the health care system. The life story of a patient repeatedly admitted for treatment of exacerbations of a chronic disease, such as diabetic ketoacidosis, can often be compared to Faulkner's family Sartoris. The Sartoris characters were wholly occupied in the pursuit of their painful decline and eventual demise. At the Johns Hopkins Hospital, 45 persons were identified who were repeatedly admitted to the medical service for diabetic ketoacidosis. Forty-two charts of "recidivist" patients and "non-recidivist" control patients matched for age and severity of disease were reviewed to determine factors that, if corrected, would prevent repeated admission. Case reports of three patients who were admitted an average of 11 times annually for several years are presented. Implications of the "Game of Sartoris" for the American teaching hospital are discussed.
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U2 - 10.1016/0002-9343(84)90297-3
DO - 10.1016/0002-9343(84)90297-3
M3 - Review article
C2 - 6424469
AN - SCOPUS:0021138799
VL - 76
SP - 691
EP - 695
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 4
ER -