BACKGROUND-Patients with alcohol use disorder (AUD) are at an increased risk of developing Wernicke's encephalopathy (WE), a devastating and difficult diagnosis caused by thiamine deficiency. Even as AUD is present in up to 25% of hospitalized patients on medical floors, appropriate thiamine supplementation in the hospital setting remains inadequate. These patients are particularly susceptible to thiamine deficiency and subsequent WE due to both their alcohol use and active medical illnesses. The electronic medical record (EMR) has become ubiquitous in health care systems and can be used as a tool to improve the care of hospitalized patients.

Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.

Key Points Question Is graduate medical education funding associated with hospital perfomance and patient outcomes? Findings This economic evaluation of 1298 academic hospitals in the US assessed the association between confounder-adjusted graduate medical education funding and hospital financial standing, patient outcomes, and resident academic performance. A statistically significant association was found between higher graduate medical education funding and worse hospital financial standing, reduced patient mortality, and improved resident academic performance. Meaning These findings suggest that graduate medical education funding does not improve the financial standing of hospitals but is associated with improved patient outcomes and resident academic performance.

Objectives: To create a straightforward scoring procedure based on widely available, inexpensive financial data that provides an assessment of the financial health of a hospital. Design: Methodological study. Setting: Multicenter study. Participants: All hospitals and health systems reporting the required financial metrics in 2017 were included for a total of 1,075 participants. Interventions: We examined a list of 232 hospital financial indicators and used existing models and financial literature to select 30 metrics that sufficiently describe hospital operations. In a set of hospital financial data from 2017, we used Principal Coordinate Analysis to assess collinearity among variables and eliminated redundant variables. We isolated 10 unique variables, each assigned a weight equal to the share of its coefficient in a regression onto Moody's Credit Rating, our predefined gold standard. The sum of weighted variables is a single composite score named the Yale Hospital Financial Score (YHFS). Primary Outcome Measures: Ability to reproduce both financial trends from a "gold standard" metric and known associations with non-fiscal data. Results: The validity of the YHFS was evaluated by: (1) assessing its reproducibility with previously excluded data; (2) comparing it to existing models; and, (3) replicating known associations with non-fiscal data. Ten percent of the initial dataset had been reserved for validation and was not used in creating the model; the YHFS predicts 96.7% of the variation in this reserved sample, demonstrating reproducibility. The YHFS predicts 90.5% and 88.8% of the variation in Moody's and Standard and Poor's bond ratings, respectively, supporting its validity. As expected, larger hospitals had higher YHFS scores whereas a greater share of Medicare discharges correlated with lower YHFS scores. Conclusions: We created a reliable and publicly available composite score of hospital financial stability.