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https://www.readbyqxmd.com/read/29417575/patient-and-surgeon-factors-explain-variation-in-the-frequency-of-frontal-sinus-surgery
#1
Christian P Soneru, Jayant M Pinto
OBJECTIVES/HYPOTHESIS: Ethmoidectomy may be sufficient to address frontal sinus disease, but some surgeons may perform frontal recess dissection initially. Our objectives were to describe patient-associated factors with frequency of frontal sinus surgery and analyze the association with provider volume. STUDY DESIGN: Retrospective cohort analysis. METHODS: The 2013 State Ambulatory Surgery Databases of New Jersey, Florida, and Kentucky were queried to identify adults who underwent anterior ethmoidectomy or total ethmoidectomy using standard Current Procedural Terminology codes...
February 8, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29403570/prospective-bundled-payments-in-a-changing-environment-the-experience-of-a-self-funded-state-sponsored-plan
#2
Frank H Lawler, Frank R Wilson, G Keith Smith, Lynn V Mitchell
Background: Healthcare reimbursement, which has traditionally been based on the quantity of services delivered, is currently moving toward value-based reimbursement-a system that addresses the quantity, quality, and cost of services. One such arrangement has been the evolution of bundled payments for a specific procedure or for an episode of care, paid prospectively or through post-hoc reconciliation. Objective: To evaluate the impact of instituting bundled payments that incorporate facility charges, physician fees, and all ancillary charges by the State of Oklahoma HealthChoice public employee insurance plan...
December 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/29401348/evaluation-of-the-group-lifestyle-balance-program-in-a-military-setting-an-investment-worth-expanding
#3
Jana L Wardian, Mark W True, Tom J Sauerwein, Nina A Watson, Austin M Hoover
Introduction: The Diabetes Prevention Program (DPP) demonstrated that lifestyle intervention programs were effective in preventing or delaying the onset of diabetes. The Group Lifestyle Balance (GLB) program translated the DPP curriculum into a 12-wk group intervention for those at risk for diabetes. This retrospective evaluation examined clinical outcomes for patients in the Diabetes Center of Excellence GLB program located at Wilford Hall Ambulatory Surgical Center from 2009 to 2013...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29288921/outcome-of-magnetic-resonance-guided-focused-ultrasound-surgery-mrgfus-for-figo-class-1-fibroids
#4
Roy Mashiach, Yael Inbar, Jaron Rabinovici, Aya Mohr Sasson, Aviva Alagem-Mizrachi, Ronit Machtinger
OBJECTIVE: Intracavitary uterine fibroids and fibroids that distort the uterine cavity are associated with excessive vaginal bleeding and infertility. While intracavitary fibroids smaller than 4 cm are usually treated safely by operative hysteroscopy, larger fibroids may require multiple surgeries or more extensive surgery with possible damage to the integrity of the uterine wall. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive approach for treating uterine fibroids, mainly the intramural type...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29274521/returns-to-specialization-evidence-from-the-outpatient-surgery-market
#5
Elizabeth L Munnich, Stephen T Parente
Technological changes in medicine have created new opportunities to provide surgical care in lower cost, specialized facilities. This paper examines patient outcomes in ambulatory surgery centers (ASCs), which were developed as a low-cost alternative to outpatient surgery in hospitals. Because we are concerned that selection into ASCs may bias estimates of facility quality, we use predicted changes in federally set Medicare facility payment rates as an instrument for ASC utilization to estimate the effect of location of treatment on patient outcomes...
December 9, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29240321/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-final-rule-with-comment-period
#6
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2018 to implement changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program...
December 14, 2017: Federal Register
https://www.readbyqxmd.com/read/29231672/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-final-rule-with-comment-period
#7
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2018 to implement changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program...
November 13, 2017: Federal Register
https://www.readbyqxmd.com/read/29200371/comparison-of-anesthesia-for-dental-oral-surgery-by-office-based-dentist-anesthesiologists-versus-operating-room-based-physician-anesthesiologists
#8
Mark A Saxen, Richard D Urman, Juan F Yepes, Rodney A Gabriel, James E Jones
Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29194621/effects-of-the-medicare-modernization-act-on-spending-for-outpatient-surgery
#9
John M Hollingsworth, Mary K Oerline, Chandy Ellimoottil, Lindsey A Herrel, Brent K Hollenbeck
OBJECTIVES: To examine the effects of Medicare's revised ambulatory surgery center (ASC) payment schedule on overall payments for outpatient surgery. DATA SOURCES: Twenty percent sample of national Medicare beneficiaries. STUDY DESIGN: We conducted a pre-post study of Medicare beneficiaries who underwent outpatient surgery in a hospital outpatient department (HOPD), ASC, or physician office between 2004 and 2011. Specifically, we used multivariable regression to compare temporal trends in outpatient surgery before and after implementation of Medicare's revised payment schedule in 2008, which reduced ASC facility payments to roughly two-thirds that of HOPDs...
November 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/29186597/factors-for-a-good-surgical-outcome-in-posterior-decompression-and-dekyphotic-corrective-fusion-with-instrumentation-for-thoracic-ossification-of-the-posterior-longitudinal-ligament-prospective-single-center-study
#10
Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
BACKGROUND: Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE: To identify factors for good surgical outcomes with prospective and comparative study. METHODS: Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29167902/trends-in-use-of-ambulatory-surgery-centers-for-cataract-surgery-in-the-united-states-2001-2014
#11
Brian C Stagg, Nidhi Talwar, Cynthia Mattox, Paul P Lee, Joshua D Stein
Importance: Cataract surgery is commonly performed at ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). These venues differ in many ways, including surgical efficiency, patient throughput, patient safety, and costs per surgery. Objective: To determine trends in use of ASCs and HOPDs for cataract surgery from 2001 to 2014 and factors affecting the site of surgery. Design, Setting, and Participants: This retrospective longitudinal cohort analysis involved individuals 40 years and older who underwent cataract surgery between January 2001 and December 2014 from a nationwide US managed care network...
November 22, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29148356/specialization-as-an-organizing-principle-the-case-of-ambulatory-surgery-centers
#12
Kathleen Carey, Jean M Mitchell
Ambulatory surgery centers (ASCs) recently have grown to become the dominant provider of specific surgical procedures in the United States. While the majority of ASCs focus primarily on a single specialty, many have diversified to offer a wide range of surgical specialties. We exploited a unique data set from Pennsylvania for the years 2004 to 2014 to conduct an empirical investigation of the relative cost of production in ASCs over varying degrees of specialization. We found that for the majority of ASCs, focus on a specialty was associated with lower facility costs...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29145986/hand-surgery-in-the-ambulatory-surgery-center
#13
REVIEW
Norfleet B Thompson, James H Calandruccio
Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2.5%). Patient dissatisfaction with ASC surgery is primarily associated with postoperative nausea and vomiting and inadequate pain control.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29125521/variation-in-surgical-management-of-neurogenic-bowel-among-centers-participating-in-national-spina-bifida-patient-registry
#14
Jonathan C Routh, David B Joseph, Tiebin Liu, Michael S Schechter, Judy K Thibadeau, M Chad Wallis, Elisabeth A Ward, John S Wiener
PURPOSE: Optimal management of neurogenic bowel in patients with spina bifida (SB) remains controversial. Surgical interventions may be utilized to treat constipation and provide fecal continence, but their use may vary among SB treatment centers. METHODS: We queried the National Spina Bifida Patient Registry (NSBPR) to identify patients who underwent surgical interventions for neurogenic bowel. We abstracted demographic characteristics, SB type, functional level, concurrent bladder surgery, mobility, and NSBPR clinics to determine whether any of these factors were associated with interventions for management of neurogenic bowel...
December 11, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29122620/three-year-outcomes-of-the-prospective-randomized-controlled-rez%C3%A5-m-system-study-convective-radiofrequency-thermal-therapy-for-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#15
Kevin T McVary, Claus G Roehrborn
OBJECTIVE: To report 3-year outcomes of a prospective, multi-center, randomized, blinded control trial after treatment with convective radiofrequency (RF) water vapor thermal therapy for moderate to severe lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Fifteen centers enrolled and randomized 197 men ≥50 years old with International Prostate Symptom Score (IPSS) ≥13, maximum flow rate (Qmax) ≤15 ml/s and prostate volume 30 to 80 cc to thermal therapy with Rezūm® System or control (2:1)...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29103779/is-outpatient-unicompartmental-knee-arthroplasty-safe-to-perform-at-an-ambulatory-surgery-center-a-comparative-study-of-early-post-operative-complications
#16
John P Cody, Kiel J Pfefferle, Deborah J Ammeen, Kevin B Fricka
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lends itself to the outpatient surgical setting. Prior literature has established a low rate of readmission and post-operative complications when performed in a hospital outpatient setting (HOP). To our knowledge, there have been no studies comparing complications of UKA performed at an ambulatory surgery center (ASC) and those in a HOP. METHODS: We retrospectively reviewed all patients who underwent outpatient UKA by a single surgeon from 2012 to 2016...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29078868/hospital-readmission-after-ambulatory-laparoscopic-cholecystectomy-incidence-and-predictors
#17
Eric B Rosero, Girish P Joshi
BACKGROUND: The aim of the study was to assess the rate of 30-d hospital readmissions after ambulatory laparoscopic cholecystectomy. MATERIALS AND METHODS: The 2009 to 2011 State Ambulatory Surgery and Services and State Inpatient Databases from California, Florida, and New York were analyzed to evaluate the incidence of 30-d readmissions after laparoscopic cholecystectomy performed in outpatient settings. Hospital transfers and the principal diagnoses of hospital readmission were analyzed as secondary outcomes...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29062640/10-years-later-lessons-learned-from-an-academic-multidisciplinary-cosmetic-center
#18
Jenny T Chen, Harry S Nayar, Venkat K Rao
BACKGROUND: In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. METHODS: Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29059083/current-opinions-in-office-based-rhinology
#19
Aykut A Unsal, Naomi Gregory, Kenneth Rosenstein
PURPOSE OF REVIEW: The care of rhinologic patients has undergone a remarkable transformation in recent years. With the advent of endoscopic sinus surgery and high-tech image-guided computer systems, the surgical care of patients with benign sinonasal disease has successfully transitioned from the main hospital operating room to the outpatient ambulatory surgical center. Currently, there is yet another movement underway, in an attempt to care for these patients in the office setting. RECENT FINDINGS: As the medical device sector continues to innovate at rapid speed, new technologies such as the radiofrequency ablator, microdebrider, balloon sinus dilator, and steroid-eluting stent have propelled the care of rhinologic patients into the clinic setting...
October 20, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29053655/assessment-of-pre-and-postoperative-anxiety-in-patients-undergoing-ambulatory-oral-surgery-in-primary-care
#20
E Reyes-Gilabert, L-G Luque-Romero, G Bejarano-Avila, A Garcia-Palma, A Rollon-Mayordomo, P Infante-Cossio
BACKGROUND: To analyze the pre- and postoperative anxiety level in patients undergoing ambulatory oral surgery (AOS) in a primary healthcare center (PHC). MATERIAL AND METHODS: Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015. Anxiety analysis was carried out with pre- and postoperative anxiety-state (STAI-S), anxiety-trait (STAI-T) and dental anxiety (MDAS) questionnaires...
November 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
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