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Costs of surgery

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https://www.readbyqxmd.com/read/28929381/recombinant-parathyroid-hormone-versus-usual-care-do-the-outcomes-justify-the-cost
#1
Kathryn H Chomsky-Higgins, Holly M Rochefort, Carolyn D Seib, Jessica E Gosnell, Wen T Shen, Quan-Yang Duh, Insoo Suh
BACKGROUND: Hypoparathyroidism is a potential outcome of anterior neck surgery. Commonly it is managed by calcium and vitamin D supplementation in large doses, with attendant side effects. A recombinant human parathyroid hormone (rhPTH) is now available in the USA, offering a potentially more effective treatment. No cost-effectiveness model investigating this new medication versus standard care has yet been published. METHODS: We constructed a decision analytic model comparing usual care versus rhPTH treatment for postsurgical hypoparathyroidism...
September 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28929274/minimally-invasive-posterior-cervical-foraminotomy-for-treatment-of-radiculopathy-an-effective-time-tested-and-cost-efficient-motion-preservation-technique
#2
REVIEW
L Papavero, R Kothe
OBJECTIVE: To relieve foraminal root impingement due to lateral soft disc fragments, bony spurs, or other rarer causes. INDICATIONS: Soft disc fragment whose bulk is >2/3 lateral to the lateral border of the thecal sac. Intraforaminal dorsal bony narrowing of the root canal. Intraforaminal synovial cyst, extra/intradural tumor. CONTRAINDICATIONS: Paramedian and median soft/hard disc protrusions. Kyphosis of the index level. SURGICAL TECHNIQUE: Patient prone in reverse Trendelenburg position with the head fixed in a Mayfield clamp...
September 19, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28927978/approaching-zero-implications-of-a-computed-tomography-reduction-program-for-pediatric-appendicitis-evaluation
#3
K Tinsley Anderson, Marisa Bartz-Kurycki, Mary T Austin, Akemi Kawaguchi, Susan D John, Lillian S Kao, KuoJen Tsao
PURPOSE: Because of awareness of iatrogenic radiation exposure, there is a national trend of diminishing computed tomography (CT) use for pediatric suspected appendicitis. The purpose of this study was to evaluate the effects of a CT reduction program for evaluation of appendicitis. METHODS: A multidisciplinary group (emergency medicine, radiology, and surgery) at a children's hospital developed a reduction program which included: ultrasound (U/S) first (2012), magnetic resonance imaging (MRI) second (2014), and standardized U/S reports (2016)...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28927926/short-dental-implants-a-scoping-review-of-the-literature-for-patients-with-head-and-neck-cancer
#4
REVIEW
Faraj Edher, Caroline T Nguyen
STATEMENT OF PROBLEM: Dental implants can be essential in the rehabilitation of various cancer defects, but their ideal placement can be complicated by the limited dimensions of the available host bone. Surgical interventions developed to increase the amount of bone are not all predictable or successful and can sometimes be contraindicated. Short dental implants have been suggested as an alternative option in sites where longer implants are not possible. Whether they provide a successful treatment option is unclear...
September 16, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28927846/cost-effectiveness-assessment-in-outpatient-sinonasal-surgery
#5
G Mortuaire, D Theis, R Fackeure, D Chevalier, I Gengler
AIMS: To assess the cost-effectiveness of outpatient sinonasal surgery in terms of clinical efficacy and control of expenses. METHODS: A retrospective study was conducted from January 2014 to January 2016. Patients scheduled for outpatient sinonasal surgery were systematically included. Clinical data were extracted from surgical and anesthesiology computer files. The cost accounting methods applied in our institution were used to evaluate logistic and technical costs...
September 15, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28927832/impact-of-weekend-admission-on-mortality-and-other-outcomes-among-patients-with-burn-injury-a-nationwide-analysis
#6
Heather Peluso, Marwan S Abougergi, Julie Caffrey
OBJECTIVE: To study the relationship between day of admission and important outcomes among patients with burn injuries. METHODS: The 2014 National Inpatient Sample database was used. Inclusion criterion was a principal diagnosis of burn injury. Exclusion criteria were age <18years, superficial burn, and non-urgent admission. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (septic shock and prolonged mechanical ventilation), treatment metrics (time to surgery and parenteral or enteral nutrition (P/E-nutrition)) and resource utilization (length of stay (LOS) and total hospitalization charges and costs)...
September 16, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28927450/unit-cost-of-healthcare-services-at-200-bed-public-hospitals-in-myanmar-what-plays-an-important-role-of-hospital-budgeting
#7
Thet Mon Than, Yu Mon Saw, Moe Khaing, Ei Mon Win, Su Myat Cho, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima
BACKGROUND: Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately...
September 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28927186/long-term-clinical-outcomes-health-related-quality-of-life-and-costs-in-different-treatment-modalities-of-stable-coronary-artery-disease
#8
Harriet Stenvall, Ilkka Tierala, Pirjo Räsänen, Mika Laine, Harri Sintonen, Risto P Roine
Aims: This study is a prospective, observational 8-year follow-up of 300 stable unselected coronary artery disease patients entering elective coronary angiography in 2002-03. Recorded were clinical outcomes, health-related quality of life (HRQoL), and secondary care costs after coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI), or medical therapy (MT). Methods and results: HRQoL was measured by the 15D instrument at baseline, 6 months, and 8 years...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926344/the-effect-of-severity-of-illness-on-spine-surgery-costs-across-new-york-state-hospitals-an-analysis-of-69-831-cases
#9
I David Kaye, Murillo Adrados, Raj J Karia, Themistocles S Protopsaltis, Joseph A Bosco
STUDY DESIGN: Observational database review. OBJECTIVE: To determine the effect of patient severity of illness (SOI) on the cost of spine surgery among New York state hospitals. SUMMARY OF BACKGROUND DATA: National health care spending has risen at an unsustainable rate with musculoskeletal care, and spine surgery in particular, accounting for a significant portion of this expenditure. In an effort towards cost-containment, health care payers are exploring novel payment models some of which reward cost savings but penalize excessive spending...
September 18, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28924572/stereovision-based-integrated-system-for-point-cloud-reconstruction-and-simulated-brain-shift-validation
#10
Xiaochen Yang, Logan W Clements, Ma Luo, Saramati Narasimhan, Reid C Thompson, Benoit M Dawant, Michael I Miga
Intraoperative soft tissue deformation, referred to as brain shift, compromises the application of current image-guided surgery navigation systems in neurosurgery. A computational model driven by sparse data has been proposed as a cost-effective method to compensate for cortical surface and volumetric displacements. We present a mock environment developed to acquire stereoimages from a tracked operating microscope and to reconstruct three-dimensional point clouds from these images. A reconstruction error of 1 mm is estimated by using a phantom with a known geometry and independently measured deformation extent...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28924249/validating-a-therapy-oriented-complication-grading-system-in-lumbar-spine-surgery-a-prospective-population-based-study
#11
David Bellut, Jan-Karl Burkhardt, Dania Schultze, Howard J Ginsberg, Luca Regli, Johannes Sarnthein
The aim of the present study was to validate a therapy-oriented complication grading system in a well-defined neurosurgical patient population in which complications may entrain neurological deficits, which are severe but not treated. The prospective patient registry of the Department of Neurosurgery, University of Zurich provides extensive population-based data. In this study we focused on complications after lumbar spine surgeries and rated their severity by Clavien-Dindo grade (CDG). Analyzing 138 consecutive surgeries we noted 44 complications...
September 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28923473/virtual-surgery-for-patients-with-nasal-obstruction-use-of-computational-fluid-dynamics-mecomland-%C3%A2-digbody-%C3%A2-noseland-%C3%A2-to-document-objective-flow-parameters-and-optimise-surgical-results
#12
Manuel A Burgos, Maria Agustina Sevilla García, Enrique Sanmiguel Rojas, Carlos Del Pino, Carlos Fernández Velez, Francisco Piqueras, Francisco Esteban Ortega
INTRODUCTION: Computational fluid dynamics (CFD) is a mathematical tool to analyse airflow. We present a novel CFD software package to improve results following nasal surgery for obstruction. METHODS: A group of engineers in collaboration with otolaryngologists have developed a very intuitive CFD software package called MeComLand®, which uses the patient's cross-sectional (tomographic) images, thus showing in detail results originated by CFD such as airflow distributions, velocity profiles, pressure, or wall shear stress...
September 15, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28923427/minimally-invasive-versus-open-surgery-for-lumbar-synovial-cysts
#13
Pierluigi Vergara, Christopher Yusuf Akhunbay-Fudge, Mark Robert Kotter, Rodney John Charles Laing
OBJECTIVE: Lumbar synovial cysts are relatively infrequent. Historically, these benign lesions have been treated with open excision, sometimes associated with fusion. The aim of this study is to compare Minimally Invasive Surgery (MIS) with Open Surgery (OS) for the treatment of lumbar synovial cysts. METHODS: Retrospective review of patients who underwent minimally invasive or open excision of lumbar synovial cysts. Clinical outcomes, recurrence rate and surgical complications were compared in the 2 groups...
September 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28923218/randomized-controlled-trials-in-soft-tissue-sarcoma-we-are-getting-there
#14
REVIEW
Andrea J MacNeill, Abha Gupta, Carol J Swallow
Soft tissue sarcoma (STS) is a family of malignancies for which individual management decisions can be complex. There is a paucity of level 1 evidence, as the rarity and heterogeneity of STS pose challenges to the design and execution of randomized controlled trials. Radiotherapy (RT) is routinely used to facilitate function-preserving surgery and to improve local control. Delivery of RT in the preoperative setting can decrease chronic toxicities at the cost of increased wound complications in the short-term...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28922883/proximal-junctional-kyphosis-prevention-strategies-a-video-technique-guide
#15
Michael M Safaee, Joseph A Osorio, Kushagra Verma, Shay Bess, Christopher I Shaffrey, Justin S Smith, Robert Hart, Vedat Deviren, Christopher P Ames
BACKGROUND: Proximal junctional kyphosis (PJK) is a well-recognized complication in patients undergoing posterior instrumented fusion procedures for adult spinal deformity. Strategies that reduce rates of PJK have the potential to improve the safety of these operations and decrease cost by eliminating the need for revision surgery. OBJECTIVE: To present a set of surgical techniques that can decrease rates of PJK in adults undergoing surgery for spinal deformity...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#16
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28920559/functional-mechanics-of-a-pectin-based-pleural-sealant-after-lung-injury
#17
Andrew B Servais, Cristian D Valenzuela, Arne Kienzle, Alexandra B Ysasi, Willi L Wagner, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
Pleural injury and associated air leaks are a major influence on patient morbidity and health care costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal weight % mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products...
September 16, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28920052/the-effect-of-intravenous-magnesium-sulfate-versus-intravenous-sufentanil-on-the-duration-of-analgesia-and-postoperative-pain-in-patients-with-tibia-fracture
#18
Ali Reza Olapour, Ahmad Reza Mohtadi, Mansour Soltanzadeh, Ali Ghomeishi, Reza Akhondzadeh, Maryam Jafari
BACKGROUND: In the recent decades controlling postoperative pain has become a popular topic as it leads to the patients' wellbeing and improved life quality, while it reduces the costs for both patients and medical facilities. OBJECTIVES: This study aimed at comparing intravenous magnesium sulfate versus intravenous sufentanil on the duration of analgesia and postoperative pain in patients undergoing tibia fracture surgery. METHODS: This double blind clinical trial study was performed on 70 candidates of tibia fractures between the ages of 18 and 55 years with American society of anesthesiologists (ASA) class I and II...
April 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919793/burden-of-uterine-fibroids-in-italy-epidemiology-treatment-outcomes-and-consumption-of-health-care-resources-in-more-than-5-000-women
#19
Marco Chiumente, Mauro De Rosa, Andrea Messori, Enrica Maria Proli
BACKGROUND AND PURPOSE: Epidemiological studies on uterine fibroids (UFs) are mostly based on surveys or analyses of small samples of patients. In 50% of women, the quality of life is worsened by disease-related symptoms; furthermore, treatments imply a remarkable health care cost. The aim of this observational study was to analyze a large sample of Italian patients with UFs and to assess the epidemiology, the appropriateness of treatments, and the consumption of disease-related resources...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#20
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
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