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Operating room cost

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https://www.readbyqxmd.com/read/29785458/high-resolution-standardization-reduces-delay-due-to-workflow-disruptions-in-laparoscopic-cholecystectomy
#1
Marco von Strauss Und Torney, Sohelia Aghlmandi, Jasmin Zeindler, Debora Nowakowski, Christian A Nebiker, Christoph Kettelhack, Rachel Rosenthal, Raoul A Droeser, Savas D Soysal, Henry Hoffmann, Robert Mechera
BACKGROUND: Optimal resource utilization in high-cost environments like operating theatres is fundamental in today's cost constrained health care systems. Interruptions of the surgical workflow, i.e. microcomplications (MC), lead to prolonged procedure times and higher costs and can be indicative of surgical mistakes. Reducing MC can improve operating room efficiency and prevent intraoperative complications. We, therefore, aimed to evaluate the impact of a high-resolution standardized laparoscopic cholecystectomy protocol (HRSL) on operative time and intraoperative interruptions in a teaching hospital...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29784549/cost-implications-of-varying-the-surgical-technique-surgical-setting-and-anesthesia-type-for-carpal-tunnel-release-surgery
#2
Nikolas H Kazmers, Angela P Presson, Yizhe Xu, Abby Howenstein, Andrew R Tyser
PURPOSE: Carpal tunnel release (CTR) is a common surgical procedure, representing a financial burden to the health care system. The purpose of this study was to test whether the choice of CTR technique (open carpal tunnel release [OCTR] vs endoscopic carpal tunnel release [ECTR]), surgical setting (operating room vs procedure room [PR]), and anesthetic type (local, monitored anesthesia care [MAC], Bier block, general) affected costs or payments. METHODS: Consecutive adult patients undergoing isolated unilateral CTR between July 2014, and October 2017, at a single academic medical center were identified...
May 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29782016/in-vivo-gene-transfer-to-the-rabbit-common-carotid-artery-endothelium
#3
Bradley K Wacker, Lianxiang Bi, David A Dichek
The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves focal endothelial-selective transgenesis, thereby allowing an investigator to determine the biological roles of endothelial-expressed transgenes and to quantify the in vivo transcriptional activity of DNA sequences in large artery endothelial cells. The method uses surgical isolation of rabbit common carotid arteries and an arteriotomy to deliver a transgene-expressing viral vector into the arterial lumen...
May 6, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781859/nonoperating-room-anesthesia-for-gastrointestinal-endoscopic-procedures
#4
Otto S Lin, Wade Weigel
PURPOSE OF REVIEW: To assess the trends in nonoperating room anesthesia (NORA) for gastrointestinal endoscopy over the past few years, and to describe alternative methods of delivering propofol sedation in selected low-risk patients. RECENT FINDINGS: The use of NORA for routine gastrointestinal endoscopic procedures has been rising steadily over the past decade in the United States, considerably increasing healthcare costs. Because of this, there have been attempts to develop nonanesthesiologist-administered propofol sedation methods in low-risk patients...
May 16, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29780598/the-impact-of-surgeon-choices-on-costs-associated-with-uncomplicated-minimally-invasive-colectomy-you-are-not-as-important-as-you-think
#5
John Tillou, Deborah Nagle, Vitaliy Poylin, Thomas Cataldo
Background: There is increasing public discussion about the escalating cost of healthcare in America. There are no published data regarding the contribution of individual surgeons' choices on the cost of uncomplicated minimally invasive colectomy. Methods: A review of a hospital cost-accounting database of the direct costs related to the index operation and post-operative care of all patients who underwent elective minimally invasive segmental colectomy over a 1-year period was performed...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#6
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#7
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29770180/factors-impacting-arthroscopic-rotator-cuff-repair-operational-throughput-time-at-an-ambulatory-care-center
#8
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29749910/a-novel-low-cost-reusable-high-fidelity-neurosurgical-training-simulator-for-cerebrovascular-bypass-surgery
#9
Ulas Cikla, Balkan Sahin, Sahin Hanalioglu, Azam S Ahmed, David Niemann, Mustafa K Baskaya
OBJECTIVE Cerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techniques. Most available training tools, however, either lack the realism of the actual bypass surgery (e.g., artificial vessel, chicken wing models) or require special facilities and regulations (e...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29746889/modular-auditory-decision-making-behavioral-task-designed-for-intraoperative-use-in-humans
#10
Anand Tekriwal, Gidon Felsen, John A Thompson
BACKGROUND: Neurosurgical interventions that require active patient feedback, such as deep brain stimulation surgery, create an opportunity to conduct cognitive or behavioral experiments during the acquisition of invasive neurophysiology. Optimal design and implementation of intraoperative behavioral experiments require consideration of stimulus presentation, time and surgical constraints. We describe the use of a modular, inexpensive system that implements a decision-making paradigm, designed to overcome challenges associated with the operative environment...
May 7, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29738877/oral-tranexamic-acid-is-equivalent-to-topical-tranexamic-acid-without-drainage-in-primary-total-hip-arthroplasty-a-double-blind-randomized-clinical-trial
#11
Ze-Yu Luo, Duan Wang, Wei-Kun Meng, Hao-Yang Wang, Hui Pan, Fu-Xing Pei, Zong-Ke Zhou
PURPOSE: To compare the efficacy of multiple doses of oral tranexamic acid (TXA) with topical TXA administration in reducing blood loss following total hip arthroplasty (THA). PATIENTS AND METHODS: In this double-blinded trial, 117 patients undergoing primary THA were randomized to receive 2 g TXA orally 2 h preoperatively, and two doses of 1 g TXA postoperatively (oral group) or 3 g of TXA topical administration in the operating room (topical group). The primary outcome was a reduction in hemoglobin concentration...
May 1, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29734348/the-impact-of-tackle-football-injuries-on-the-american-healthcare-system-with-a-neurological-focus
#12
Michael J McGinity, Ramesh Grandhi, Joel E Michalek, Jesse S Rodriguez, Aron M Trevino, Ashley C McGinity, Ali Seifi
BACKGROUND: Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. OBJECTIVE: Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013...
2018: PloS One
https://www.readbyqxmd.com/read/29727349/the-feasibility-of-laparoscopic-surgery-in-gynecologic-oncology-for-obese-and-morbidly-obese-patients
#13
Jessie Peng, Sarah Sinasac, Katherine J Pulman, Liying Zhang, Joan Murphy, Tomer Feigenberg
BACKGROUND: Surgical interventions are the mainstay of treatment for many gynecological cancers. Although minimally invasive surgery offers many potential advantages, performing laparoscopic pelvic surgery in obese patients remains challenging. To overcome this, many centers have shifted their practice to robotic surgery; however, the high costs associated with robotic surgery are concerning and limit its use. OBJECTIVE: This study aimed to examine the feasibility of performing laparoscopic gynecologic oncology procedures in obese and morbidly obese patients...
June 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29727169/room-temperature-low-threshold-lasing-from-monolithically-integrated-nanostructured-porous-silicon-hybrid-microcavities
#14
Valentina Robbiano, Giuseppe M Paterno, Antonino A La Mattina, Silvia G Motti, Guglielmo Lanzani, Francesco Scotognella, Giuseppe Barillaro
Silicon photonics would strongly benefit from monolithically integrated low-threshold silicon-based laser operating at room-temperature, representing today the main bottleneck towards low-cost and power-efficient electronic-photonic integrated circuits. Here we demonstrate low-threshold lasing from fully-transparent nanostructured porous silicon (PSi) monolithic microcavities (MCs) infiltrated with a polyfluorene derivative, namely poly(9,9-di-n-octylfluorenyl-2,7-diyl) (PFO). The PFO-infiltrated PSiMCs support single-mode blue lasing at the resonance wavelength of 466 nm, with line width of ~1...
May 4, 2018: ACS Nano
https://www.readbyqxmd.com/read/29715227/comparison-of-direct-perioperative-costs-in-treatment-of-unstable-distal-radial-fractures-open-reduction-and-internal-fixation-versus-closed-reduction-and-percutaneous-pinning
#15
Sreeharsha V Nandyala, Aviram M Giladi, Amber M Parker, Tamara D Rozental
BACKGROUND: As the United States transitions to value-based insurance, bundled payments, and capitated models, it is paramount to understand health-care costs and resource utilization. The financial implications of open reduction and internal fixation (ORIF) with a volar locking plate for management of unstable distal radial fractures have not been established. We aimed to elucidate cost differences between ORIF and closed reduction and percutaneous pinning (CRPP). Our hypothesis was that ORIF has greater direct perioperative costs than CRPP but that the costs equilibrate over time...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29714381/an-ammonia-detecting-mechanism-for-organic-transistors-as-revealed-by-their-recovery-processes
#16
Xu Zhou, Kaifeng Niu, Zi Wang, Lizhen Huang, Lifeng Chi
Organic thin film transistor (OTFT) based gas sensors have demonstrated promising applications, owing to their advantages of high selectivity and room temperature operation, accompanied by their low cost, large scale manufacture, and flexibility. However, the understanding of the sensing mechanism is far from clear. Herein, we reveal the sensing mechanism of an organic transistor sensor for ammonia (NH3) detection through studying the recovery behavior in various atmospheres. Inspired by the significant difference in the recovery of the transistor sensor in N2 and in air, we deduced that the operation mechanism should not only involve the NH3-film interaction...
May 1, 2018: Nanoscale
https://www.readbyqxmd.com/read/29714169/porous-si-nanowires-for-highly-selective-room-temperature-no2-gas-sensing
#17
Yong Jung Kwon, Ali Mirzaei, Han Gil Na, Sung Yong Kang, Myung Sik Choi, Jae Hoon Bang, Wansik Oum, Sang Sub Kim, Hyoun Woo Kim
We report the room temperature sensing characteristics of Si nanowires (NWs) fabricated from p-Si wafers by a metal-assisted chemical etching method, which is a facile and low-cost method. X-ray diffraction was used to the study crystallinity and phase formation of Si NWs, and product morphology was examined using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). After confirmation of the Si NWs formation via the SEM and TEM micrographs, sensing tests were carried out at room temperature and it was found that the Si NWs sensor prepared from Si wafers with a resistivity of 0...
May 1, 2018: Nanotechnology
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#18
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29710318/a-3-dimensional-printed-short-segment-template-prototype-for-mandibular-fracture-repair
#19
Parul Sinha, Gary Skolnick, Kamlesh B Patel, Gregory H Branham, John J Chi
Importance: After reduction of complex mandibular fractures, contouring of the fracture plates to fixate the reduced mandibular segments can be time-consuming. Objective: To explore the potential application of a 3-dimensional (3-D)-printed short-segment mandibular template in the management of complex mandibular fractures. Design, Setting, and Participants: A feasibility study was performed at a tertiary academic center using maxillofacial computed tomography data of 3 patients with comminuted mandibular fractures who required preoperative planning with a perfected complete mandible model...
April 26, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29698865/mopeds-the-high-cost-of-cheap-and-poorly-legislated-transportation-for-negligent-drivers
#20
Gabriella Ode, Ronald Sing, Joseph Hsu, Rachel Seymour, Michael Bosse
INTRODUCTION: This study evaluates the impact of moped crashes in North Carolina, a state with lenient moped legislation by(1) describing the characteristics of moped crashes and (2) estimating the cost burden of moped-related injuries. METHODS: Health and public records of moped crash subjects treated at our hospital were reviewed. Direct costs were billed hospital charges. Indirect costs based on age and outcomes were calculated. RESULTS: Between 2008-2013, 368 subjects were involved in 373 moped crashes...
April 23, 2018: Accident; Analysis and Prevention
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