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https://www.readbyqxmd.com/read/29676679/principles-of-system-design-not-realized-for-pediatric-craniospinal-trauma-care-in-the-united-states
#1
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29665053/the-determinants-of-the-technical-efficiency-of-acute-inpatient-care-in-canada
#2
Li Wang, Michel Grignon, Sheril Perry, Xi-Kuan Chen, Alison Ytsma, Sara Allin, Katerina Gapanenko
OBJECTIVE: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. DATA SOURCES/STUDY SETTING: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. STUDY DESIGN: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only)...
April 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29582743/associations-between-provider-and-hospital-volumes-and-postoperative-mortality-following-total-hip-arthroplasty-in-new-brunswick-results-from-a-provincial-level-cohort-study
#3
Dan L Crouse, Philip S J Leonard, Jonathan Boudreau, James T McDonald
BACKGROUND: Several international studies have reported negative associations between hospital and/or provider volume and risk of postoperative death following total hip arthroplasty (THA). The only Canadian studies to report on this have been based in Ontario and have found no such association. We describe associations between postoperative deaths following THA and provider caseload volume, also adjusted for hospital volume, in a population-based cohort in New Brunswick. METHODS: Our analyses are based on hospital discharge abstract data linked to vital statistics and to patient registry data...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29566567/exploring-dutch-surgeons-views-on-volume-based-policies-a-qualitative-interview-study
#4
Roos Mesman, Marjan J Faber, Gert P Westert, Bart Berden
Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29529579/midwives-perceptions-of-women-s-preferences-related-to-midwifery-care-in-germany-a-focus-group-study
#5
Susanne Lohmann, Elke Mattern, Gertrud M Ayerle
OBJECTIVE: To explore how midwives perceive patient preferences related to midwifery care in Germany. DESIGN: This qualitative study, which was part of a larger study, used a hermeneutic-interpretive approach and involved focus group interviews with midwives. Data collection and analysis were done in a conjoined fashion between April 2015 and September 2016. SETTING: Four focus group interviews were conducted in four different federal states of Germany...
February 10, 2018: Midwifery
https://www.readbyqxmd.com/read/29519145/changes-in-the-practice-patterns-and-demographics-of-ontario-dermatologists
#6
Robert Micieli, Raed Alhusayen
BACKGROUND: Changes in the practice patterns and demographics of Canadian dermatologists remain largely unknown and would be helpful in assessing the future practice of dermatology across Canada. OBJECTIVE: To assess changes in the population of Ontario dermatologists over time and the factors that influence their practice patterns, caseload, and the procedures they perform. METHODS: A retrospective population-based analysis was performed using comprehensive administrative data on Ontario Health Insurance Plan insured dermatology visits and procedures from April 1, 2009, to March 31, 2015...
March 1, 2018: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29504226/impact-of-hospital-volume-and-surgeon-volume-on-robot-assisted-partial-nephrectomy-outcomes-a-multicenter-study
#7
Benoit Peyronnet, Lauranne Tondut, Jean-Christophe Bernhard, Christophe Vaessen, Nicolas Doumerc, Philippe Sebe, Benjamin Pradere, Bertrand Guillonneau, Zine-Eddine Khene, Francois-Xavier Nouhaud, Nicolas Brichart, Thomas Seisen, Quentin Alimi, Jean-Baptiste Beauval, Romain Mathieu, Adham Rammal, Alexandre De La Taille, Herve Baumert, Stéphane Droupy, Franck Bruyere, Morgan Roupret, Arnaud Mejean, Karim Bensalah
OBJECTIVE: To assess the impact of hospital volume (HV) and surgeon volume (SV) on perioperative outcomes of robot assisted partial nephrectomy (RAPN). PATIENTS AND METHODS: All consecutive patients who underwent a RAPN from 2009 to 2015 at eleven institutions were included in a retrospective study. To evaluate the impact of hospital volume we divided RAPN into four quartiles according to the caseload per year: low HV (<20/year); moderate HV (20-44/year); High HV (45-70/year); very high HV (>70/year)...
March 5, 2018: BJU International
https://www.readbyqxmd.com/read/29496100/pilot-study-of-the-financial-and-practice-protocol-impacts-of-canine-influenza-virus-h3n2-outbreaks-in-example-veterinary-practices
#8
Kennedy Mwacalimba, Annette Litster
Since March 2015, canine influenza virus (CIV) H3N2 has caused widespread outbreaks in dogs across the USA. The effects of local H3N2 outbreaks on veterinary practices were investigated using an online interface and followed with phone calls to respondents when necessary. An outbreak was defined as confirmed diagnosis of H3N2 by either PCR or serology in at least four dogs. Of 30 practices invited to participate, five met the entry criteria: at least one documented H3N2 outbreak in the previous 12 months, a predominantly (≥70%) small animal caseload, and adequate financial records to complete the survey...
March 1, 2018: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/29468657/comparative-analysis-of-the-outcomes-of-elective-abdominal-aortic-aneurysm-repair-in-england-and-sweden
#9
A Karthikesalingam, M J Grima, P J Holt, A Vidal-Diez, M M Thompson, A Wanhainen, M Bjorck, K Mani
BACKGROUND: There is substantial international variation in mortality after abdominal aortic aneurysm (AAA) repair; many non-operative factors influence risk-adjusted outcomes. This study compared 90-day and 5-year mortality for patients undergoing elective AAA repair in England and Sweden. METHODS: Patients were identified from English Hospital Episode Statistics and the Swedish Vascular Registry between 2003 and 2012. Ninety-day mortality and 5-year survival were compared after adjustment for age and sex...
February 22, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29468604/urinary-diversion-after-radical-cystectomy-for-bladder-cancer-comparing-trends-in-the-us-and-germany-from-2006-to-2014
#10
Christer Groeben, Rainer Koch, Martin Baunacke, Marianne Schmid, Angelika Borkowetz, Manfred P Wirth, Johannes Huber
OBJECTIVE: Our aim was to assess and compare trends of urinary diversion (UD) for patients receiving radical cystectomy for the treatment of bladder cancer in the US and Germany, and to investigate decisive predictors for the choice of UD. METHODS: We analyzed the nationwide German hospital billing database and the Nationwide Inpatient Sample (NIS) from 2006 to 2014. Cases with a bladder cancer diagnosis combined with RC were included, and trends in the choice of UD, transfusion rates, length of stay, and mortality were assessed...
February 21, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29457248/duty-hours-restriction-for-our-surgical-trainees-an-ethical-obligation-or-a-bad-idea
#11
REVIEW
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29398528/completeness-of-handwritten-preanaesthetic-records-at-two-veterinary-referral-institutions
#12
Alastair Mair, Alessandra Mathis
OBJECTIVE: To retrospectively analyse handwritten preanaesthetic records for completeness at two veterinary referral institutions: a university veterinary teaching hospital and a private veterinary referral hospital. To evaluate if emergency records were less complete compared with non-emergency records. Animal or Animal Population Two hundred and fifty preanaesthetic records at each referral institution. MATERIALS AND METHODS: Handwritten preanaesthetic records were analysed for completeness...
September 18, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29394265/impact-of-2015-earthquakes-on-a-local-hospital-in-nepal-a-prospective-hospital-based-study
#13
Samita Giri, Kari Risnes, Oddvar Uleberg, Tormod Rogne, Sanu Krishna Shrestha, Øystein Petter Nygaard, Rajendra Koju, Erik Solligård
INTRODUCTION: Natural disasters pose a great challenge to the health systems and individual health facilities. In low-resource settings, disaster preparedness systems are often limited and not been well described. Two devastating earthquakes hit Nepal within a 17-days period in 2015. This study aims to describe the burden and distribution of emergency cases to a local hospital. METHODS: This is a prospective observational study of patients presenting to a local hospital for a period of 21 days following the earthquake on April 25, 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29387145/provision-of-emergency-obstetric-care-at-secondary-level-in-a-conflict-setting-in-a-rural-area-of-afghanistan-is-the-hospital-fulfilling-its-role
#14
Daphne Lagrou, Rony Zachariah, Karen Bissell, Catherine Van Overloop, Masood Nasim, Hamsaya Nikyar Wagma, Shafiqa Kakar, Séverine Caluwaerts, Eva De Plecker, Renzo Fricke, Rafael Van den Bergh
Background: Provision of Emergency Obstetric and Neonatal Care (EmONC) reduces maternal mortality and should include three components: Basic Emergency Obstetric and Neonatal Care (BEmONC) offered at primary care level, Comprehensive EmONC (CEmONC) at secondary level and a good referral system in-between. In a conflict-affected province of Afghanistan (Khost), we assessed the performance of an Médecins Sans Frontières (MSF) run CEmONC hospital without a primary care and referral system...
2018: Conflict and Health
https://www.readbyqxmd.com/read/29383826/variation-in-practice-of-pouch-surgery-in-england-using-sword-data-to-cut-to-the-chase-and-justify-centralisation
#15
Nicola S Fearnhead, Matthew J Lee, Austin G Acheson, Guy Worley, Omar D Faiz, Steven R Brown
INTRODUCTION: Increasing scrutiny on both individual and unit outcomes after surgical procedures is now expected. In the field of inflammatory bowel disease, this is particularly pertinent for outcomes after ileoanal pouch surgery. METHODS: The Surgical Workload and Outcomes Research Database (SWORD) relies on administrative data derived from Hospital Episode Statistics (HES) collected in England. The platform was interrogated for pouch procedures undertaken in England between April 2009 and December 2016 to assess national case load, and, between April 2012 and December 2016, to assess variation in caseload and outcomes after pouch surgery...
January 31, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29376819/associations-between-provider-and-hospital-volumes-and-postoperative-mortality-following-total-hip-arthroplasty-in-new-brunswick-results-from-a-provincial-level-cohort-study
#16
Dan L Crouse, Philip S J Leonard, Jonathan Boudreau, James T McDonald
BACKGROUND: Several international studies have reported negative associations between hospital and/or provider volume and risk of postoperative death following total hip arthroplasty (THA). The only Canadian studies to report on this have been based in Ontario and have found no such association. We describe associations between postoperative deaths following THA and provider caseload volume, also adjusted for hospital volume, in a population-based cohort in New Brunswick. METHODS: Our analyses are based on hospital discharge abstract data linked to vital statistics and to patient registry data...
January 24, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29370066/abdominal-trauma-surgery-during-recent-u-s-combat-operations-from-2002-2016
#17
Zsolt T Stockinger, Caryn A Turner, Jennifer M Gurney
BACKGROUND: Abdominal surgery constitutes approximately 13% of surgical procedures performed for combat injuries. This study examines the frequencies and type of abdominal surgical procedures performed during recent U.S. Military operations. METHODS: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Role 2 (R2) and Role 3 (R3) medical treatment facilities (MTFs), from January 2002 to May 2016. The 273 ICD-9-CM procedure codes that were identified as abdominal surgical procedures were stratified into 24 groups based on anatomic and functional classifications and then grouped by whether or not they were laparoscopic...
January 24, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29351136/trends-and-variability-in-the-use-of-total-shoulder-arthroplasty-for-medicare-patients
#18
Benjamin Zmistowski, Eric M Padegimas, Michael Howley, Joseph Abboud, Gerald Williams, Surena Namdari
INTRODUCTION: As policies are implemented to encourage high-quality care, it is important to identify any persistent limitations to the uniform delivery of anatomic and reverse total shoulder arthroplasty (TSA). The study's goal was to assess current TSA use and identify predictors of geographic variability. METHODS: We used data from 2012 through 2014 that was obtained from public Medicare databases to identify the case volume, locations, and names of surgeons performing >10 TSAs annually...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29341048/intrapartum-care-working-patterns-of-midwives-the-long-road-to-models-of-care-in-germany
#19
Mechthild M Gross, Claire Michelsen, Bernhard Vaske, Sonja Helbig
INTRODUCTION: Midwifery models of care help to enhance perinatal health outcomes, women's satisfaction, and continuity of care. Despite the ubiquitous presence of certified midwives at births in Germany, no research has investigated the diversity of midwives' practice patterns. Describing the variety of working patterns through which midwives provide intrapartum care may contribute to improving the organisation of midwifery services. METHODS: This cross-sectional survey took place in the region of Hannover and Hildesheim, Germany...
January 16, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29329964/is-quality-of-registry-treatment-data-related-to-registrar-experience-and-workload-a-study-of-taiwan-cancer-registry-data
#20
Chin-Ying Cheng, Chun-Ju Chiang, Cheng-Hsing Hsieh, You-Kang Chang, Mei-Shu Lai
BACKGROUND: Although cancer treatment information has been collected through the Cancer Registry system in Taiwan for more than 10 years, the accuracy of such data has never been evaluated. This study examined the accuracy rate between registrar experience and on-site chart review for the first course of cancer treatment. METHODS: In this retrospective chart review study, 392 randomly selected medical records from 14 hospitals were re-abstracted by experienced abstractors...
January 10, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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