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Spine healthcare administration

Mario Bressan-Neto, Carlos Fernando Pereira da Silva Herrero, Lilian Maria Pacola, Altacílio Aparecido Nunes, Helton Luiz Aparecido Defino
OBJECTIVE: Underfunding of the surgical treatment of complex spinal deformities has been an important reason for the steadily growing waiting lists in publicly funded healthcare systems. The aim of this study is to characterize the management of the treatment of spinal deformities in the public healthcare system. METHODS: A cross-sectional study of 60 patients with complex pediatric spinal deformities waiting for treatment in December 2013 was performed. The evaluated parameters were place of origin, waiting time until first assessment at a specialized spine care center, waiting time for the surgical treatment, and need for implants not reimbursed by the healthcare system...
August 2017: Clinics
Sean D Rundell, Laura S Gold, Ryan N Hansen, Brian W Bresnahan
RATIONALE, AIMS AND OBJECTIVES: To assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. METHODS: We conducted a retrospective cohort study using administrative claims data from 2007-2011. We included individuals ≥18 years with an index visit for back pain. Co-morbidities were measured 12 months prior to index. Co-morbidity burden was measured using Quan's Co-morbidity Index. Co-morbidities categories were measured using chronic condition indicators from the Agency for Healthcare Research and Quality...
December 2017: Journal of Evaluation in Clinical Practice
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
January 2017: Journal of Hand Surgery
Shuman Yang, William D Leslie, Randy Walld, Leslie L Roos, Suzanne N Morin, Sumit R Majumdar, Lisa M Lix
Parental hip fracture (HF) is associated with increased risk of offspring major osteoporotic fractures (MOFs; comprising hip, forearm, clinical spine or humerus fracture). Whether other sites of parental fracture should be used for fracture risk assessment is uncertain. The current study tested the association between objectively-verified parental non-hip MOF and offspring incident MOF. Using population-based administrative healthcare data for the province of Manitoba, Canada, we identified 255,512 offspring with linkage to at least one parent (238,054 mothers and 209,423 fathers)...
April 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
E Eve Shaffer, An Pham, Robert L Woldman, Andrew Spiegelman, Scott A Strassels, George J Wan, Thomas Zimmerman
INTRODUCTION: The provision of safe, effective, cost-efficient perioperative inpatient acute pain management is an important concern among clinicians and administrators within healthcare institutions. Overreliance on opioid monotherapy in this setting continues to present health risks for patients and increase healthcare costs resulting from preventable adverse events. The goal of this study was to model length of stay (LOS), potential opioid-related complications, and costs for patients reducing opioid use and adding intravenous acetaminophen (IV APAP) for management of postoperative pain...
January 2017: Advances in Therapy
Catherine Rousseau, Sonia Jean, Philippe Gamache, Stéfane Lebel, Fabrice Mac-Way, Laurent Biertho, Laëtitia Michou, Claudia Gagnon
OBJECTIVE:  To investigate whether bariatric surgery increases the risk of fracture. DESIGN:  Retrospective nested case-control study. SETTING:  Patients who underwent bariatric surgery in the province of Quebec, Canada, between 2001 and 2014, selected using healthcare administrative databases. PARTICIPANTS:  12 676 patients who underwent bariatric surgery, age and sex matched with 38 028 obese and 126 760 non-obese controls...
July 27, 2016: BMJ: British Medical Journal
Jacob R Joseph, Brandon W Smith, Paul Park
OBJECTIVE: National databases are used with increasing frequency in spine surgery literature to evaluate patient outcomes. The differences between individual databases in relationship to outcomes of lumbar fusion are not known. We evaluated the variability in standard outcomes of posterior lumbar fusion between the University HealthSystem Consortium (UHC) database and the Healthcare Cost and Utilization Project National Inpatient Sample (NIS). METHODS: NIS and UHC databases were queried for all posterior lumbar fusions (International Classification of Diseases, Ninth Revision code 81...
January 2017: World Neurosurgery
Arno Bisschop, Maurits W van Tulder
BACKGROUND: Spinal pathology and related symptoms are among the most common health problems and are associated with high health care costs and productivity losses. Due to the aging population, these costs are further increasing every year. Another important reason for the increasing costs is the market approval of new technologies, such as spinal devices that are usually more expensive than the existing technologies. Previous cases of medical device failure led to concern about possible deficiencies in the market approval process...
September 2016: European Spine Journal
Benjamin C Mayo, Philip K Louie, Daniel D Bohl, Dustin H Massel, Stephanie E Iantorno, Junyoung Ahn, Ehsan Tabaraee, Krishna D Modi, William W Long, Kern Singh
STUDY DESIGN: Retrospective cohort analysis. OBJECTIVE: The aim of the study was to identify medications that may potentially contribute to developing postoperative urinary retention (POUR) after lumbar spinal fusion procedures. SUMMARY OF BACKGROUND DATA: POUR is a concerning event that may occur after routine orthopedic surgery. The relation between intraoperative medications and POUR after lumbar spine surgery has not been well characterized...
September 15, 2016: Spine
Risha Gidwani, Patricia Sinnott, Tigran Avoundjian, Jeanie Lo, Stevem M Asch, Paul G Barnett
OBJECTIVES: To analyze inappropriate use of magnetic resonance imaging (MRI) for patients with low back pain in a healthcare system with no financial incentives for overuse. STUDY DESIGN: We used administrative data to assess the appropriateness of lumbar spine (LS) MRI in the Veterans Health Administration. METHODS: All veterans who received LS MRI in the outpatient setting in fiscal year 2012 were included. We based our assessments of appropriateness on CMS criteria, which have been endorsed by the National Quality Forum...
February 1, 2016: American Journal of Managed Care
Sergio Mendoza-Lattes, Javier Besomi, Cormac O'Sullivan, Zachary Ries, Gnanapragasam Gnanapradeep, Rachel Nash, Yubo Gao, Stuart Weinstein
BACKGROUND: Few references are available describing the epidemiology of pediatric spine injuries. The purpose of this study is to examine the prevalence, risk factors and trends during the period from 1997 to 2009 of pediatric spine injuries in the United States using a large national database. METHODS: Data was obtained from the Kid's Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP), for the years 1997-2009. This data includes >3 million discharges from 44 states and 4121 hospitals on children younger than 20 years...
2015: Iowa Orthopaedic Journal
Chibuikem Akamnonu, Thomas Cheriyan, Jeffrey A Goldstein, Thomas J Errico, John A Bendo
BACKGROUND: Unplanned hospital readmissions result in significant clinical and financial burdens to patients and the healthcare system. Readmission rates and causes have been investigated using large administrative databases which have certain limitations in data reporting and coding. The objective of this study was to provide a description of 90 day post-discharge readmissions following surgery for common degenerative cervical spine pathologies at a large-volume tertiary hospital. The study also compared the readmission rates of patients who underwent anterior- and posterior-approach procedures...
2015: International Journal of Spine Surgery
Joseph T King, Melissa F Perkal, Ronnie A Rosenthal, Adam J Gordon, Stephen Crystal, Maria C Rodriguez-Barradas, Adeel A Butt, Cynthia L Gibert, David Rimland, Michael S Simberkoff, Amy C Justice
IMPORTANCE: Antiretroviral therapy (ART) has converted human immunodeficiency virus (HIV) infection into a chronic condition, and patients now undergo a variety of surgical procedures, but current surgical outcomes are inadequately characterized. OBJECTIVE: To compare 30-day postoperative mortality in patients with HIV infection receiving ART with the rates in uninfected individuals. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of nationwide electronic medical record data from the US Veterans Health Administration Healthcare System, October 1, 1996, to September 30, 2010...
April 2015: JAMA Surgery
Gazanfar Rahmathulla, H Gordon Deen, Judith A Dokken, Stephen M Pirris, Mark A Pichelmann, Eric W Nottmeier, Ronald Reimer, Robert E Wharen
BACKGROUND: On 1 October 2015, a new federally mandated system goes into effect requiring the replacement of the International Classification of Disease-version 9-Clinical Modification (ICD-9-CM) with ICD-10-CM. These codes are required to be used for reimbursement and to substantiate medical necessity. ICD-10 is composite with as many as 141,000 codes, an increase of 712% when compared to ICD-9. METHODS: Execution of the ICD-10 system will require significant changes in the clinical administrative and hospital-based practices...
2014: Surgical Neurology International
Evan O Baird, Natalia N Egorova, Steven J McAnany, Sheeraz A Qureshi, Andrew C Hecht, Samuel K Cho
Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age > 20 years)...
August 2014: Global Spine Journal
Louis G Jenis, Wellington K Hsu, Joseph R O'Brien, Peter G Whang
Lumbar spine surgery is often associated with complications in the perioperative and postoperative periods. Evidence-based literature in the prevention and management of adverse events, including surgical site infection, venous thromboembolism, and positioning-related complications, has advanced the understanding of the etiology of these complications and preventive measures. Cost-effective measures to reduce intraoperative bleeding can lead to a lower incidence of infection, disease transmission, and morbidity in the postoperative period...
2014: Instructional Course Lectures
Martin P Eccles, Jeremy M Grimshaw, Graeme MacLennan, Debbie Bonetti, Liz Glidewell, Nigel B Pitts, Nick Steen, Ruth Thomas, Anne Walker, Marie Johnston
BACKGROUND: In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change...
2012: Implementation Science: IS
Irene Bargellini, Francesca Turini, Elena Bozzi, Dario Lauretti, Antonio Cicorelli, Alessandro Lunardi, Roberto Cioni, Carlo Bartolozzi
PURPOSE: To assess feasibility of proper hepatic artery catheterization using a 3D model obtained from preprocedural computed tomographic angiography (CTA), fused with real-time fluoroscopy, during transarterial chemoembolization of hepatocellular carcinoma. METHODS: Twenty consecutive cirrhotic patients with hepatocellular carcinoma undergoing transarterial chemoembolization were prospectively enrolled onto the study. The early arterial phase axial images of the preprocedural CTA were postprocessed on an independent workstation connected to the angiographic system (Innova 4100; GE Healthcare, Milwaukee, WI), obtaining a 3D volume rendering image (VR) that included abdominal aorta, splanchnic arteries, and first and second lumbar vertebrae...
April 2013: Cardiovascular and Interventional Radiology
W D Leslie, S L Brennan, H J Prior, L M Lix, C Metge, B Elias
UNLABELLED: We examined the independent contributions of First Nations ethnicity and lower income to post-fracture mortality. A similar relative increase in mortality associated with fracture appears to translate into a larger absolute increase in post-fracture mortality for First Nations compared to non-First Nations peoples. Lower income also predicted increased mortality post-fracture. INTRODUCTION: First Nations peoples have a greater risk of mortality than non-First Nations peoples...
April 2013: Osteoporosis International
Mary S Fewtrell, Caroline J Edmonds, Elizabeth Isaacs, Nick J Bishop, Alan Lucas
Aluminium is the most common metallic element, but has no known biological role. It accumulates in the body when protective gastrointestinal mechanisms are bypassed, renal function is impaired, or exposure is high - all of which apply frequently to preterm infants. Recognised clinical manifestations of aluminium toxicity include dementia, anaemia and bone disease. Parenteral nutrition (PN) solutions are liable to contamination with aluminium, particularly from acidic solutions in glass vials, notably calcium gluconate...
August 2011: Proceedings of the Nutrition Society
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