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Spine healthcare administration

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https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#1
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)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27859612/objectively-verified-parental-non-hip-major-osteoporotic-fractures-and-offspring-osteoporotic-fracture-risk-a-population-based-familial-linkage-study
#2
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)...
November 10, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27830448/estimating-the-effect-of-intravenous-acetaminophen-for-postoperative-pain-management-on-length-of-stay-and-inpatient-hospital-costs
#3
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...
November 9, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27814663/change-in-fracture-risk-and-fracture-pattern-after-bariatric-surgery-nested-case-control-study
#4
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
https://www.readbyqxmd.com/read/27742512/variability-in-standard-outcomes-of-posterior-lumbar-fusion-determined-by-national-databases
#5
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 (ICD-9 81...
October 11, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27235154/market-approval-processes-for-new-types-of-spinal-devices-challenges-and-recommendations-for-improvement
#6
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
https://www.readbyqxmd.com/read/26974835/effects-of-intraoperative-anesthetic-medications-on-postoperative-urinary-retention-after-single-level-lumbar-fusion
#7
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
https://www.readbyqxmd.com/read/26881322/inappropriate-ordering-of-lumbar-spine-magnetic-resonance-imaging-are-providers-choosing-wisely
#8
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 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/26361456/pediatric-spine-trauma-in-the-united-states-analysis-of-the-hcup-kid-s-inpatient-database-kid-1997-2009
#9
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
https://www.readbyqxmd.com/read/26114088/ninety-day-readmissions-after-degenerative-cervical-spine-surgery-a-single-center-administrative-database-study
#10
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
https://www.readbyqxmd.com/read/25714794/thirty-day-postoperative-mortality-among-individuals-with-hiv-infection-receiving-antiretroviral-therapy-and-procedure-matched-uninfected-comparators
#11
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
https://www.readbyqxmd.com/read/25184097/migration-to-the-icd-10-coding-system-a-primer-for-spine-surgeons-part-1
#12
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
https://www.readbyqxmd.com/read/25083354/national-trends-in-outpatient-surgical-treatment-of-degenerative-cervical-spine-disease
#13
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
https://www.readbyqxmd.com/read/24720312/recent-advances-in-the-prevention-and-management-of-complications-associated-with-routine-lumbar-spine-surgery
#14
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
https://www.readbyqxmd.com/read/23075284/explaining-clinical-behaviors-using-multiple-theoretical-models
#15
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
https://www.readbyqxmd.com/read/23070106/image-fusion-of-preprocedural-cta-with-real-time-fluoroscopy-to-guide-proper-hepatic-artery-catheterization-during-transarterial-chemoembolization-of-hepatocellular-carcinoma-a-feasibility-study
#16
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
https://www.readbyqxmd.com/read/22872069/the-contributions-of-first-nations-ethnicity-income-and-delays-in-surgery-on-mortality-post-fracture-a-population-based-analysis
#17
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
https://www.readbyqxmd.com/read/21781356/aluminium-exposure-from-parenteral-nutrition-in-preterm-infants-and-later-health-outcomes-during-childhood-and-adolescence
#18
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/21542947/fracture-prevention-in-postmenopausal-women
#19
REVIEW
Peter Vestergaard, Leif Mosekilde, Bente Langdahl
INTRODUCTION: The lifetime risk of fracture in white women is 20% for the spine, 15% for the wrist, and 18% for the hip, with an exponential increase in risk beyond the age of 50 years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of bisphosphonates to prevent fractures in postmenopausal women? What are the effects of pharmacological treatments other than bisphosphonates to prevent fractures in postmenopausal women? What are the effects of non-pharmacological treatments to prevent fractures in postmenopausal women? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review)...
2011: Clinical Evidence
https://www.readbyqxmd.com/read/21488247/who%C3%A2-s-in-the-driver-s-seat-the-influence-of-patient-and-physician-enthusiasm-on-regional-variation-in-degenerative-lumbar-spinal-surgery-a-population-based-study
#20
S Samuel Bederman, Peter C Coyte, Hans J Kreder, Nizar N Mahomed, Warren J McIsaac, James G Wright
STUDY DESIGN: Cross-sectional population-based study using administrative databases, census data, and surveys of orthopedic/neurosurgeons, family physicians (FPs) and patients in Ontario, Canada. OBJECTIVE: To determine the influence of the enthusiasm of patients, FPs, and surgeons for surgery on the regional variation in surgical rates for degenerative diseases of the lumbar spine (DDLS), such as spinal stenosis and degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: Rates of surgery and healthcare costs for treating DDLS have been increasing...
March 15, 2011: Spine
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