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Amir Ghaferi

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https://www.readbyqxmd.com/read/28767560/variation-in-bariatric-surgery-episode-costs-in-the-commercially-insured-implications-for-bundled-payments-in-the-private-sector
#1
Alexander C Kelsall, Ruth Cassidy, Amir A Ghaferi
OBJECTIVE: To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND: Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in the Medicare population found that the index hospitalization is responsible for the majority of payment variation among hospitals. However, this research largely excluded SG, now the most commonly performed bariatric surgery procedure nationally...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28746723/factors-associated-with-achieving-a-body-mass-index-of-less-than-30-after-bariatric-surgery
#2
Oliver A Varban, Ruth B Cassidy, Aaron Bonham, Arthur M Carlin, Amir Ghaferi, Jonathan F Finks
Importance: Achieving a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of less than 30 is an important goal of bariatric surgery, given the increased risk for weight-related morbidity and mortality with a BMI above this threshold. Objective: To identify predictors for achieving a BMI of less than 30 after bariatric surgery. Design, Setting, and Participants: This retrospective study used data from the Michigan Bariatric Surgery Collaborative, a statewide quality improvement collaborative that uses a prospectively gathered clinical data registry...
July 26, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28730276/effect-of-patient-reported-smoking-status-on-short-term-bariatric-surgery-outcomes
#3
Michael Inadomi, Rahul Iyengar, Ilana Fischer, Xing Chen, Emily Flagler, Amir A Ghaferi
INTRODUCTION: Preoperative patient screening is a major contributor to the remarkable safety of bariatric surgery. Smoking status is a modifiable patient risk factor, and smoking cessation is associated with improved outcomes in surgical patients. However, the length of smoking cessation necessary to optimize bariatric surgery patient outcomes is not yet defined. We sought to explore the relationship between patient-reported smoking status and short-term bariatric surgery outcomes. METHODS: Using prospectively collected data from the MBSC registry, we evaluated the effects of patient-reported length of tobacco abstinence on 30-day surgical outcomes...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28686537/far-from-standardized-using-surgical-videos-to-identify-variation-in-technique-for-laparoscopic-sleeve-gastrectomy
#4
Oliver A Varban, Adam Niemann, Amanda Stricklen, Rachel Ross, Amir A Ghaferi, Jonathan F Finks, Justin B Dimick
BACKGROUND: Video assessment is an emerging tool for understanding variation in surgical technique. METHODS: Representative videos of laparoscopic sleeve gastrectomy (LSG) were voluntarily submitted by 20 surgeons who participated in a statewide quality improvement collaborative. The amount of time required to complete the salient steps of the operation was measured and variations in the tasks performed during each step were captured. RESULTS: Twenty-two videos of LSG were submitted and 11 videos included concurrent hiatal hernia repair...
August 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28636703/transforming-the-national-surgical-quality-improvement-program-to-the-delivery-of-precision-medicine-to-improve-the-value-of-surgical-care-summary-of-the-john-r-clarke-keynote-address-for-the-surgical-outcomes-club-2016-annual-meeting
#5
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#6
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593215/cutting-edge-efforts-in-surgical-patient-safety
#7
Thomas K Varghese, Amir A Ghaferi
No abstract text is available yet for this article.
August 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28486391/effect-of-surgeon-age-on-bariatric-surgery-outcomes
#8
Haley Stevens, Arthur M Carlin, Rachel Ross, Amanda Stricklen, Michael H Wood, Amir A Ghaferi
OBJECTIVE: This study sought to explore the relationship of bariatric surgeon age and patient outcomes. BACKGROUND: Regulators, policy makers, and patient advocacy groups have recently been pushing to establish clear guidelines for physician retirement in the United States. Although it is often assumed that increasing physician age leads to worse patient outcomes, the relationship is lacking robust evidence, and is still unclear. METHODS: We conducted a study analyzing all bariatric surgeons in Michigan who participated in a statewide collaborative quality improvement program (n = 71) who performed primary laparoscopic Roux-en-Y Gastric Bypass, or sleeve gastrectomy operations, and data on their patients (n = 60430) over the past 10 years...
May 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28445566/variation-in-outcomes-at-bariatric-surgery-centers-of-excellence
#9
Andrew M Ibrahim, Amir A Ghaferi, Jyothi R Thumma, Justin B Dimick
Importance: In the United States, reports about perioperative complications associated with bariatric surgery led to the establishment of accreditation criteria for bariatric centers of excellence and many bariatric centers obtaining accreditation. Currently, most bariatric procedures occur at these centers, but to what extent they uniformly provide high-quality care remains unknown. Objective: To describe the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers...
July 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28425841/adipocyte-hypertrophy-hyperplasia-balance-contributes-to-weight-loss-after-bariatric-surgery
#10
Lindsey A Muir, Nicki A Baker, Alexandra R Washabaugh, Christopher K Neeley, Carmen G Flesher, Jennifer B DelProposto, Lynn M Geletka, Amir A Ghaferi, Jonathan F Finks, Kanakadurga Singer, Oliver A Varban, Carey N Lumeng, Robert W O'Rourke
Predictors of weight loss responses are not well-defined. We hypothesized that adipose tissue phenotypic features related to remodeling would be associated with bariatric surgery weight loss responses. Visceral and subcutaneous adipose tissues collected from patients during bariatric surgery were studied with flow cytometry, immunohistochemistry, and QRTPCR, and results correlated with weight loss outcomes. Age, male sex, and a diagnosis of type 2 diabetes were associated with less weight loss. Adipocyte size was increased and preadipocyte frequency was decreased in visceral adipose tissue from diabetic subjects...
April 3, 2017: Adipocyte
https://www.readbyqxmd.com/read/28359093/diabetes-specific-regulation-of-adipocyte-metabolism-by-the-adipose-tissue-extracellular-matrix
#11
Nicki A Baker, Lindsey A Muir, Alexandra R Washabaugh, Christopher K Neeley, Sophie Yu-Pu Chen, Carmen G Flesher, John Vorwald, Jonathan F Finks, Amir A Ghaferi, Michael W Mulholland, Oliver A Varban, Carey N Lumeng, Robert W O'Rourke
Context: The role of the extracellular matrix (ECM) in regulating adipocyte metabolism in the context of metabolic disease is poorly defined. Objective: The objective of this study was to define the metabolic phenotype of adipocytes associated with human diabetes (DM) and the role of the ECM in regulating adipocyte metabolism. Design: Adipose tissues from obese patients were studied in standard 2-dimensional (2D) cell culture and an in vitro model of decellularized adipose tissue ECM repopulated with human adipocytes, and results were correlated with DM status...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28306648/site-specific-approach-to-reducing-emergency-department-visits-following-surgery
#12
Hassaan Abdel Khalik, Haley Stevens, Arthur M Carlin, Amanda Stricklen, Rachel Ross, Carl Pesta, Jonathan F Finks, Andrew Ibrahim, Amir A Ghaferi
OBJECTIVE: The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. SUMMARY OF BACKGROUND DATA: Many ED visits following bariatric surgery do not result in readmission and may be preventable. Little research exists evaluating the efficacy of perioperative measures aimed at reducing ED visits in this population. Therefore, understanding the driving factors behind these preventable ED visits may be a fruitful approach to prevention...
March 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28169205/evaluating-organizational-factors-associated-with-postoperative-bariatric-surgery-readmissions
#13
Ryan Macht, Ruth Cassidy, Howard Cabral, Lewis E Kazis, Amir Ghaferi
BACKGROUND: Several patient and surgical characteristics have been identified as risk factors for readmission after bariatric surgery, but there is a paucity of information on how organizational factors influence this metric. OBJECTIVE: To evaluate the association between readmissions and several organizational factors, including compliance with best practices to reduce unplanned hospital visits, major complication rates, and the emergency department-sourced readmission (EDSR) rate...
January 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27706473/variation-in-medicare-expenditures-for-treating-perioperative-complications-the-cost-of-rescue
#14
Jason C Pradarelli, Mark A Healy, Nicholas H Osborne, Amir A Ghaferi, Justin B Dimick, Hari Nathan
Importance: Treating surgical complications presents a major challenge for hospitals striving to deliver high-quality care while reducing costs. Costs associated with rescuing patients from perioperative complications are poorly characterized. Objective: To evaluate differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. Design, Setting, and Participants: Retrospective cohort study using claims data from the Medicare Provider Analysis and Review files...
December 21, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27611481/are-patient-reported-outcomes-correlated-with-clinical-outcomes-after-surgery-a-population-based-study
#15
Jennifer F Waljee, Amir Ghaferi, Ruth Cassidy, Oliver Varban, Jonathan Finks, Kevin C Chung, Noelle E Carlozzi, Justin B Dimick
OBJECTIVE: To evaluate the extent to which patient-reported outcomes (PROs) (eg, health-related quality of life) are distinct from clinical outcomes following bariatric surgery. BACKGROUND: Hospital quality measurement often focuses on traditional clinical outcomes (eg, complications). However, PROs may provide a unique perspective regarding performance, particularly for common, low-risk procedures. METHODS: We used data from 11,420 patients who underwent bariatric surgery (2008-2012) from the Michigan Bariatric Surgery Collaborative (39 hospitals)...
October 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27607102/hospital-quality-and-medicare-expenditures-for-bariatric-surgery-in-the-united-states
#16
Andrew M Ibrahim, Amir A Ghaferi, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To examine the relationship between hospital outcomes and expenditures in patients undergoing bariatric surgery in the United States. BACKGROUND: As one of the most common surgical procedures in the United States, bariatric surgery is a major focus of policy reforms aimed at reducing surgical costs. These policy mechanisms have made it imperative to understand the potential cost savings of quality-improvement initiatives. METHODS: We performed a retrospective review of 38,374 Medicare beneficiaries undergoing bariatric surgery between 2011 and 2013...
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27324569/surgical-skill-in-bariatric-surgery-does-skill-in-one-procedure-predict-outcomes-for-another
#17
COMPARATIVE STUDY
Oliver A Varban, Caprice C Greenberg, Jon Schram, Amir A Ghaferi, Joythi R Thumma, Arthur M Carlin, Justin B Dimick
BACKGROUND: Recent data establish a strong link between peer video ratings of surgical skill and clinical outcomes with laparoscopic gastric bypass. Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. METHODS: Twenty surgeons voluntarily submitted videos of a standard laparoscopic gastric bypass procedure, which was blindly rated by 10 or more peers using a modified version of the Objective Structured Assessment of Technical Skills...
November 2016: Surgery
https://www.readbyqxmd.com/read/27097015/the-behavior-and-biology-behind-bariatric-surgery-outcomes
#18
Amir A Ghaferi, Marilyn Woodruff, Jenna Arnould
No abstract text is available yet for this article.
August 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/26790400/revisiting-nursing-s-effect-on-surgical-quality-and-cost
#19
Amir A Ghaferi, Christopher R Friese
No abstract text is available yet for this article.
June 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/26506567/hospital-variation-in-perioperative-complications-for-laparoscopic-sleeve-gastrectomy-in-michigan
#20
Jason C Pradarelli, Oliver A Varban, Amir A Ghaferi, Matthew Weiner, Arthur M Carlin, Justin B Dimick
BACKGROUND: Laparoscopic sleeve gastrectomy has surpassed gastric bypass and laparoscopic adjustable gastric banding recently as the most common weight-loss procedure. Previously, substantial concerns existed regarding variation in perioperative safety with bariatric surgery. This study aimed to assess rates of perioperative complications for laparoscopic sleeve gastrectomy across hospitals and in relation to procedure volume within the Michigan Bariatric Surgery Collaborative. STUDY DESIGN: We analyzed 8,693 patients who underwent laparoscopic sleeve gastrectomy from 2013 through 2014 across 40 hospitals in the Michigan Bariatric Surgery Collaborative...
April 2016: Surgery
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