Retrospective review. To determine the correlation of surgeon/hospital volume with complication/mortality rates and with in-hospital health care utilization in lumbar spine surgery. Studies have shown improved outcomes in patients treated by high-volume surgeons and hospitals. To our knowledge, no studies evaluate this relationship for lumbar spine surgery. To evaluate the ...

This study assessed the efficacy of a 'dry' hydrogen peroxide vapour decontamination in an Australian hospital via a two-armed study. The in vivo arm examined the baseline bacterial counts in high-touch zones within wards and evaluated the efficacy of cleaning with a neutral detergent followed by either hydrogen peroxide vapour decontamination, ...

Objective To understand how the source of information affects different adverse event (AE) surveillance methods. Design Retrospective analysis of inpatient adverse drug events (ADEs) and hospital-associated infections (HAIs) detected by either a computerized surveillance system (CSS) or manual chart review (MCR). Measurement Descriptive analysis of events detected using the two ...

: To estimate the effects of surgeon and hospital volume on perioperative morbidity and mortality in women who underwent hysterectomy for endometrial cancer. : Patients who underwent abdominal hysterectomy for endometrial cancer between 2003 and 2007 and who recorded in an inpatient, acute-care database were examined. Procedure-associated intraoperative, perioperative, and ...

Specialty hospitals have lower mortality rates for cardiac revascularization than general hospitals, but previous studies have found that this advantage disappears after adjusting for patient characteristics and hospital procedural volume. Questions have been raised about whether simultaneous relationships between volume and mortality might have biased these analyses. We use two-stage ...

OBJECTIVES: To assess the relationship between hospital volume and in-hospital mortality of patients undergoing four surgical procedures for gastrointestinal cancers in Korea. METHODS: Using the database of the Health Insurance Review and Assessment Service, we identified 66,201 patients who underwent the four types of gastrointestinal resection during the period 2005-2006. ...

STUDY OBJECTIVE: Current guidelines recommend that ST-elevation myocardial infarction (STEMI) patients receive percutaneous coronary intervention less than or equal to 90 minutes from first medical contact, preferably at high-volume percutaneous coronary intervention centers (≥400 percutaneous coronary interventions annually). Because many patients present to low-volume or non-percutaneous coronary intervention-capable STEMI referral ...

OBJECTIVES: To evaluate associations among hospital volume, costs, and length of stay (LOS) and to assess whether reduced hospital cost of care adversely affected quality of care. DESIGN: Four-year, nationwide, population-based study. SETTING: Data were obtained from claims submitted to the South Korean National Health Insurance database. PATIENTS: We identified ...

PURPOSE: We analyzed the impact of hospital volume and laser use on postoperative complications and in-hospital mortality in transurethral prostatic surgery. MATERIALS AND METHODS: We evaluated data from 18,578 patients in 686 hospitals who underwent transurethral prostatic surgery between July and December, 2006 to 2008, using the Diagnosis Procedure Combination ...

BACKGROUND: ERCP practice patterns in the United States are largely unknown. OBJECTIVE: To characterize the ERCP practice of U.S. gastroenterologists, stratified by their annual case volume: high volume (HV, >200), moderate volume (MV, 50-200), and low volume (LV, <50). DESIGN: Anonymous electronic survey. SUBJECTS: American Society for Gastrointestinal Endoscopy members ...

To evaluate the impact of surgeon and hospital case volume and other related variables on short-term outcomes after surgery for oropharyngeal cancer. The Maryland Health Service Cost Review Commission database was queried for oropharyngeal cancer surgical case volumes from 1990 to 2009. Multivariable regression models were used to identify significant ...

The Leapfrog Group established a minimum hospital case volume of 13 for esophageal resection in a response to known improved outcomes in larger volume centers. The aim of this study was to evaluate variation in short-term outcomes among hospitals that met the Leapfrog volume criteria. Using the Washington State Comprehensive ...

: This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals. : Little is known about the variation between hospitals in 30-day mortality after CRC surgery, and the impact ...

OBJECTIVE:: To evaluate the association between systems characteristics and esophagectomy mortality at low-volume hospitals BACKGROUND:: High-volume hospitals have lower esophagectomy mortality rates, but receiving care at such centers is not always feasible. We examined low-volume hospitals and sought to identify characteristics of those with better outcomes. METHODS:: Using national data ...

OBJECTIVE: Positive volume-outcome relationships exist for diseases treated with technically complex surgery. Contemporary patterns of oropharyngeal cancer surgery by hospital and surgeon volume are poorly defined. METHODS: The Maryland Health Service Cost Review Commission database was queried for hospital and surgeon oropharyngeal cancer surgical case volumes from 1990 to 2009. ...

OBJECTIVE: We analyzed use of venous thromboembolism (VTE) prophylaxis in patients undergoing oncologic surgery and examined the influence of surgeon and hospital characteristics on prophylaxis. BACKGROUND: Cancer patients undergoing surgery are at high-risk for VTE. Despite the risk of VTE, the use of prophylaxis is variable. Little is known about ...

Study Type - Therapy (cohort) Level of Evidence 2b OBJECTIVE: • To provide updated figures on urinary diversion, length of stay and mortality after cystectomy in two regions of northern Italy. PATIENTS AND METHODS: • Discharge records of patients undergoing cystectomy for bladder cancer in 2000-2008 were extracted from the regional archives of ...

ACADEMIC EMERGENCY MEDICINE 2011; 18:158-166 © 2011 by the Society for Academic Emergency Medicine ABSTRACT: Objectives:  The objective was to describe the emergency department (ED) resource burden of the spring 2009 H1N1 influenza pandemic at U.S. children's hospitals by quantifying observed-to-expected utilization. Methods:  The authors performed an ecologic analysis for ...

CONTEXT: There is an ongoing debate about centralisation of radical cystectomy (RC) procedures. OBJECTIVE: To conduct a systematic review of the literature on the volume-outcome relationship for RC for bladder cancer (BCa) with consideration for the methodologic quality of the available evidence and to perform a meta-analysis on the studies ...

BACKGROUND:: Little information is available on the relationship between hospital volume and compliance with clinical practice guidelines (CPGs). OBJECTIVES:: To investigate the relationship between hospital volume and compliance with CPGs using a Japanese administrative database. DESIGN AND SUBJECTS:: This was an observational study that included 60,842 patients with acute cholangitis ...

Congestive heart failure (CHF) is common and costly, and outcomes remain suboptimal despite pharmacologic and technical advances. To examine whether hospitals with more experience in caring for patients with CHF provide better, more efficient care. Retrospective cohort study. 4095 hospitals in the United States. Medicare fee-for-service patients with a primary ...

BACKGROUND: Community emergency physicians (EPs) are often required to respond to unstable patients outside of their department during off-hours. OBJECTIVE: The primary objective of this study was to describe the critical care responsibility of community EPs outside of their departments. METHODS: A one-page survey was mailed to emergency department (ED) ...

OBJECTIVES: To investigate access to surgical care for endometrial cancer in Arizona. METHODS: The Arizona HealthQuery (AZHQ) data warehouse with claims information on over 7million patients in Arizona was searched using the International Classification of Disease (ICD-9) codes and Current Procedural Terminology (CPT) codes for endometrial cancer surgery from 2005 ...

Limited studies have examined electronic prescribing (e-prescribing) adoption in physician office practices. Specifically, none have explored the influence of payer mix on e-prescribing adoption among physicians. This study examines the impact of practice composition of Medicare, Medicaid, and private insurance on e-prescribing adoption among physicians. Logistic regression was used to ...

Academic research investigating health care costs in the Palestinian region is limited. Therefore, this study examines the costs of the cardiac catheterization unit of one of the largest hospitals in Palestine. We focus on costs of a cardiac catheterization unit and the increasing number of deaths over the past decade ...

To evaluate the impact of surgeon and hospital case volume and other related variables on short-term outcomes after surgery for laryngeal cancer. The Maryland Health Service Cost Review Commission database was queried for laryngeal cancer surgical case volumes from 1990 to 2009. Multivariate logistic regression analyses and multiple linear regression ...

Many physicians are familiar with the parotid duct and the Danish physician/anatomist's name associated with it. However, most are unaware of Niels Stensen's life and his significant contributions to the early study of the brain. This physician of the Medici court was clearly ahead of his time and found errors ...

Higher hospital surgical volumes have been associated with lower complication rates following total-hip replacement. The objective of this study was to identify the characteristics of patients who undergo total-hip replacement at high-volume hospitals and their differences from those who receive care at low-volume hospitals. Discharge data from patients undergoing total ...

Primary percutaneous coronary intervention (PCI) is an important treatment option for patients with acute myocardial infarction (MI). Although an inverse association between a hospital's PCI volume and in-hospital mortality has been observed in Western studies, previous Japanese investigations have not found any such relationship. A retrospective analysis of 8,391 cases ...

In this community-based study, we assessed the advantages of laparoscopic gastrectomy (LG) and the impact of volume-related hospital characteristics on gastrectomy care. The quality of gastrectomy care and the potential effects of volume-related hospital characteristics on gastrectomy care have not been comprehensively evaluated to date. We used a Japanese administrative ...

Aims To quantify the determinants of primary percutaneous coronary intervention (PCI) performance in England and Wales between 2004 and 2007. Methods and results All 8653 primary PCI cases admitted to acute hospitals in England and Wales as recorded in the Myocardial Ischaemia National Audit Project (MINAP) 2004-2007. We studied the ...

Evidence-based hospital referral (EBHR) is a Leapfrog group quality metric based primarily on hospital procedural volume. It has yet to be determined if EBHR has led to regionalized surgical care and whether it has improved patient outcomes. We conducted a before and after cohort study of 13,157 adults (1994 to ...

Disparities in limb salvage procedures may be driven by socioeconomic status (SES) and access to high-volume hospitals. We sought to identify SES factors associated with major amputation in the setting of critical limb ischemia (CLI). The 2003-2007 Nationwide Inpatient Sample was queried for discharges containing lower extremity revascularization (LER) or ...

Hospital cystectomy volume has been associated with in-hospital perioperative mortality in previous studies. In this study, we examine the relationship between hospital cystectomy volume and 90-day mortality in a population-based cohort of patients undergoing cystectomy for bladder cancer. We performed a retrospective cohort study using population from the State of ...

Objectives:  Ongoing efforts to improve access to emergency care and emergency department (ED) staffing would benefit from a better understanding of the distribution of EDs in the United States by size and location. This article describes the distribution of U.S. ED visit volumes according to ED urban versus rural status. ...

Little is known about how often patients have revision total hip replacement in the same hospital in which they had the primary procedure. We examined Medicare claims data to identify patients who had primary total hip replacement from July 1995 to June 1996 and subsequently had revision through December 31, ...

/st> To compare process designs of three high-volume cataract pathways in a lean thinking framework and to explore how efficiency in terms of lead times, hospital visits and costs is related to process design. /st> International retrospective comparative benchmark study with a mixed-method design. /st> Three eye hospitals in the ...

INTRODUCTION: Close to 30,000 people die of cirrhosis in the USA each year. Previous studies have shown a survival advantage with high-volume (HV) hospitals for complex surgical procedures. We examined whether a volume benefit exists for hospitals dealing with specialized disorders like complications of cirrhosis. METHODS: Using the Nationwide Inpatient ...

PURPOSE: To examine the association between hospital surgical volume and the use of radiation therapy (RT) after breast-conserving surgery (BCS) in Taiwan. METHODS AND MATERIALS: We used claims data from the National Health Insurance program in Taiwan (1997-2005) in this retrospective population-based study. We identified patients with breast cancer, receipt ...

What is the level of knowledge of pharmacists concerning pain management and the use of opioids at the end of life, and how do they cooperate with physicians? A written questionnaire was sent to a sample of community and hospital pharmacists in the Netherlands. The questionnaire was completed by 182 ...

Nifekalant hydrochloride (NIF) is an intravenous class-III antiarrhythmic agent that purely blocks the K(+)-channel without inhibiting β-adrenergic receptors. The present study was designed to investigate the feasibility of NIF as a life-saving therapy for out-of-hospital ventricular fibrillation (VF). The Japanese Population-based Utstein-style study with basic and advanced Life Support Education ...

Professor J.A.N. Corsellis, whose life and work is recalled here, gained great insight into the meaning of morphological cerebral aberrations found in neuropsychiatric disease through exact neuropathological investigations of tissue specimens obtained from patients with distinct syndromes. He was a leading authority in the field. We have searched and compiled ...

A nationwide population-based study with questionnaires involving 90 pediatric oncologists was performed in Sweden in 2006/2007. On the basis of this quantitative study, a qualitative study was performed. The aim of this qualitative study was to focus on the main concern of these physicians facing malignant disorders, psychosocial issues, and ...

The purpose of this research was to describe the perceptions of people living with severe chronic obstructive pulmonary disease (COPD) with respect to the end of life. For this descriptive exploratory qualitative study, semi-structured interviews were conducted with six participants suffering from severe COPD hospitalized in the past year following ...

Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, ...

Despite the high prevalence of pacemakers and implantable cardioverter-defibrillators, little is known about physicians' views surrounding the ethical and legal aspects of managing these devices at the end of life. The purpose of this study was to identify physicians' experiences and views surrounding the ethical and legal aspects of managing ...

Objective To investigate attitudes towards physician-assisted death in minors among all physicians involved in the treatment of children dying in Flanders, Belgium over an 18-month period, and how these are related to actual medical end-of-life practices. Design Anonymous population-based postmortem physician survey. Setting Flanders, Belgium. Participants Physicians signing death certificates ...

AIM: The aim of the study was to investigate the relationship between insight and quality of life (QOL) and the respective predictive factors in long-term hospitalized patients with chronic schizophrenia. METHODS: The present subjects were 47 Japanese patients with chronic schizophrenia who were hospitalized for >1 year (mean hospitalization period, ...

The goal of this project was to provide a way for hospital staff to form meaningful therapeutic relationships with patients in the fast-paced hospital environment. Watson's Theory of Human Caring was the framework guiding the project. The Lifestory intervention was a Tree of Life poster depicting sources of encouragement and ...

The present study aimed to examine the prevalence of burnout, levels of life satisfaction and job satisfaction in anaesthetists in France. A cross-sectional study was conducted among 193 anaesthetists from eight French public hospitals. The results indicated low levels of emotional exhaustion and depersonalization scores, but high levels of reduced ...