PubMed Journals Articles About "Effect Centralization Complex Surgical Care Population Based Case" RSS

16:34 EST 8th December 2019 | BioPortfolio

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Showing "Effect centralization complex surgical care population based case" PubMed Articles 1–25 of 76,000+

Effect of centralization on complex surgical care: A population-based case study of radical cystectomy.

We sought to determine whether non-mandated or passive centralization of radical cystectomy (RC) to higher-volume centers leads to enhanced processes-of-care and outcomes.

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries.

While recommendations for the optimal distribution of surgical services in high-income countries (HICs) exist, it is unclear how these translate to resource-limited settings. Given the significant shortage and maldistribution of surgical workforce and infrastructure in many low- and middle-income countries (LMICs), the optimal role of decentralization versus regionalization (centralization) of surgical care is unknown. The aim of this study is to review evidence around interventions aimed at redistributing ...

How Should We Decide Whether and When Some Care Is Better Than No Care?

This case of cleft lip and palate repair by a surgical mission team is common. Low-risk, single-procedure surgical interventions requiring minimal follow-up with substantial quality of life improvement are well suited for this type of mission. However, cleft repair can also be quite complex and require multiple surgeries and other care over time, postoperative surveillance, and speech therapy. These benefits and burdens prompt us to investigate, from clinical and ethical perspectives, whether and when some ...

Effects of psychological problems on surgical outcomes.

Surgeons are becoming aware that surgical outcomes are not only based on technical skills. The impact of psychological problems on outcomes must be studied from both the patient's and the health care provider's viewpoint. Psychological problems may affect up to 20% of the population, with almost half of them non-treated. Surgeons have to deal with a significant number of patients with psychological problems, which affect surgical outcomes changing how symptoms, results and side effects are interpreted. Surg...

Association Between the Implementation of a Population-Based Primary Care Payment System and Achievement on Quality Measures in Hawaii.

Hawaii Medical Service Association (HMSA), the Blue Cross Blue Shield of Hawaii, introduced Population-based Payments for Primary Care (3PC), a new capitation-based primary care payment system, in 2016. The effect of this system on quality measures has not been evaluated.

Clinical and functional results of radial club hand with centralization and pollicization using the second metacarpus: A clinical case series.

Radial club hand (RCH) is a rare congenital deformity leading in several functional and psychological problems. However, our knowledge about the long-term functional outcomes of treating RCH is limited. In current study, we investigated the outcomes of centralization and pollicization using second or third metacarpal bone in RCH patients.

Surgical suspensions, a quality factor in pediatric surgical patient care.

To identify the factors that influence surgical suspensions (SQ) in a pediatric surgery service, to estimate its economic impact and to analyze the effect that strategies aimed at increasing efficiency and improving medical-surgical care would have.

Effect of Regionalization of Endometrial Cancer Care on Site of Care and Patient Travel.

Complex oncologic surgeries, including those for endometrial cancer, have been increasingly concentrated to higher volume centers, owing to previous research that has demonstrated associations between higher surgical volume and improved outcomes. There is a potential for concentration of care to have unwanted consequences, including cost burden, delayed treatment, patient dissatisfaction, and possibly worse clinical outcomes, especially for more vulnerable populations.

Potential Impact of Interventions to Enhance Retention in Care During Real-World HIV Pre-Exposure Prophylaxis Implementation.

Pre-exposure prophylaxis (PrEP) has the potential to significantly reduce HIV incidence among men who have sex with men (MSM) in the United States. However, the extent to which suboptimal PrEP adherence and retention in care may limit successful implementation is unknown. An agent-based model was used to represent the entire population of MSM in Rhode Island from 2013 to 2017. The impact of potential interventions to improve PrEP adherence and retention in care on HIV transmission was evaluated. Demographic...

Penile Prosthesis Implantation in an Exstrophy-Epispadias Complex Patient: A Case Report.

Penile prosthesis implantation (PPI) is a definitive treatment option for patients with medically refractory erectile dysfunction (ED). It is a safe, reliable operation with high patient satisfaction and few complications. We report a novel case of an adult patient with exstrophy-epispadias complex who underwent PPI for ED and discuss the surgical challenges presented by the unique anatomic constraints of this condition. Sotimehin AE, Burnett AL. Penile Prosthesis Implantation in an Exstrophy-Epispadias Com...

Population-Based Quality Indicators for End-of-Life Cancer Care: A Systematic Review.

Improving the quality of cancer care is an international priority. Population-based quality indicators (QIs) are key to this process yet remain almost exclusively used for evaluating care during the early, often curative, stages of disease.

Can Home-Based Primary Care Drive Integration of Medical and Social Care for Complex Older Adults?

How "Age" Shapes Health Care.

Age plays a role in health care: both the age of the case management population and the age of the consumers. The Advisory Group surveyed consumers of 4 different age groups, and differences in health care priorities and wishes are detailed.

Association of Pain Centralization and Patient-Reported Pain in Active Rheumatoid Arthritis.

Pain is a significant burden for rheumatoid arthritis (RA) patients despite advancements in treatment. We examined the independent contribution of pain centralization to the pain experience of patients with active RA.

Disparities in surgical care for children across Brazil: Use of geospatial analysis.

Health systems for surgical care for children in low- and middle-income countries remain poorly understood. Our goal was to characterize the delivery of surgical care for children across Brazil and to identify associations between surgical resources and childhood mortality.

Patient classification based on volume and case-mix in the emergency department and their association with performance.

Predicting daily patient volume is necessary for emergency department (ED) strategic and operational decisions, such as resource planning and workforce scheduling. For these purposes, forecast accuracy requires understanding the heterogeneity among patients with respect to their characteristics and reasons for visits. To capture the heterogeneity among ED patients (case-mix), we present a patient coding and classification scheme (PCCS) based on patient demographics and diagnostic information. The proposed P...

Association between socioeconomic deprivation and surgical complications in adults undergoing ankle fracture fixation: a population-based analysis

Few studies have investigated the outcomes of surgical fracture care among socially deprived patients despite the increased incidence of fractures and the inequality of care received in this group. We evaluated whether socioeconomic deprivation affected the complications and subsequent management of marginalized/homeless patients following surgery for ankle fracture.

Epidemiology of common otologic surgical procedures in pediatric patients: A population-based birth cohort study.

It is generally recognized the most common pediatric otologic surgical procedure is ventilation tube insertion (VTI). Tympanoplasty and mastoidectomy are more frequently performed on adults. In this study we examined the incidence and age distribution of these procedures by use of a population-based birth cohort design, in order to provide an overall view of the role of these procedures in the pediatric population.

An Evaluation of Risk Factors for Extubation Failure in Surgical Patients in Intensive Care.

Reintubations following extubation from mechanical ventilation are costly, resulting in increased morbidity and mortality. The preparation for and timing of extubation from mechanical ventilation can reduce unplanned reintubations. Few studies have investigated reintubation in the surgical intensive care unit (SICU) population.

Population-based estimates of engagement in HIV care and mortality using double-sampling methods following home-based counseling and testing in western Kenya.

Data on engagement in HIV care from population-based samples in sub-Saharan Africa are limited. The objective of this study was to use double-sampling methods to estimate linkage to HIV care, ART initiation, and mortality among all adults diagnosed with HIV by a comprehensive home-based counseling and testing (HBCT) program in western Kenya.

Development of a Comprehensive, Nonsurgical Joint Health Program for People With Osteoarthritis: A Pilot Case Report.

Existing osteoarthritis (OA) care models often fall short in addressing the many biological, psychological, social and behavioral characteristics that contribute to disability. As US health care shifts towards value-based payment, there is an increasing need to develop and test scalable, cost-effective, and multi-modal OA care models. This administrative case report will describe the development and pilot of a new, value-based comprehensive care model for OA.

How to Succeed Under Medicaid Managed Care.

North Carolina's move to Medicaid managed care is part of the larger move to value-based care nationally. Keys to value-based care guide how practices and health systems can navigate the new payment model. The experience of North Carolina's Area Health Education Centers with primary care practices that work on value-based care can serve as an important case study.

Clavien-Dindo Analysis of NSQIP Data Objectively Measures Patient-Focused Quality.

Current quality measures intended to drive improved clinical performance are perceived as an inappropriate administrative burden. Surgeon-constructed quality measures, including the NSQIP, are more closely aligned with provider performance and relevant outcome. We hypothesized that NSQIP participation would be associated with measurable improvement in surgical outcomes. Elective general surgical cases were compared by case volume and incidence of postoperative adverse events (AEs) from 2014 to 2017. Using t...

Predisposed to Failure? The Challenge of Rescue in the Medical Intensive Care Unit.

Medical Intensive Care Unit (MICU) patients develop acute surgical processes that require operative intervention. There are limited data addressing outcomes of emergency general surgery (EGS) in this population. The aim of our study was to characterize the breadth of surgical consults from the MICU and assess mortality after abdominal EGS cases.

The Effect of Web-Based Preoperative and Postoperative Patient Care Education on Nursing Students: A Randomized Controlled Study.

This study examined the effect of Web-based preoperative and postoperative patient care education among undergraduate nursing students. This was an experimental, randomized controlled study. The study included 305 nursing students (experimental group: n = 155, control group: n = 150), who were assessed with the following instruments: the Preoperative and Postoperative Care Knowledge Test, Preoperative and Postoperative Care Skill Control List, Clinical Decision Making in Nursing Scale, and Nursing Student C...

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