Abstract：
BACKGROUND:We hypothesize that medical centers that prioritize altruism can also deliver superior quality care. METHODS:Data were obtained from California's Office of Statewide Health Planning and Development, Medicare Hospital Compare, and the Joint Commission US Census Bureau's American Community Survey. Outcomes were measured using summary statistics, regression analysis, and quality indices. Total discounted revenue/total revenue (TDR/TR) served as a proxy for altruistic care. RESULTS:In nonprofit hospitals, TDR/TR positively correlated with 5 quality indices including pneumonia (P < .001), heart failure (P = .05), and overall surgical process of care (P = .009). Hospital size predicted higher quality surgical process (P = .06, 201 to 300 beds; P = .01, >301 beds), hospital teaching status demonstrated positive correlation (β = .048, P = .69), and poverty was negatively correlated (β = -.00072, P = .89). Positive TDR/TR did not adversely affect mortality or readmission rates (P = .52). CONCLUSIONS:TDR/TR predicts quality in nonprofit hospitals without increasing mortality and readmission. Altruistic motivation may be associated with the delivery of higher quality surgical care.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Chang V,Kuo PC,Wai PYdoi
10.1016/j.amjsurg.2014.10.016subject
Has Abstractpub_date
2015-03-01 00:00:00pages
457-62issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(14)00613-8journal_volume
209pub_type
杂志文章,多中心研究abstract：BACKGROUND:Response evaluation criteria in solid tumors (RECIST) is the accepted method for determining tumor progression. However, RECIST may not estimate disease burden accurately because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.007
更新日期：2012-11-01 00:00:00
abstract：:Seven patients who had typical and persistent symptoms of gallbladder disease but repeatedly normal oral cholecystograms were seen in an 18 month period. Ultrasound examination of the gallbladder was diagnostic of cholelithiasis in all seven patients. Six patients were found to have gallstones at operation, and the se...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90339-8
更新日期：1979-11-01 00:00:00
abstract：:Abnormal persistent of the embryonic axial blood supply to the leg, the sciatic artery, is a rare but often clinically important condition. The sciatic artery may vary from a small collateral in the upper thigh to a very large vessel that is the leg's sole arterial blood supply. The abnormal artery is prone to aneurys...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90122-8
更新日期：1983-05-01 00:00:00
abstract：BACKGROUND:Currently, the management strategy of pancreatic cyst (PC) remains controversial because of the inability to diagnose this type of cyst accurately and the limited knowledge of its natural history. Previously, many clinicians have advocated an aggressive resectional policy. This approach is no longer appropri...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2006.07.019
更新日期：2007-06-01 00:00:00
abstract：BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.019
更新日期：2009-01-01 00:00:00
abstract：:Obesity is a serious health problem in the United States today, and surgical treatment is recognized as long-term effective therapy. Minimally invasive techniques are becoming the "gold standard" approach to the treatment of disease, and robotic surgery has the potential to advance the use and development of minimally...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.027
更新日期：2004-10-01 00:00:00
abstract：:The wire introducer method is a satisfactory technique for management of central venous catheters if bacteriologic monitoring of the removed catheter is used to determine whether the introduced catheter should be allowed to remain. The data indicate that when central venous catheters become infected, they do so throug...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90327-5
更新日期：1981-12-01 00:00:00
abstract：:Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(98)00133-0
更新日期：1998-08-01 00:00:00
abstract：:A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross dis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90360-3
更新日期：1976-11-01 00:00:00
abstract：BACKGROUND:The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. METHODS:A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.022
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:A high rate of facial nerve paralysis (FNP) develops after parotid surgery, but there have been few clinical trials on treatments to improve recovery times. This study evaluated the efficacy of prednisolone in these patients. METHODS:A total of 123 patients who underwent parotidectomy without injury to the ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2008.04.010
更新日期：2008-11-01 00:00:00
abstract：BACKGROUND:This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs). METHODS:We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy. RESULTS:A SLN was identified in 381 patients. Of 61 patients with a true...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.020
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:Cancer of unknown primary (CUP) origin is a very aggressive disease with a poor prognosis. Most of the literature reports of CUP are generated from tertiary cancer centers. METHODS:A retrospective chart review of all patients with a diagnosis of CUP was performed between January 1995 and January 2005. Age, ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.039
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:The tension-free hernioplasty as introduced by Lichtenstein has gained increasing acceptance during the last decade although the technique has not been evaluated in a randomized trial. METHODS:This randomized study compares the 2-year follow-up results after 102 tension-free hernioplasties with implantation...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/S0002-9610(96)00188-2
更新日期：1996-10-01 00:00:00
abstract：:The records of 104 patients with primary adenocarcinoma of the duodenum were reviewed. All patients were followed up to the date of this report, 91 for at least 5 years. Melena was an ominous preoperative finding. Survival was directly related to nodal status, the grade of the lesion, and the ability of the surgeon to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90163-x
更新日期：1981-02-01 00:00:00
abstract：:Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic dise...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90043-q
更新日期：1992-04-01 00:00:00
abstract：BACKGROUND:We hypothesized that the increasing body mass index of the population has affected general surgery malpractice claims. METHODS:We queried the Physician Insurers Association of America database from 1990 to 1999 (ie, period 1) and 2000 to 2009 (ie, period 2) for claims associated with obesity and morbid obes...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.023
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Traditional treatment of breast abscesses involves incision and drainage, with and without ultrasound guidance. These procedures cause considerable discomfort and morbidity for the patient. This study was conducted to determine whether needle aspiration of breast abscesses without ultrasound guidance was an ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(01)00683-3
更新日期：2001-08-01 00:00:00
abstract：INTRODUCTION:The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons. METHODS:Publicly available financial data from the CMS website reg...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.08.017
更新日期：2018-07-01 00:00:00
abstract：:Appendicitis in preschool children is not uncommon. A duration of greater than 40 hours usually implied perforation. The most common findings were abdominal pain, tenderness, temperature elevation and vomiting. In the presence of perforation or abscess formation, appendectomy followed by copious wound irrigation, absc...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90265-2
更新日期：1980-02-01 00:00:00
abstract：:The salient clinical and pathological features of verrucous carcinoma, as first described by Ackerman in 1948, are reviewed. Two case reports are presented. The first concerns a personal experience with a patient who had five surgical procedures for multifocal oral verrucous carcinoma and remains alive and well 28 yea...
journal_title：American journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/s0002-9610(98)00232-3
更新日期：1998-11-01 00:00:00
abstract：BACKGROUND:A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. METHODS:Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.05.004
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Surgery is indicated for acute uncomplicated appendicitis but the optimal timing is controversial. Recent literature is conflicting on the effect of time to intervention. METHODS:We queried the American College of Surgeons National Surgical Quality Improvement Project dataset for patients undergoing laparos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.10.013
更新日期：2015-03-01 00:00:00
abstract：:A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this devi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90600-6
更新日期：1982-07-01 00:00:00
abstract：BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2009.06.018
更新日期：2009-10-01 00:00:00
abstract：:Fifty-eight patients with invasive melanoma of the head and neck underwent regional nodal dissections by one surgeon from 1971 to 1981. Types of nodal dissections employed were radical neck dissection and modified radical neck dissection, alone or in combination, with selective nodal dissection of the parotid, jugular...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90367-2
更新日期：1984-10-01 00:00:00
abstract：BACKGROUND:Hepatic resection is main approach to treatment of hepatolithiasis, but the long-term follow-up results of hepatic resection for hepatolithiasis are rarely reported. METHODS:A retrospective study was conducted of 87 patients with hepatolithiasis who underwent hepatic resection. RESULTS:The final stone clea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.020
更新日期：2009-08-01 00:00:00
abstract：PURPOSE:To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery. METHODS:After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey ask...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00112-0
更新日期：2003-07-01 00:00:00
abstract：:Twenty-six patients with advanced melanoma metastases confined to the lower extremity underwent 28 therapeutic limb perfusions without a major complication or treatment-related death. A complete response to treatment occurred in 21 patients (81 percent). Of 16 patients, response persisted until death in 13 and was not...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90006-6
更新日期：1985-07-01 00:00:00
abstract：:Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90333-6
更新日期：1977-12-01 00:00:00
