Abstract:
BACKGROUND:Limited data exist regarding the downstream effects of surgical transitional care programs. We explored the impact of such programs on patient satisfaction and fiscal metrics. METHODS:A telephone-based surgical transitional care program enrolled patients undergoing complex abdominal surgery between 2015 to 2017. A matched cohort undergoing similar procedures between 2010 to 2015 were used as controls. Press Ganey scores were used to reflect patient satisfaction. Hospital costs, reimbursements, and margins were analyzed for index hospitalizations and readmissions within 90 days of surgery. RESULTS:There were 607 patients in the control group and 608 in the transitional care program; survey response rates were 37% and 35%, respectively. Transitional care patients rated their understanding of personal responsibilities in post-discharge care higher than controls (59% vs 69%, P = .02). Transitional care patients felt they received better educational materials about their condition or treatment (55% vs 68%, P < .01) and rated their global hospital experience higher (46% vs 57%, P = .02). The aggregate (index plus readmission) cost was greater for the transitional care ($22,814 vs $25,827, P < .01), but there was no difference in aggregate margin ($7,027 vs $4,698, P = .25). Multivariable adjustment yielded similar results for the aggregate cost (ref vs $2,232, P = .03) and margin (ref vs $1,299, P = .23). CONCLUSION:The use of this dedicated abdominal surgery transitional care program is associated with improved Press Ganey patient education and global rating scores. The cost to support this program did not adversely affect the hospital margin when considering all factors. These data support broader investment in patient centered initiatives that may significantly enhance patient experience.
journal_name
Surgeryjournal_title
Surgeryauthors
Schreiter NA,Fisher A,Barrett JR,Acher A,Sell L,Edwards D,Leverson G,Joachim A,Weber SM,Abbott DEdoi
10.1016/j.surg.2020.09.015subject
Has Abstractpub_date
2021-02-01 00:00:00pages
347-355issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(20)30618-8journal_volume
169pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:Patients in the accelerated or blastic phases of chronic myelogenous leukemia (CML) often have painful splenomegaly and secondary thrombocytopenia. We tested the hypothesis that splenectomy can be performed with minimal complications in advanced CML, thereby alleviating pain, reversing thrombocytopenia, and ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90259-2
更新日期:1997-07-01 00:00:00
abstract::Radiation for benign problems of the head and neck area has been uniformly recognized as unacceptable practice. This includes epilation for facial hirsutism. Twelve such patients, recently encountered, have characteristic radiodermatitis facies and have demonstrated multisite neoplastic involvement--including skin, th...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Differentiation between parathyroid hyperplasia and adenoma is difficult and based on the surgeon's skill. Microarrays and other sophisticated research tools generate information about differential gene expression in various tissues. Exploration of genes that express differentially in 1 tissue will enable id...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.128614
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:While roughly half of adrenocortical carcinomas are functional, whether functional status impacts outcomes remains controversial. We compared presentation and survival for functional and nonfunctional neoplasms. METHODS:Adult patients presented with adrenocortical carcinomas at the Mayo Clinic were included...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.04.066
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Metastatic neuroendocrine tumors (NETs) can present with complications of gastrointestinal tract obstruction or ischemia and carcinoid syndrome (CS). The purpose of this study was to assess whether aggressive surgical intervention of metastatic NETs provides effective palliation from these symptoms. METHODS...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.06.008
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Endotoxemia stimulates tumor necrosis factor (TNF) and interleukin-1 (IL-1) production in mucosa of the small intestine, but the effect on IL-6 production is not known. Intestinal IL-6 may be especially important, considering its role in the acute phase response. We tested the influence of endotoxemia and se...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80342-3
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:We hypothesized that intraoperative parathyroid hormone monitoring (IOPTH) reliably would detect double parathyroid adenomas. METHODS:This was a retrospective study of 20 patients undergoing conventional parathyroidectomy with resection of exactly 2 abnormal glands. Full exploration was performed regardless...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2001.118385
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Apoptotic cell death and c-Jun N-terminal kinase (JNK) activation occur after hepatic ischemia/reperfusion injury. In other cell types, JNK activation was shown to be required for apoptosis. This study tested the hypotheses that JNK contributes to hepatocellular apoptosis, and that inhibition of JNK activity...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2003.237
更新日期:2003-08-01 00:00:00
abstract::Restoration of circulation following occlusion of an aortofemoral graft was attempted in 50 limbs in 38 patients. Progressive arteriosclerosis in the femoral vessels was the cause of graft limb thrombosis in most instances. Profundaplasty was employed in 47 limbs and femoral-popliteal bypass in two to provide effectiv...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-12-01 00:00:00
abstract:BACKGROUND:Patients with colon cancer often present with obstruction. Large series have reported obstruction among the high-risk features, yet prospective data on its specific prognostic influence are lacking. We hypothesized that obstruction is an independent risk factor for poor prognosis in patients with stage III c...
journal_title:Surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.surg.2018.06.044
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Long-term follow-up of heart, liver, and lung transplantation has led to an increased recognition of secondary end-stage renal failure (ESRF) in transplant recipients. This study examines our center's experience with renal transplantation following previous solid organ transplantation. METHODS:From January ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2001.115834
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Splenocaval shunts have been used in this hospital since 1974 as an alternative to the distal splenorenal shunt. This report will detail the long-term results with this operation. METHODS:Thirty-three patients who were subjected to selective splenocaval shunts for treatment of hemorrhagic portal hypertensio...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:We present the largest single-center study to date of surgical and quality-of-life outcomes among patients treated with laparoscopic antireflux surgery for reflux-associated chronic cough. Extraesophageal manifestations of chronic gastroesophageal reflux are increasingly recognized, among which chronic cough...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.01.036
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Liver resection (LR) for hilar cholangiocarcinoma (HCA) remains challenging because of the occurrence of unanticipated vascular and longitudinal bile duct invasion. Operative strategies to achieve negative resection margins vary, and the benefit of routine portal vein resection (PVR) is discussed controversi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.04.032
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases, and their pathogenesis is attributed, in part, to alterations of the mucosal immune system. This study was designed to define the possible contribution of epithelial cells to the activation of lamina propria T lymphocytes (LP...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90091-x
更新日期:1997-10-01 00:00:00
abstract::The influence of early graft surface thromboreactivity on long-term arterial polyester (Dacron) graft patency was investigated with separate ex vivo and in vivo animal models. First, parallel, flow-regulated external aortocaval fistulae were created in five pigs with use of paired 8 mm X 35 cm crimped, warp-knitted, l...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:The performances of the American Joint Committee on Cancer staging systems of the 7th and 8th edition were compared using a cohort of patients undergoing surgery for perihilar cholangiocarcinoma at 2 tertiary referral Italian hepatobiliary centers. METHODS:The American Joint Committee on Cancer 7th and 8th ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.03.012
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Our ability to predict respiratory compromise during general anesthesia in a child with an anterior mediastinal mass is limited. Two prior reports have found a correlation between adequacy of ventilation during general anesthesia and the tracheal cross-sectional area obtained from computed tomograms (compute...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80360-5
更新日期:1995-09-01 00:00:00
abstract::Treatment of rat allograft recipients before grafting with donor spleen cells and whole, pooled antidonor alloimmune serum results in indefinite renal allograft survival. The enhancement is immunologically specific. In these experiments a monoclonal, homogenous anti-BN antibody was produced by a hybridoma clone create...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::The isolation and characterization of oncogenes from human colon cancer and the recognition of their homology with the ras gene of the Harvey and Kirsten strain of murine sarcoma virus (MSV) led us to investigate the effect of exogenous MSV on 1,2 dimethylhydrazine (DMH)-induced colon carcinoma in rats. DMH, 20 mg bas...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::Cowden's disease (multiple hamartoma syndrome) is a syndrome involving abnormalities of multiple organ systems. Transmitted in an autosomal dominant pattern, it carries a high frequency of mammary carcinoma in early middle age in affected women. The hyperkeratotic cutaneous and gingival markers of the disease are its ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::The effect of a new extracorporeal system combining direct hemoperfusion (DHP) with venovenous bypass was evaluated in the elimination of anticancer drugs in hepatic artery infusion. Adriamycin (3 mg/kg) and mitomycin C (1 mg/kg) were given to mongrel dogs through the hepatic artery with three different durations of 1...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::We measured transcutaneous oxygen tension (TcPo2) at a skin temperature of 44 degrees C on 319 limbs in an approximately equal number of nondiabetic and diabetic patients with peripheral vascular disease. Measurements were made above the knee, below the knee (BK), and on the dorsum of the foot. Nondiabetic limbs with ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate whether ultrasonography is helpful in predicting malignancy in patients with a thyroid nodule and atypia/follicular lesion of undetermined significance (AFLUS). METHODS:All patients with a preoperative ultrasound who underwent thyroidectomy for a nodule with AFLUS comp...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2014.06.043
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Guidelines for management of small adrenal incidentalomas are mutually inconsistent. No cost-effectiveness analysis has been performed to evaluate rigorously the relative merits of these strategies. METHODS:We constructed a decision-analytic model to evaluate surveillance strategies for <4cm, nonfunctional,...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.07.030
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:It was shown in a murine model that sham laparotomy is associated with a higher incidence of postoperative lung metastases when compared with results seen after carbon dioxide pneumoperitoneum. Using the same tumor model, the present study was undertaken to determine if the addition of bowel resection to the...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/s0039-6060(03)00136-3
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:We attempted to assess liver ischemia/reperfusion injury under a mild decrease in core liver temperature of 10 degrees C by in situ hypothermic perfusion during ischemia. METHODS:Liver ischemia was induced in pigs by total hepatic vascular exclusion with concomitant in situ perfusion with hypothermic (4 degr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(03)00125-9
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The incidence of adenocarcinoma of the esophagogastric junction is rapidly increasing, and the extent of lymphadenectomy for such tumors remains controversial. The aim of this study was to identify the pattern of dissemination by examination of all lymph nodes retrieved from resected tumors of the esophagoga...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2001.110024
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The Hedgehog (Hh) gene family is known to regulate development of stem cells. In addition, activation is responsible for the induction of GLI1 proto-oncogene and subsequent cellular proliferation. Sonic Hedgehog (SHh), one of the Hh family members promotes carcinogenesis in airway and pancreatic epithelia, i...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2005.10.012
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Liver cell proliferation after partial hepatectomy in rats has been thoroughly investigated. Although DNA synthesis and morphologic restoration have been studied in this rat model, the functional capacity of the remnant liver during regeneration has not been elucidated. METHODS:We measured the indocyanine g...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90058-1
更新日期:1997-06-01 00:00:00