Abstract：
BACKGROUND:A review of 1993 data on length of stay (LOS) and charges for diagnosis-related group (DRG) 195 (complicated cholecystectomies) showed that Maricopa Medical Center charged more and had longer LOS than all other area hospitals. METHODS:Twenty DRG 195 charts were analyzed for the causes of the inefficiencies. The remaining cholecystectomy DRGs were similarly analyzed. RESULTS:Analysis of the charts for DRG 195 showed that 55% of the patients had laparoscopic conversions. Charges and LOS varied significantly because of the conversions, increased preoperative hospital days and increased operative times. Moreover, 30% of patients were more than 70 years old. Comparisons of other cholecystectomy DRGs showed similar inefficiencies, indicating a hospital system's problem. CONCLUSIONS:Diagnosis-related group delta analysis is a powerful performance improvement tool. Once problem areas are identified and corrected, monitoring prospective data produces rapid analysis of quality of care and cost improvements. The models can serve as a means for teaching hospitals to become more competitive and satisfy the Joint Commission on Accreditation of Healthcare Organizations requirements for patient-care improvements.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Weiland DE,Malone JM,Bay C,Garren Rdoi
10.1016/s0002-9610(99)80035-xsubject
Has Abstractpub_date
1995-12-01 00:00:00pages
651-4; discussion 654-5issue
6eissn
0002-9610issn
1879-1883pii
S000296109980035Xjournal_volume
170pub_type
杂志文章abstract：:Over the last decade, significant technological advancements have occurred in cardiac surgery. One such breakthrough has been the use of robotic telemanipulation systems, which allow the surgeon to perform cardiac surgery through a minimally invasive approach. As a result, surgery for atrial fibrillation and resynchro...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.08.001
更新日期：2004-10-01 00:00:00
abstract：:Gastroduodenal artery pseudoaneurysm is a rare but life threatening complication of pancreatitis. Diagnosis and management of it remain challenging. Surgical treatment was associated with a high mortality. Percutaneous transarterial embolization of bleeding artery has recently been advocated as a definitive therapy an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.05.014
更新日期：2009-04-01 00:00:00
abstract：:From 1941 through 1983, a total of 66 patients with sacrococcygeal teratoma were seen, representing 41 percent of the total of 162 patients with teratomas from all anatomic sites seen over this period. Forty-six (70 percent) of the patients with sacrococcygeal teratomas were female and 34 (52 percent) were neonates. Y...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90082-0
更新日期：1985-09-01 00:00:00
abstract：:Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90393-2
更新日期：1977-10-01 00:00:00
abstract：BACKGROUND:Incidental abnormalities are increasingly being detected. The pathology and clinical outcome of patients with pancreatic incidentalomas have not been well characterized. METHODS:We reviewed the records of 356 patients with pancreatic abnormalities from August 2001 to June 2007. Clinical and pathologic data ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.027
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation. METHODS:Patients undergoing TIPS from 2001 to 2010 at a t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.005
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:A history of therapeutic irradiation to the neck complicates the management of carotid artery occlusive disease. Serious surgical concerns are raised regarding alternative incisions, difficult dissections, and adequate wound closure. Pathology may be typical atherosclerotic occlusive disease or radiation-ind...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00150-X
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS:Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharin...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.01.024
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND:Previous studies have shown that advanced age, diabetes, and male gender are associated with higher morbidity and mortality after bariatric surgery. Those risk factors are characteristic of patients in the Veterans Affairs (VA) health care system. Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an es...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.07.021
更新日期：2004-11-01 00:00:00
abstract：OBJECTIVE:Surgeons' vigilance regarding patient condition was assessed using eye-tracking techniques during a simulated laparoscopic procedure. METHODS:Surgeons were required to perform a partial cholecystectomy in a virtual reality trainer (SurgicalSim; METI Inc, Sarasota, FL) while wearing a lightweight head-mounted...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.01.016
更新日期：2011-05-01 00:00:00
abstract：:The accuracy of the hepatobiliary scan in the diagnosis of acute cholecystitis was determined at a major United States Army Medical Center. Forty-two patients with complete medical records were selected for the study. There was 18 positive findings and 24 negative findings. The accuracy rate for the positive findings ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90333-7
更新日期：1984-11-01 00:00:00
abstract：:Surgeons need to be aware of the various options available to remove enlarged gallbladders or gallstones lost during laparoscopic cholecystectomy. Every attempt should be made to recover stones that have escaped from a ruptured gallbladder during laparoscopic cholecystectomy, short of converting to laparotomy. Initial...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80949-3
更新日期：1993-04-01 00:00:00
abstract：:Previous studies of small bowel transplantation using a variety of animal models and immunosuppressive regimens have failed to demonstrate consistently prolonged survival of bowel allografts capable of maintaining a normal nutritional state. In the present study, total orthotopic small bowel transplantation was perfor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90011-5
更新日期：1986-01-01 00:00:00
abstract：:A simple classification of inguinal hernias is presented which can be valuable to surgeons as a (1) blueprint for dissecting the canal, (2) means for choosing the most appropriate operative procedure, (3) means for evaluating and correlating the prognosis of postoperative symptoms, time of convalescence, and degree of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90564-3
更新日期：1989-03-01 00:00:00
abstract：BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.011
更新日期：2014-05-01 00:00:00
abstract：:A significant impairment in the intestinal absorption of D-xylose and vitamin A was observed in the first weeks after preservation and transplantation of the whole small bowel. Functional recovery was only observed in long-term survivors, usually transplanted dogs that lived more than five weeks. There was no impairme...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90297-4
更新日期：1975-02-01 00:00:00
abstract：BACKGROUND:We have previously shown the inhibitory effects of keyhole limpet hemocyanin (KLH) against breast and pancreatic cancer in vitro. We hypothesize that its actions in breast and pancreas cancer cells are via apoptotic or cytokine pathways. METHODS:Two breast cancer cell lines, ZR75-1 and MCF-7, and one pancre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.10.005
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:Teletrauma programs allow rural patients access to advanced trauma and emergency medical services that are often limited to urban areas. METHODS:A retrospective analysis of 59 teleconsults between 5 rural hospitals and a level I trauma center was performed. The objectives of this study were to report the in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.011
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:Minority patients are at risk for delayed breast cancer treatment. Using nonsurgical breast specialists could improve access but requires appropriate referral to ensure prompt cancer care. Our objective was to evaluate a referral triage system in a combined medical/surgical breast health program (BHP). METHO...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.06.014
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:Lymphoepithelial cyst of the pancreas is a rare but distinctive cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded by lymphoid tissue. METHODS:To gain more insights into this entity, we describe 5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly descri...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80247-5
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
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/j.amjsurg.2004.08.066
更新日期：2005-04-01 00:00:00
abstract：:Twenty patients treated by femorofemoral bypass were retrospectively reviewed to determine if femorofemoral bypass was efficacious in the treatment of disabling claudication. The data have clearly demonstrated that two criteria are necessary for the successful outcome of femorofemoral bypass. First, the donor artery s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90245-x
更新日期：1986-08-01 00:00:00
abstract：BACKGROUND:The authors determined the radiological misdiagnosis rate of primary epiploic appendagitis (PEA) and its impact on patient management and hospital resource use. METHODS:A total of 660 computed tomography scans performed for clinically suspected diverticulitis (348 cases) or appendicitis (312 cases) were rev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00103-2
更新日期：1998-07-01 00:00:00
abstract：:This is the Presidential Address from the 104th meeting of the North Pacific Surgical Association held in Tacoma, Washington November 8-9, 2016. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.01.041
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS:A s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.024
更新日期：2015-07-01 00:00:00
abstract：OBJECTIVE:Invasive lobular carcinoma (ILC) presents special challenges to treating physicians because of the diffuse infiltrative growth pattern. As sentinel lymph node dissection (SLND) is rapidly replacing axillary lymph node dissection (ALND) in the management of patients with early-stage breast cancer, we sought to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.06.021
更新日期：2005-10-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. METHODS:Our prospective...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01050-4
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. METHODS:Patients from a multi...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2007.07.021
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Atrial fibrillation and atrial flutter (AF) frequently complicate coronary artery bypass surgery (CABG) and increase hospital stay as well as morbidity. Studies of drug prophylaxis to prevent AF with beta-adrenergic blocking agents administered in fixed doses have had conflicting results. METHODS:One hundre...
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(97)00077-9
更新日期：1997-05-01 00:00:00
