Abstract:
BACKGROUND:We developed a model for capitation and global pricing for carotid endarterectomy. METHODS:A care algorithm for diagnosis, perioperative management, and postoperative care using cost data was developed. Perioperative care charges were extrapolated from a 1-year experience and applied to models to determine pricing for a 1-year global fee and a 5-year capitated contract. RESULTS:Global pricing was estimated at $12,071 per patient while a capitated price for 5-year care was $17,175. Based on the age mix of the population, a per member, per month cost could be calculated assuming a frequency of 414 procedures per 100,000 patients over age 65 and 31 procedures per 100,000 patients under 65. Sources of costs were extensive preoperative diagnostic testing, particularly angiography, brain imaging, and cardiac evaluation. CONCLUSIONS:Global pricing and capitation are both feasible for carotid endarterectomy. Each approach has unique risks and benefits.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ricotta JJ,Hargadon T,O'Brien-Irr Mdoi
10.1016/s0002-9610(98)00128-7subject
Has Abstractpub_date
1998-08-01 00:00:00pages
188-92issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(98)00128-7journal_volume
176pub_type
杂志文章abstract:BACKGROUND:Melanomas are aggressive neoplasms with limited therapeutic options. Therefore, developing new therapies with low toxicity is of utmost importance. Honokiol is a natural compound that recently has shown promise as an effective anticancer agent. METHODS:The effect of honokiol on melanoma cancer cells was ass...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.09.001
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:This study defines the clinical settings in which extended radical neck dissection (ERND) was performed and determines its impact on control of disease in the neck and on survival. METHODS:We reviewed the records of 106 patients undergoing ERND between 1984 and 1993. Most (76) had metastatic squamous cell c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00163-3
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The purpose of the current study was to evaluate whether a totally implanted valved subcutaneous port system would have fewer complications as compared to a standard nonvalved port. METHODS:Study subjects requiring port placement were randomized to receive a valved port (PASV; Boston Scientific, Natick, MA)...
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.2004.08.041
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are sequelae of severe trauma. It is unknown if certain races are at greater risk of developing ALI/ARDS, and once established, if there are racial differences in the severity of lung injury or mortality. METHODS:Retrospective cohort stu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.02.003
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:There is disagreement regarding the preferred injection site for breast sentinel lymph node mapping. METHODS:The concordance of blue staining and radioactivity in the sentinel nodes of 730 consecutive patients was analyzed based on injection of mapping agents into the same or separate intradermal and subare...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.06.018
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration. METHODS:The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all el...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.01.024
更新日期:2016-08-01 00:00:00
abstract::From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80438-6
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer. PATIENTS AND METHODS:We developed a novel preoperative therapy combining radiation, intralumina...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(97)89639-0
更新日期:1996-03-01 00:00:00
abstract::Injuries to the inferior vena cava are being seen with increasing frequency in the civilian population. A review of the experience at UCLA/Harbor General Hospital Medical Center over a ten year period (1966 to 1976) discloses thirty-four patients with major injuries to the inferior vena cava, with an overall mortality...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/0002-9610(77)90279-3
更新日期:1977-07-01 00:00:00
abstract::Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether th...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-9610(92)90264-r
更新日期:1992-01-01 00:00:00
abstract::The palliative management of malignant obstruction of the biliary tree continues to challenge clinicians. The technique of PTBD has become increasingly popular to decompress the obstructed biliary system. Our initial experience with 30 consecutive patients treated with PTBD has been retrospectively reviewed. Internal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90125-9
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association. METHODS:All major surgical complications are reported to the association because it handles financial compensatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.04.018
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Race and insurance status influence the likelihood of undergoing laparoscopic appendectomy (LA) versus open appendectomy for the treatment of acute appendicitis. We hypothesized that these disparities are caused by presenting hospitals' use of LA. METHODS:The analysis included 26,104 appendectomies for acut...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.11.024
更新日期:2007-07-01 00:00:00
abstract::Despite undergoing a curative resection, many patients with colorectal cancer will develop and die of metastatic disease. It has been shown clinically and experimentally that surgery causes a transient period of immunosuppression, and it is postulated that this may encourage both the implantation of surgically dissemi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90070-1
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The prognostic value of traditional staging classification for colorectal cancer has changed little since Dukes created the first staging scheme. Some patients with known metastatic disease are long-term survivors, while other patients with local disease die early. New intraoperative cancer detection technol...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80295-5
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS:We reviewed 273 resident performance evaluations from ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2021.01.020
更新日期:2021-01-19 00:00:00
abstract::The incidence of postoperative wound complications and early cancer recurrence was studied in 289 patients who had mastectomy alone and in 113 patients who underwent immediate reconstruction following mastectomy. Patients undergoing immediate reconstruction were younger and had less advanced disease than patients who ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80572-0
更新日期:1993-07-01 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:BACKGROUND:In recent years, increasingly accessible and novel genetic technologies have spurred keen interest in the application of cancer genetics in predicting prognosis and response to treatment. In particular, investigators have eagerly sought to establish and validate genetic signatures that might improve the iden...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2016.06.019
更新日期:2016-10-01 00:00:00
abstract::Cysts of the mesothelial investment of the round ligament are rare and occur in women in their late third or fourth decades. They are relatively painless, mobile, may be perceived to be reducible, and should be included in the differential diagnosis of groin masses in women. Differentiation of these cysts from a small...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90116-9
更新日期:1986-04-01 00:00:00
abstract::Extralaryngeal branches of the recurrent laryngeal nerve have been noted in the literature, but frequently the researchers fail to indicate with accuracy the site of bifurcation. The current study was undertaken to designate the exact level of bifurcation of the recurrent laryngeal nerve, with more precise localizatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90425-1
更新日期:1982-10-01 00:00:00
abstract::A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and oth...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90300-1
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80285-2
更新日期:1995-08-01 00:00:00
abstract::Lasers have been used for endoscopic gastrointestinal surgery at our institution since 1977. The argon and Nd-YAG lasers are valuable for coagulating upper gastrointestinal hemorrhage, arteriovenous malformations, and benign and malignant lesions, as well as a variety of anatomic anomalies. Between December 1977 and S...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90427-6
更新日期:1984-12-01 00:00:00
abstract:INTRODUCTION:Surgical educators' professional behavior constitutes a hidden curriculum and impacts trainee's professional identity formation. This study explores the nuances of professional behaviors as observed in varying surgical settings. METHODS:411 Transcripts originated from essays written by MS3 students during...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.003
更新日期:2020-09-08 00:00:00
abstract::Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80017-0
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Stress can negatively impact surgical performance, but mental skills may help. We hypothesized that a comprehensive mental skills curriculum (MSC) would minimize resident performance deterioration under stress. METHODS:Twenty-four residents were stratified then randomized to receive mental skills and FLS tr...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2017.09.039
更新日期:2018-02-01 00:00:00
abstract::Urinary tract infection continues to be a major source of morbidity for surgical patients, and treating these infections continues to be a difficult problem in clinical surgical practice. The majority of these infections are due to urinary catheters. One strategy that has been advanced to prevent the morbidity associa...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(03)00120-x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:On surgical simulators, measures of economy of hand motion have been shown to be reliable, valid, and objective measures of technical competence. Our goal was to validate hand-motion analysis (HMA) as an objective measure of surgical skill on real patients. METHODS:HMA (hand movement frequency, hand travel ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.033
更新日期:2010-01-01 00:00:00
abstract::This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90191-7
更新日期:1987-08-01 00:00:00