Cost-Effective Carotid Endarterectomy in Community Practice

Gibbs, Benjamin F.; Guzzetta, Vincent J.; Furmanski, Denise

doi:10.1007/bf02143853

Cited by 19 publications

(9 citation statements)

References 16 publications

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“…However, we found almost 50% of RCRs in New York state are performed by surgeons who do less than one RCR per month. Several studies from the nonorthopaedic and orthopaedic literature document physicians drive resource utilization, at least partially through length-of-stay decision making [8,9,17,18]. This has a major impact on total cost [9,17].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Readmission and Revision Surgery Following Rotator Cuff Repair

Sherman

Lyman

Koulouvaris

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Risk factors for revision surgery and hospitalization following rotator cuff repair (RCR) have not been clearly identified. We hypothesized patient factors and surgeon and hospital volume independently contribute to the risk of readmission within 90 days and revision RCR within one year. Using the SPARCS database, we included patients undergoing primary RCR in New York State between 1997 and 2002. These patients were tracked for readmission within 90 days and revision RCR within 1 year. A generalized estimating equation was developed to determine whether patient factors, surgeon volume, or hospital volume were independent risk factors for the above outcome measures. The total annual number of RCR increased from 6,656 in 1997 to 10,128 in 2002. Ambulatory cases increased from 57% to 82% during this time period. Independent risk factors for readmission within 90 days included increasing age and increased number of comorbidities. Independent risk factors for revision RCR included increasing age, increased comorbidity, and lower surgeon volume. Hospital volume had a minimal effect on either outcome measure. The shift toward out-patient surgery mirrors the shift from open to arthroscopic rotator cuff repair. The finding that surgeon volume is a predictor of revision RCR reflects the findings in other orthopaedic procedures.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Readmission and Revision Surgery Following Rotator Cuff Repair

Sherman

Lyman

Koulouvaris

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…It is generally recognized that reducing variations in clinical practice among surgeons performing similar operations is a key to reducing inventory and moving towards the use of less costly, but equally effective, alternatives among supplies [13,14]. With this in mind, the dashboard should be constructed to generate individual surgeon scorecards, with peer group information made available to those who perform the same or similar operations.…”

Section: Dashboard For or Supply Managementmentioning

confidence: 99%

The Operating Room Dashboard

Park

Smaltz

McFadden

et al. 2010

Journal of Surgical Research

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“…Consistent with the incentives of managed care and capitated health care delivery systems, the underlying theme driving these changes has been to seek ways of providing health services more efficiently. Most studies exploring this issue have focused on limiting hospital resource use and have been retrospective case series from either single community hospitals [11][12][13][14][15] or academic medical centers (AMCs). 16,17 For example, some studies have successfully limited hospital resource use by admitting patients the same day or 1 day prior to the scheduled procedure.…”

mentioning

confidence: 99%

Carotid Endarterectomy Trends in the Patterns and Outcomes of Care at Academic Medical Centers, 1990 Through 1995

Holloway¹,

Witter²,

Mushlin³

et al. 1998

Arch Neurol

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Despite dramatic changes that have occurred in patient characteristics and in hospital management practices for patients undergoing a carotid endarterectomy from 1990 to 1995, we were unable to detect any measurable impact on patient outcomes. These data have implications for monitoring and evaluating the impact of systemwide change on the overall quality of care for patients undergoing a carotid endarterectomy.

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Cost-Effective Carotid Endarterectomy in Community Practice

Cited by 19 publications

References 16 publications

Risk Factors for Readmission and Revision Surgery Following Rotator Cuff Repair

Risk Factors for Readmission and Revision Surgery Following Rotator Cuff Repair

The Operating Room Dashboard

Carotid Endarterectomy Trends in the Patterns and Outcomes of Care at Academic Medical Centers, 1990 Through 1995

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