Annals of surgery
-
Multicenter Study
Medicare Reimbursement for General Surgery Procedures: 2000 to 2018.
The purpose of this study is to evaluate monetary trends from 2000 to 2018 in Medicare reimbursement rates for the most common general surgery procedures. ⋯ After adjusting for inflation, Medicare reimbursement rates in general surgery have steadily decreased from 2000 to 2018. It is important that these trends are understood and considered by surgeons, healthcare administrators, and policy-makers in order to develop and implement agreeable models of reimbursement while ensuring access to quality general surgery care in the United States.
-
Multicenter Study
Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes.
The purpose of this study was to evaluate the impact of optimization of preoperative comorbidities by nonsurgical clinicians on short-term postoperative outcomes. ⋯ We demonstrated an association between use of nonsurgical clinician visits by comorbid patients prior to surgery and a significantly lower rate of complications. These findings support the prospective study of preoperative optimization as a potential mechanism for improving postoperative outcomes.
-
Multicenter Study
Hospital Volume Matters: The Volume-Outcome Relationship in Open Juxtarenal AAA Repair.
We studied whether the volume-outcome relationship would persist in more complex aortic operations. ⋯ Hospitals with low annualized volumes of open juxtarenal repair have higher perioperative mortality, irrespective of their total open aortic volume. Complex open AAA repairs should be performed at experienced centers, and future efforts should focus on centralization of complex aortic care.
-
Multicenter Study
Surgical Transgastric Necrosectomy for Necrotizing Pancreatitis: A Single-stage Procedure for Walled-off Pancreatic Necrosis.
The aim of this study was to evaluate the role of surgical transgastric necrosectomy (TGN) for walled-off pancreatic necrosis (WON) in selected patients. ⋯ Surgical TGN is an excellent 1-stage surgical option for symptomatic WON in a highly selected group of patients. Precise surgical technique and long-term outpatient follow-up are mandatory for optimal patient outcomes.
-
Multicenter Study
Leveraging the Incidence, Burden, and Fiscal Implications of Unplanned Hospital Revisits for the Prioritization of Prevention Efforts in Pediatric Surgery.
To characterize procedure-level burden of revisit-associated resource utilization in pediatric surgery with the goal of establishing a prioritization framework for prevention efforts. ⋯ A small number of procedures account for a disproportionate burden of revisit-associated resource utilization in pediatric surgery. Gastrostomy, fundoplication, and appendectomy should be considered high-priority targets for prevention efforts within pediatric surgery.