Annals of surgery
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Multicenter Study
The Increasing Financial Burden of Outpatient Elective Surgery for the Privately Insured.
To examine temporal trends of OOP expenses, total payments, facility fees, and professional fees for outpatient surgery. ⋯ Increases in outpatient surgery total payments were driven primarily by facility fees and OOP expenses. OOP expenses are rising faster than total payments, highlighting the transition of costs to patients. Healthcare cost reduction policies should consider the largest areas of spending growth such as facility fees and OOP expenses to minimize the financial burden placed on patients.
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Multicenter Study
The Impact of Mental Illness on Postoperative Outcomes Among Medicare Beneficiaries: A Missed Opportunity to Help Surgical Patients?
The aim of this study was to define the prevalence of preexisting mental illness, as well as characterize the impact of a preexisting mental illness diagnosis on postoperative outcomes. ⋯ Three in 10 Medicare beneficiaries had a preexisting mental illness diagnosis, which was strongly associated with worse postoperative outcomes, as well as suicide risk. Surgeons need to optimize mental health assessment and services in the preoperative setting to improve outcomes for this vulnerable population.
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Randomized Controlled Trial
Surgical Outcome Results From SWOG S1505: A Randomized Clinical Trial of mFOLFIRINOX Versus Gemcitabine/Nab-paclitaxel for Perioperative Treatment of Resectable Pancreatic Ductal Adenocarcinoma.
The optimal neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma (PDA) and the impact on surgical outcomes remains unclear. ⋯ We have demonstrated: (1) Based on the high percentage of enrolled, but ineligible patients, it is clear that adherence to strict definitions of resectable PDA is challenging; (2) Patients can tolerate modern systemic therapy and undergo successful surgical resection without prohibitive perioperative complications; (3) Completion of adjuvant therapy in the perioperative format is difficult; (4) Major pathologic response rate of 33% is encouraging.