Articles: hospitals.
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This retrospective study compared unilateral pedicle screw combined with contralateral translaminar facet joint screw (UPS+TFS) fixation with bilateral pedicle screw (BPS) fixation in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-segment lumbar degenerative disease. ⋯ UPS+TFS and BPS fixation during MIS-TLIF can achieve favorable clinical outcomes with no difference in long-term clinical efficacy. UPS+TFS demonstrates perioperative advantages such as reduced intraoperative blood loss, shorter operation time, reduced postoperative hospital stay, and less iatrogenic injury. Therefore, MIS-TLIF with UPS+TFS fixation is a reliable treatment for single-segment lumbar degenerative disease.
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Nonprofit hospitals are under increasing scrutiny to justify the generous tax benefit they receive due to their tax-exempt status. Quantifying the value of the tax benefit they receive at the federal, state, and local levels is critical for designing informed public health policies and ensuring nonprofit hospitals' taxpayer accountability. ⋯ This study highlights the wide variation of nonprofit hospitals' tax benefit across states, its high concentration among a small number of hospitals, and the primary role played by state and local taxes. Policy efforts to strengthen nonprofit hospitals' taxpayer accountability are likely to be more effective when pursued at the local level. The detailed standardized estimation road map can be used by various stakeholders to estimate tax benefit for external valuation and reporting purposes, updated as laws change, and improved upon as better data sources become available.
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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Recent studies suggest that early administration of fibrinogen concentrate is feasible and effective to prevent coagulopathy. We conducted a scoping review to characterize the existing quantity of literature and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. ⋯ Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.
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Evidence on patient experiences with pain in hospitals and its impact on post-discharge outcomes is limited. This study investigated the prevalence of pain in hospitals, patient characteristics associated with pain management adequacy, and the link between pain experiences, care ratings, readmission and emergency department visits after discharge. ⋯ This study highlights the importance of adequate pain management in patients' perception of care and recovery outcomes, especially among culturally and linguistically diverse patients.