American journal of physical medicine & rehabilitation
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Containment of health care costs is a pressing national issue. In this study, we examined physician knowledge of rehabilitation hospital costs by quantifying their awareness of hospital charges. All physicians at a free-standing rehabilitation hospital were surveyed. ⋯ Physicians' confidence in their knowledge of these fees was quite low. They indicated that they were guessing 80 to 90% of the time, had an idea of the cost for 10 to 20% of the items, and were confident in their knowledge for less than 1% of the items. There were no significant correlations between accuracy of the charge estimates and ordering frequency, actual charge of the item, or experience level of the physicians.
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Am J Phys Med Rehabil · Nov 1996
Anatomy of the iliolumbar ligament: a review of its anatomy and a magnetic resonance study.
Data of the postmortem studies of the iliolumbar ligament are controversial because of the number, complexity, and variability of the structures present in the lumbosacral region. The objective of this work was to study the anatomy of the iliolumbar ligament to resolve some clinical problems: (1) do anatomic bases exist that can explain the lumbar painful syndrome termed "iliolumbar syndrome?" (2) do iliolumbar ligament varieties exist that can influence lumbosacral joint stability? Magnetic resonance was used to analyze the anatomic structure of the iliolumbar ligament of live human beings. Thirty iliolumbar ligaments of 15 volunteers were analyzed with magnetic resonance. ⋯ This posterior band is thinner than the anterior, with a smaller insertional base on the iliac crest, which explains its lesser resistance to torsional overloading and also explains the frequency of this painful syndrome. It is probable that the spatial disposition of the iliolumbar ligament influences its antitorsional role. Further anatomic and biomechanic studies are needed.
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Am J Phys Med Rehabil · Nov 1996
Revised trauma score: an additive predictor of disability following traumatic brain injury?
Recent studies have clarified the role of hypoxic-ischemic damage as a secondary factor in traumatic brain injury (TBI). Many trauma centers are now consistently using the Revised Trauma Score (Glasgow Coma Scale, systolic blood pressure, and respiratory rate) to assist with triage of multitrauma patients. This study investigated the predictive power of the Revised Trauma Score (RTS) instead of the Glasgow Coma Scale (GCS) in determination of disability as measured by the Disability Rating Scale (DRS). ⋯ Lowest GCS within the first 24 h postinjury also failed to show a strong relationship with DRS at rehabilitation admission (-0.28) and discharge (-0.24). Multiple regression analysis performed on RTS subsets for systolic blood pressure and respiratory rate did not reveal an added predictive value. Although RTS may be important in emergency triage for its ability to predict mortality, this study indicates its limited usefulness in prediction of disability.