Journal of the American College of Surgeons
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The aim of this study is to investigate patient-centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair. ⋯ Laparoscopic paraesophageal hernia repair results in significantly improved QOL as measured by the 36-Item Short Form Health Survey at both short- and long-term intervals. Additionally, Reflux Symptom Index and GERD Health Related Quality of Life scores improved at all postoperative time points.
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An initiative was established to improve value-based care for pancreatic surgery in a large nonprofit health system. Cost data were presented bimonthly to a hepatobiliary clinical performance group via videoconference. ⋯ There was a significant cost reduction for PD but not DP when the threshold of 5 PDs was used as a definition of high volume. The sharing of detailed financial data with HPB surgeons on a regular basis provides an opportunity to evaluate practice patterns and thereby reduce direct costs.