Surgery
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Although hospital variation in costs and outcomes has been described for patients undergoing operation, the relationship between them is unknown. The purpose of this study was to evaluate this relationship among patients undergoing colon resection for cancer and identify characteristics of "high-quality, low-cost" hospitals. ⋯ Hospital costs are not correlated with outcomes in this population. More work is needed to identify means of providing high-quality care at lesser costs.
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The goal of this study was to examine how industrial process improvement techniques could help streamline the preoperative workup. ⋯ Utilizing process improvement methodology, surgery patients can benefit from an improved, streamlined process with significant reduction in wait time from call to initial consult and initial consult to surgery, with reduced cancellations. This generalized process has resulted in increased practice throughput and efficiency and is applicable to any surgery practice.
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Little information is available about postdischarge adverse events after laparoscopic cholecystectomy. ⋯ More than 18% of Medicare patients undergoing presumably low-risk elective inpatient laparoscopic cholecystectomy died, had a severe inpatient complication, or were readmitted within 90 days of discharge.
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The aim of this study is to determine if resident involvement in a large cohort of laparoscopic colorectal surgery (LCS) cases negatively impacts outcomes and ultimately increases costs. ⋯ Although resident participation in LCS does not affect overall mortality or morbidity, it may negatively impact hospital costs through increased operative time and length of hospital stay. Early and intensive laparoscopy training may be necessary for improving residents' laparoscopy skills before their involvement in LCS.