OBJECTIVE It is widely accepted that, when feasible, nephron-sparing surgery (NSS) is preferable to radical nephrectomy (RN) for treatment of renal tumors in adults. However, RN is more frequently used in children. We sought to compare in-hospital outcomes after NSS and RN for malignant pediatric renal tumors. MATERIAL AND METHODS The pediatric health information system (PHIS) combines data f...

OBJECTIVES To determine associations between intraoperative neurophysiologic monitoring (IOM) for spinal decompressions and simple fusions with neurologic complications, length of stay, and hospitalization charges. METHODS Adult discharges in the Nationwide/National Inpatient Sample (NIS) (2007-2012) with spinal decompressions and simple spinal fusions were included. Revision surgeries, instr...

Objective Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery. Methods Patients aged >18 who underwent TV repair or replacement...

BACKGROUND AND PURPOSE Studies of several complex medical conditions have shown that outcomes are better at hospitals that treat more cases. We tested the hypothesis that patients with subarachnoid hemorrhage treated at high-volume hospitals have better outcomes. METHODS Using a database of all admissions to nonfederal hospitals in California from 1990 to 1999, we obtained discharge abstracts...

Introduction Case management is an effective, short-term means to reduce emergency department (ED) visits in frequent users of the ED. This study sought to determine the effectiveness of case management on frequent ED users, in terms of reducing ED and hospital length of stay (LOS), accrued costs, and utilization of diagnostic tests. Methods The study consisted of a retrospective chart review...

BACKGROUND Continuity of care (COC) has received attention over the past decade. COC has also become increasingly important for hospital managers and policy makers because of competitive health care market conditions. The purpose of this study was to assess the association between hospital charges and patients' continuity of care-assessed by three indices of continuity of care-among outpatients...

CONTEXT Although medical injuries are recognized as a major hazard in the health care system, little is known about their impact. OBJECTIVE To assess excess length of stay, charges, and deaths attributable to medical injuries during hospitalization. DESIGN, SETTING, AND PATIENTS The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) were used to identify medi...

BACKGROUND Atlantoaxial fusion is an effective procedure for treating degenerative, traumatic, and congenital abnormalities that result in upper cervical instability; however, data on which factors affect the length of stay and hospitalization-related charges are limited. The purpose of this study was to evaluate the pre-, intra-, and postoperative variables that affect these healthcare cost fa...

The purpose of this study was to determine the charges for radiofrequency catheter modification of the atrioventricular (AV) node in 15 patients with symptomatic AV node reentrant tachycardia despite pharmacologic therapy and to compare these charges with the estimated charges for health care utilization by the same patients before the catheter procedure was performed. There were seven men and ...

Cost-benefit analysis of endovascular treatment compared to open-surgical treatment of cerebral aneurysms in the setting of global economic restrictions is of growing importance. We present our experience with coil embolization and a modified thumb-sized pterional craniotomy for clip ligation of unruptured anterior circulation cerebral aneurysms performed in a major tertiary cerebrovascular cen...