scholarly journals Impact of an active hemostatic product treatment approach on bleeding-related complications and hospital costs among inpatient surgeries in the United States

2021 ◽  
pp. 1-1
Author(s):  
David A. Iannitti ◽  
Chong Kim ◽  
Diane Ito ◽  
Josh Epstein
Keyword(s):  
United States ◽  
Treatment Approach ◽  
Hospital Costs ◽  
The United States

The Diffusion of New Hospital Technologies in the United States

1976 ◽  
Vol 6 (4) ◽  
pp. 557-580 ◽  
Author(s):  
Louise B. Russell
Keyword(s):  
United States ◽  
Intensive Care ◽  
Hospital Care ◽  
Hospital Costs ◽  
The United States ◽  
Major Contributor ◽  
Certificate Of Need ◽  
Hospital Regulation ◽  
Resource Requirements ◽  
Competing Technologies

Increases in the real resources used in hospital care have been an important cause behind rising hospital costs in the United States. Many of these resources have taken the form of new hospital technologies, and this paper begins by reviewing the trends in adoption of new hospital technologies over the years 1950–1974. The resource requirements, costs, and to the extent possible the patient benefits, of two of these technologies are then discussed in more detail: intensive care, a widespread facility with many variations, has been a major contributor to hospital costs; radiotherapy has been characterized by a succession of competing technologies. Regulatory efforts such as certificate-of-need reviews would be more effective if they viewed hospitals as flexible collections of such technologies—with the costs and patient benefits of each to be weighed separately—rather than primarily in terms of numbers of beds. A national center to collect information on the separate technological functions of hospitals and make it available to interested groups would make a useful contribution to hospital regulation.

Trends in utilization, perioperative outcomes, and costs among open, laparoscopic, and robotic nephroureterectomies: A 10-year population-based analysis.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 337-337
Author(s):  
Francisco Jose Gelpi-Hammerschdmidt ◽  
Christopher B. Allard ◽  
Benjamin I. Chung ◽  
Steven L. Chang
Keyword(s):  
United States ◽  
Hospital Costs ◽  
The United States ◽  
Population Based ◽  
Perioperative Outcomes ◽  
Patient Specific ◽  
Complication Rates ◽  
Incidence Risk ◽  
Nationally Representative ◽  
Survey Weighting

337 Background: Nephroureterectomy (NU) is the standard treatment for upper tract urothelial carcinoma (UTUC). Minimally invasive (MI) laparoscopic or robotic-assisted approaches have been introduced in an effort to reduce morbidity. We performed a population-based study to evaluate contemporary utilization trends, morbidity, and costs associated with NUs in the United States. Methods: Using the Premier Hospital Database (Premier, Inc., Charlotte, NC), a nationally representative discharge database with data from over 600 non-federal hospitals in the United States, we captured patients who underwent a NU (ICD-9 55.51) with diagnoses of renal pelvis (189.1) or ureteral (189.2) neoplasms from 2004 to 2013. We fitted regression models, adjusting for clustering by hospitals and survey weighting to evaluate 90-day postoperative complications, length of stay (LOS), OR time, and direct hospital costs among open, laparoscopic, and robotic NU. Results: The weighted cohort included 17,245 open, 13,298 laparoscopic, and 3,745 robotic NUs. MI surgeries increased from 36% to 54% from 2004 to 2013, while the number of NUs decreased by nearly 20% during the same period (Figure 1). The overall 90-day mortality, major (Clavien 3-5), and minor (Clavien 1-2) complication rates were 1.89%, 9.4%, and 27.7%, respectively, with no statistically significant differences between the three approaches based on adjusted logistic regression analyses. The LOS was decreased for laparoscopic (Incidence Risk Ratio [IRR]: 0.87, 95% CI: 0.82-0.92, p<0.001) and robotic (IRR: 0.76, 95% CI: 0.7-0.83, p<0.001) NU compared to open NU. OR time was 10.35 (p<0.05) and 56.35 (p<0.001) minutes longer for laparoscopic and robotic NU. Adjusted 90-day median direct hospital costs were $1,354 and $3,533 higher for laparoscopic and robotic NU (p<0.001). Conclusions: During this contemporary 10-year study, the use of MI NUs increased to over half of procedures with a recent surge in robotic NUs, along with a concurrent reduction in total NUs performed in the United States. Comparable perioperative outcomes suggest that the morbidity profile may be driven primarily by patient-specific characteristics as opposed to surgical approach.

335 Hospital Costs for Supporting Children with Ventricular Assist Device in the United States

2012 ◽  
Vol 31 (4) ◽  
pp. S119 ◽  
Author(s):  
A.X. Samayoa ◽  
B.S. Moffett ◽  
M.S. Khan ◽  
C.M. Mery ◽  
J.S. Heinle ◽  
...  
Keyword(s):  
United States ◽  
Ventricular Assist Device ◽  
Hospital Costs ◽  
The United States ◽  
Assist Device ◽  
Ventricular Assist

Antibiotic-Stewardship Practices at Top Academic Centers Throughout the United States and at Hospitals Throughout Massachusetts

2006 ◽  
Vol 27 (7) ◽  
pp. 695-703 ◽  
Author(s):  
Tamar F. Barlam ◽  
Margarita DiVall
Keyword(s):  
United States ◽  
Antibiotic Stewardship ◽  
Bacterial Resistance ◽  
Hospital Costs ◽  
Geographic Area ◽  
The United States ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Community Hospitals ◽  
Management Interventions

Objective.Improvements in antibiotic prescribing to reduce bacterial resistance and control hospital costs is a growing priority, but the way to accomplish this is poorly defined. Our goal was to determine whether certain antibiotic stewardship interventions were universally instituted and accepted at top US academic centers and to document what interventions, if any, are used at both teaching and community hospitals within a geographic area.Design.Two surveys were conducted. In survey 1, detailed phone interviews were performed with the directors of antibiotic stewardship programs at 22 academic medical centers that are considered among the best for overall medical care in the United States or as leaders in antibiotic stewardship programs. In survey 2, teaching and community hospitals throughout Massachusetts were surveyed to ascertain what antibiotic oversight program components were present.Results.In survey 1, each of the 22 participating hospitals had instituted interventions to improve antibiotic prescribing, but none of the interventions were universally accepted as essential or effective. In survey 2, of 97 surveys that were mailed to prospective participants, a total of 54 surveys from 19 teaching hospitals and 35 community hospitals were returned. Ninety-five percent of the teaching hospitals had a restricted formulary, compared with 49% of the community hospitals, and 89% of teaching hospitals had an antibiotic approval process, compared with 29% of community hospitals.Conclusion.There was great variability among the approaches to the oversight of antibiotic prescribing at major academic hospitals. Antibiotic management interventions were lacking in more than half of the Massachusetts community hospitals surveyed. More research is needed to define the best antibiotic stewardship interventions for different hospital settings.

scholarly journals To market, to market: Corporatisation, privatisation and hospital costs

1997 ◽  
Vol 20 (2) ◽  
pp. 13 ◽  
Author(s):  
Kevin White ◽  
Fran Collyer
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Services ◽  
Hospital Costs ◽  
The United States ◽  
Political Arena ◽  
The Public ◽  
Care Services ◽  
Health Strategy ◽  
Australian Hospital

The Australian political arena echoes with calls for the privatisation of health careinstitutions, the contracting-out of health care services and the introduction of variousmarketing strategies into hospital management. These calls are justified by assertingthat the market, rather than the public sector, can provide better services, greaterproductivity and increased efficiency. The National Health Strategy (1991, p 17)provides a good example. Noting that Australia is copying American investment trendsfor hospital ?chains? rather than for independent small establishments, the strategydismisses any concern over changes in ownership, pointing instead to a ?process ofrationalisation? that is to be ?welcomed?. Using evidence from the United States,United Kingdom and Australian hospital sectors, this paper examines claims for thegreater efficiency of market processes.

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