scholarly journals Resident Involvement in Common Plastic and Reconstructive Procedures: Is There an Opportunity Cost?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Connor J. Peck ◽  
Sumun Khetpal ◽  
Alvaro Reategui ◽  
Sarah Phillips ◽  
Joseph Lopez ◽  
...  
2022 ◽  
pp. 175857322110654
Author(s):  
Hasani W Swindell ◽  
Alirio J deMeireles ◽  
Jack R Zhong ◽  
Elise C. Bixby ◽  
Bryan M Saltzman ◽  
...  

Background There is minimal work defining the economic impact of resident participation in shoulder arthroplasty. Thus, this study quantified the opportunity cost of resident participation in total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) by determining differences in operative time, relative value units (RVUs)/hour, and RVUs/case. Methods A retrospective analysis of shoulder arthroplasty procedures were identified from the ACS-NSQIP database from 2006 to 2014 using CPT codes. Demographic, comorbidity, preoperative laboratory data and surgical procedure were used to develop matched cohorts. Mean differences in operative time, RVUs/case and RVUs/hour between attending-only (AO) cases and cases with resident involvement (RI) were examined. Cost analysis was performed to identify differences in RVUs generated per hour in dollars/case. Results A total of 1786 AO and 1102 RI cases were identified. With the exception of PGY-3 and PGY-4 cases, RI cases had lower mean operative times compared to AO cases. The cost of RI was highest for PGY-3 ($199.87 per case) and PGY-4 ($9 .2 9) residents with all other postgraduate years providing a cost reduction. Discussion Involvement of residents was associated with shorter operative times leading to a savings of $29.64 per case. Involvement of intermediate-level (PGY-3) residents were associated with increased costs that ultimately decreased as residents became more senior.


2019 ◽  
Vol 35 (12) ◽  
pp. e33-e34
Author(s):  
Nikhil Verma ◽  
Alexander Beletsky ◽  
Bhavik H. Patel ◽  
Yining Lu ◽  
Brian Forsythe

2020 ◽  
Vol 36 (3) ◽  
pp. 834-841 ◽  
Author(s):  
Alexander Beletsky ◽  
Yining Lu ◽  
Brandon J. Manderle ◽  
Bhavik H. Patel ◽  
Jorge Chahla ◽  
...  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sumun Khetpal ◽  
Sarah Phillips ◽  
Yassmin Parsaei ◽  
Connor Peck ◽  
Joseph Lopez ◽  
...  

1998 ◽  
Vol 3 (5) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham

Abstract Accurate measurement of shoulder motion is critical in assessing impairment following shoulder disorders. To this end, measuring and recording joint motion are important steps in diagnosing, determining the severity and progression of a disorder, assessing the results of treatment, and evaluating impairment. Shoulder movement usually is composite rather than in a single plane, so isolating single movements is challenging. Universal goniometers with long arms are used to measure shoulder motion, and testing must be performed and recorded consistently. Passive motion may be carried out cautiously by the examiner; two measurements of the same patient by the same examiner should lie within 10° of each other. Shoulder extension and flexion are illustrated. Maximal flexion of the shoulder also includes slight external rotation and abduction, and controlling or eliminating these components during evaluation is challenging. Abduction and adduction are illustrated. Deficits in external rotation may occur in patients who have undergone reconstructive procedures with an anterior approach; deficits in internal rotation may result from issues with shoulder instability. The authors recommend recording the shoulder's range of motion measurements according to the Upper Extremity Impairment Evaluation Record in the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition.


Swiss Surgery ◽  
2002 ◽  
Vol 8 (2) ◽  
pp. 45-52 ◽  
Author(s):  
Remmel ◽  
Harder

Prophylactic mastectomy is an aggressive strategy for breast cancer risk reduction. The indications and efficiency of this procedures are not yet clearly defined. Randomized, prospective studies, comparing different surgical procedures with other modalities of breast cancer risk reduction are lacking. The report evaluates the existing controversy, based on Medline search in the following sequence: risk factors, possibilities of risk reduction, effectiveness of risk reduction, technical considerations and recommendations. Patient selection is difficult and needs an interdisciplinary approach. The women have to be well informed about all treatment alternatives and various reconstructive procedures. An appropriate risk reduction strategy should be selected individually for each patient. Up to now, there exist only recommendations from different institutions but no definitive guidelines.


2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
T. Yano ◽  
M. Okazaki ◽  
K. Tanaka ◽  
A. Tsunoda ◽  
M. Aoyagi ◽  
...  

2018 ◽  
Author(s):  
J Neymeyer ◽  
AY Weintraub ◽  
S Weinberger ◽  
DE Moldovan ◽  
K Kornienko ◽  
...  

2012 ◽  
Vol 9 (1) ◽  
pp. 65-74 ◽  
Author(s):  
Agustín Escobar Latapi

Although the migration – development nexus is widely recognized as a complex one, it is generally thought that there is a relationship between poverty and emigration, and that remittances lessen inequality. On the basis of Latin American and Mexican data, this chapter intends to show that for Mexico, the exchange of migrants for remittances is among the lowest in Latin America, that extreme poor Mexicans don't migrate although the moderately poor do, that remittances have a small, non-significant impact on the most widely used inequality index of all households and a very large one on the inequality index of remittance-receiving households, and finally that, to Mexican households, the opportunity cost of international migration is higher than remittance income. In summary, there is a relationship between poverty and migration (and vice versa), but this relationship is far from linear, and in some respects may be a perverse one for Mexico and for Mexican households.


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