An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank

2020 ◽  
pp. 019459982094249
Author(s):  
Christopher T. Breen ◽  
Saral Mehra
Keyword(s):  
Medical Malpractice ◽  
Kendall Test ◽  
Data Bank ◽  
Annual Number ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Trends Over Time ◽  
National Practitioner Data Bank ◽  
Sectional Analysis

Objective To describe malpractice payments made on behalf of otolaryngologists, analyze trends over time, and test the association of payment amount with severity of alleged malpractice and patient age. Study Design Retrospective cross-sectional analysis. Setting National Practitioner Data Bank. Subjects and Methods This study comprised all payments made on behalf of otolaryngologists from 1991 to 2018 that were reported to the National Practitioner Data Bank. Descriptive statistics were calculated within and across years. Trends in payments were analyzed with the Mann-Kendall test. Generalized linear regression was utilized to test for association of payment amount with severity of the alleged injury and patient age. Results From 1991 to 2018, there was a significant decrease in the number of payments (272 to 81) and number of otolaryngologists on whose behalf payments were made (250 to 77). Mean and median payments increased significantly from $248,848 to $420,386 and from $96,813 to $275,000, respectively. By severity of alleged injury, mean payments ranged from $39,755 (95% CI, $20,957-$75,412) for insignificant injury to $754,349 (95% CI, $624,847-$910,692) for patients who were left quadriplegic, sustained brain damage, or required lifelong care. By patient age, mean payments for patients ≥60 years old were $191,465 (95% CI, $159,880-$229,292) versus $247,878 (95% CI, $209,416-$293,402) for patients aged 20 to 39 years and $232,225 (95% CI, $197,691-$272,793) for patients aged 40 to 59 years. Conclusion The annual number and total value of malpractice payments decreased, while the annual mean and median payments increased. Payment amount was associated with severity of alleged malpractice and patient age.

scholarly journals Prevalence and Degree of Breast Arterial Calcifications on Mammography: A Cross-sectional Analysis

2013 ◽  
Vol 3 ◽  
pp. 36 ◽  
Author(s):  
Norman Loberant ◽  
Vera Salamon ◽  
Nurit Carmi ◽  
Anna Chernihovsky
Keyword(s):  
Regression Analysis ◽  
Statistical Analysis ◽  
Strong Correlation ◽  
Ethnic Origin ◽  
Patient Age ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Patient Âgé ◽  
Sectional Analysis ◽  
High Degree

Objectives: The purpose of this study is to establish a database including prevalence and degree of breast arterial calcifications (BAC) in our population of women presenting for mammography. Materials and Methods: The mammograms of 1786 women over the age of 40 years were examined for the presence and degree of BAC. Statistical analysis was performed to correlate patient's age and ethnic origin with the presence and degree of BAC. Results: There was statistically significant and strong correlation between the patient's age and presence of BAC. There was also a less strong yet statistically significant correlation between patient age and degree of BAC. Regression analysis showed the likelihood of BAC at various ages. The prevalence of BAC is only 2% of women under 50 years of age; the prevalence of Grade 2-3 BAC is only 1% in women under 60 years of age. Conclusion: There is a predictable increase with age in both prevalence and degree of BAC in women. The presence of high degree BAC in women under 60 years of age or any BAC in women under 50 years of age is unusual.

scholarly journals Influence of patient age and colorectal polyp size on histopathology findings

2014 ◽  
Vol 27 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Silvana Marques e SILVA ◽  
Viviane Fernandes ROSA ◽  
Antônio Carlos Nóbrega dos SANTOS ◽  
Romulo Medeiros de ALMEIDA ◽  
Paulo Gonçalves de OLIVEIRA ◽  
...  
Keyword(s):  
Demographic Data ◽  
Colorectal Polyp ◽  
Proximal Colon ◽  
Colorectal Polyps ◽  
University Hospital ◽  
Consecutive Series ◽  
Polyp Size ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé

BACKGROUND: Colorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening. AIM: To assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size. METHODS: Retrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older. RESULTS: A total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia. CONCLUSION: Polyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.

scholarly journals Patient-level and practice-level factors associated with consultation duration: a cross-sectional analysis of over one million consultations in English primary care

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018261 ◽  
Author(s):  
Sarah Stevens ◽  
Clare Bankhead ◽  
Toqir Mukhtar ◽  
Rafael Perera-Salazar ◽  
Tim A Holt ◽  
...  
Keyword(s):  
Older Patient ◽  
Consultation Rate ◽  
Patient Age ◽  
Cross Sectional ◽  
Face To Face ◽  
Practice Level ◽  
Patient Level ◽  
Patient Gender ◽  
Patient Âgé ◽  
General Practices

ObjectivesConsultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care.Design and settingCross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement.Participants218 304 patients, from 316 English general practices, consulting from 1 April 2013 to 31 March 2014.AnalysisMultilevel mixed-effects models described the association between consultation duration and patient-level and practice-level factors (patient age, gender, smoking status, ethnic group, deprivation and practice rurality, number of full-time equivalent GPs/nurses, list size, consultation rate, quintile of overall QOF achievement and training status).ResultsMean duration of face-to-face GP consultations was 9.24 min and 5.32 min for telephone consultations. Nurse face-to-face and telephone consultations lasted 9.70 and 5.73 min on average, respectively. Longer GP consultation duration was associated with female patient gender, practice training status and older patient age. Shorter duration was associated with higher deprivation and consultation rate. Longer nurse consultation duration was associated with male patient gender, older patient age and ever smoking; and shorter duration with higher consultation rate. Observed differences in duration were small (eg, GP consultations with female patients compared with male patients were 8 s longer on average).ConclusionsSmall observed differences in consultation duration indicate that patients are treated similarly regardless of background. Increased consultation duration may be beneficial for older or comorbid patients, but the benefits and costs of increased consultation duration require further study.

scholarly journals Food Insecurity in a Pediatric Emergency Department and the Feasibility of Universal Screening

2021 ◽  
Vol 22 (6) ◽  
pp. 1295-1300
Author(s):  
Jaqueline Valdez Gonzalez ◽  
Emily Hartford ◽  
Jennifer Moore ◽  
Julie Brown
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Food Insecurity ◽  
Private Insurance ◽  
Care Quality ◽  
Screening Methods ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Medical Complexity

Introduction: Children with food insecurity (FI) experience adverse health outcomes due to inadequate quantity or quality of food. Food insecurity may be high among families seeking emergency care. The Hunger Vital Sign (HVS) is a two-question validated tool used to screen families for FI. Our goal in this study was to assess prevalence of FI among emergency department (ED) patients, patient-level risk factors for FI, and the feasibility of screening. Methods: This was a cross-sectional analysis of FI in the ED. Parents or guardians of ED patients and adult patients (18 years or older) were approached for screening using the HVS during screening periods spanning weekdays/weekends and days/evenings. All ED patients were eligible, excluding siblings, repeat visits, critically ill patients, minors without a guardian, and families that healthcare staff asked us not to disturb. Families answered the HVS questions verbally or in writing, based on preference. Families with positive screens received information about food resources. We summarized patient and visit characteristics and defined medical complexity using a published algorithm. Multivariable logistic regression was used to assess FI risk factors. Results: In July-August 2019, 527 patients presented during screening periods: 439 agreed to screening, 18 declined, 19 met exclusions, and 51 were missed. On average the screening tool required five minutes (range 3-10 minutes) to complete. Most families (328; 75%) preferred to answer in writing rather than verbally. Overall, 77 participants (17.5%) screened positive for FI. In regression analyses, FI was associated with self-reported race/ethnicity (combined variable) of African American or Black (odds ratio [OR] 5.21, 95% confidence interval [CI], 2.13-12.77), Hispanic (OR 3.47, 95% CI, 1.48-8.15), or mixed/other (OR 3.81, 95% CI, 1.54-9.39), compared to non-Hispanic white. FI was also associated with public insurance type (OR 5.74, 95% CI, 2.52-13.07, reference: private insurance), and each year of increasing patient age (OR 1.05, 95% CI, 1.01-1.09). There were no associations between FI and medical complexity or preferred language. Conclusion: Food insecurity was common among our ED patients. Race and ethnicity, insurance status, and increasing patient age were associated with increased odds of FI. Efforts to include universal FI screening for ED patients with immediate connection to resources will enhance overall care quality and address important health needs.

scholarly journals Factors that influence functional ability in individuals with spinal cord injury: A cross-sectional, observational study

2015 ◽  
Vol 71 (1) ◽  
Author(s):  
Bronwyn M. Hastings ◽  
Mokgobadibe V. Ntsiea ◽  
Steve Olorunju
Keyword(s):  
Spinal Cord ◽  
Observational Study ◽  
Functional Ability ◽  
Functional Independence ◽  
Pressure Sores ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Rehabilitation Facilities ◽  
Influence Functional

Background: Spinal cord injuries result in devastating impairments that can produce severe functional limitations. However, few documented studies have investigated the levels of function and factors that influence functional ability at discharge from in-patient rehabilitation facilities in Gauteng following such injuries. This necessitated further investigation.Method: Fifty participants were recruited for this cross-sectional, observational study. Participants were recruited from one private and one government spinal rehabilitation unit in Gauteng. A custom-developed questionnaire was used to establish the physical and demographic characteristics of the sample, whilst existing classification scales and measures were used to establish the degree of a lesion and a patient’s associated functional ability. Data were analysed using descriptive statistics. Multiple regression analysis was performed to determine factors that influenced the level of functional ability.Results: Patients achieved an average functional independence score of 64.6 (± 27.6) at discharge according to the Spinal Cord Independence Measure III. Longer stays at rehabilitation facilities were associated with higher scores, whereas scores decreased with increasing patient age. Pressure sores and spasticity affected scores negatively. The type of funding also influenced patients’ scores, with government funding being associated with the best outcome. Both the degree and the level at which the injury occurred could be considered predictive measures that influenced functional independence scores.Conclusion: Most participants were not functionally independent at discharge. Factors such as patient age, length of rehabilitation, presence of pressure sores or spasticity, degree of motor ability and location of the injury should be considered in tailoring rehabilitation therapy.

scholarly journals Decision-Making in Implantology—A Cross-Sectional Vignette-Based Study to Determine Clinical Treatment Routines for the Edentulous Atrophic Mandible

2021 ◽  
Vol 18 (4) ◽  
pp. 1596
Author(s):  
Michael Korsch ◽  
Winfried Walther ◽  
Bernt-Peter Robra ◽  
Aynur Sahin ◽  
Matthias Hannig ◽  
...  
Keyword(s):  
Decision Making ◽  
Cross Sectional Study ◽  
Bone Block ◽  
Bone Resection ◽  
Patient Age ◽  
Cross Sectional ◽  
Therapy Decision ◽  
Patient Âgé ◽  
Edentulous Mandible ◽  
Radiation Area

This cross-sectional study aimed to investigate the influence of possible factors in the patient history on decision making in the therapy for a severely atrophied edentulous mandible. A vignette-based survey among 250 maxillofacial and oral surgeons was conducted. Determinants that could influence the therapy decision were patient age, smoking, fear of surgery, and radiotherapy in the head and neck area (the implant region is not in the direct radiation area). To achieve a suitable implant site, the options offered to the surgeons were bone split, bone block, augmentation with bone substitute material, and bone resection. There also was the option of rejecting any therapy. The response rate was 47%. Patient age, radiotherapy, and fear of surgery did not influence the approval of a therapy. Smoking was associated with a significantly lower endorsement of a treatment. Resection was preferred by a large majority to all other forms of therapy, regardless of the four determinants. Surgeons tend to refrain from bone block transplants in older patients. In summary, it can be said that, of the four determinants, only smoking influenced treatment refusal. Bone resection is the preferred therapy independent of all determinants.

Individual Case Safety Reports Analysis for Patients with Diabetes Mellitus on Insulin in Africa and the Middle East

2021 ◽  
Vol 16 ◽  
Author(s):  
Charity R.N. Mlotshwa ◽  
Johanita R. Burger ◽  
Martine Vorster ◽  
Dorcas M. Rakumakoe ◽  
Marike Cockeran
Keyword(s):  
Diabetes Mellitus ◽  
Middle East ◽  
Microvascular Complications ◽  
Individual Case ◽  
Cross Sectional Study ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Patients With Diabetes ◽  
Insulin Use

Background: The growing numbers of patients with diabetes mellitus in Africa and the Middle East on antidiabetic therapies necessitate an understanding of adverse event (AE) reporting in these regions. Objective: To provide an AE reporting overview in patients using insulins in Africa and the Middle East by characterizing and comparing individual case safety reports (ICSRs) features. Method: The cross-sectional study analyzed ICSR data from a global pharmaceutical company’s pharmacovigilance database for January to December 2018 to describe and compare patient demographics, report sources, reporter types, ICSR seriousness, suspect products, indication for insulin use and AE preferred terms, by country. Results: Overall 7076 ICSRs were analyzed, 63.6% from the Middle East. Most ICSRs were non-serious (91.5%), from solicited sources (83.5%), and reported by consumers (70.7%). Patients from the Middle East were, on average, 34.2 years of age, had gestational diabetes mellitus as indication (64.3%), insulin detemir as suspect product (76.5%), and exposure during pregnancy as AE preferred term (89.1%). Patients from Africa were 48.1 years old on average, a higher proportion of type 2 diabetes mellitus was observed (52.2%), human insulins the suspect product (51.6%), and blood glucose increased the AE preferred term (23.1%). Few macrovascular and microvascular complications were reported (<1% in both regions). Associations between the region and patient age, gender, report sources, reporter types, indications for insulin use, suspect products, and AE preferred term were significant (p <0.001). Conclusion: ICSRs features were region-specific and dependent on patient age, gender, report sources, reporter types, suspect products, and AE preferred terms.

Factors Associated with Antihypertensive Prescribing

1997 ◽  
Vol 31 (2) ◽  
pp. 154-159 ◽  
Author(s):  
Michael B Nichol ◽  
Jane E Margolies ◽  
Mark A Gill
Keyword(s):  
Combination Therapy ◽  
Physician Specialty ◽  
Health Utilization ◽  
Patient Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Patient Âgé ◽  
Multiple Variable ◽  
Ambulatory Medical Care ◽  
Diagnosis Of Hypertension

Objective To investigate factors associated with treatment approaches to hypertension, a major risk factor for coronary heart and cerebrovascular disease and a significant healthcare problem in the US. The study reports on three cross-sectional national surveys of patient–physician encounters. Population Visits were selected for adults with hypertension diagnoses from the National Ambulatory Medical Care Surveys, which represent office encounters during a given year. Years of observation included 1989, 1990, and 1991. Methods Multiple variable logistic regression was used to identify predisposing, need, enabling, and health utilization characteristics associated with whether the visit resulted in a prescription of an antihypertensive. Additionally, the association of these visits with combination therapy is determined. Results For each of the 3 years, 69–75% of the encounters were associated with a prescription for drugs to treat hypertension. Prescribing is consistent with current literature demonstrating decreasing reliance on diuretics and β-blockers, and increasing reliance on calcium antagonists. Combination therapy decreased as a percentage of prescriptions in 1990 and 1991. Variables associated with receiving an antihypertensive prescription included predisposing characteristics (patient age >65 y), need characteristics (diagnosis of congestive heart failure [CHF]), and health utilization characteristics (physician specialty, previous diagnosis of hypertension). The most significant variables associated with combination therapy were predisposing characteristics (patient age >65 y), need (CHF diagnosis, diagnosis of hypertension with end organ involvement), and health utilization characteristics (physician specialty). Conclusions These national estimates reinforce previous regional data regarding the categories of hypertension medications used. Patient visits involving multiple diagnoses, cardiologists, or patients older than 65 years, are more likely to generate prescriptions for combination antihypertensive therapy.

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