scholarly journals Complications and Cost of Syndactyly Reconstruction in the United States: Analysis of the Pediatric Health Information System

Hand ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Maria F. Canizares ◽  
Lanna Feldman ◽  
Patricia E. Miller ◽  
Peter M. Waters ◽  
Donald S. Bae
Keyword(s):  
United States ◽  
Information System ◽  
Health Information ◽  
Orthopedic Surgery ◽  
Complication Rate ◽  
Health Information System ◽  
The United States ◽  
Pediatric Health ◽  
Pediatric Hospitals ◽  
Pediatric Orthopedic

Background: Syndactyly is one of the most common congenital differences of the upper extremity and offers an exceptional opportunity to evaluate value-based care in pediatric orthopedic surgery. We designed a study to characterize complications and cost associated to syndactyly surgery among US pediatric hospitals. Methods: A total of 2047 patients were identified for syndactyly surgery at 38 pediatric hospitals from 2009 to 2012 using the Pediatric Health Information System (PHIS) database. We examined costs as well as complication rates across hospitals stratified by patient and hospital variables. Results: The postoperative complication rate was 1.9% (95% confidence interval [CI]: 1.3%-2.5%). Postoperative infection rate was 1.6% and surgical complication rate was 0.3%. Median adjusted standardized cost was $4112.5 (interquartile range: $2979-$6049). Patients with more than 1 diagnosis had 19 times higher risk of complications and were associated with 13% more hospital cost than those with syndactyly as single diagnosis ( P < .001). Finally, there was a wide variation in cost across hospitals; 8 (21%) yielded confidence limits above the benchmarked value. Conclusions: In the United States, it is important to recognize variations in practice of syndactyly surgery in hopes of developing quality improvement strategies in pediatric orthopedic surgery.

Posaconazole Administration in Hospitalized Children in the United States

2018 ◽  
Vol 8 (5) ◽  
pp. 481-484
Author(s):  
Sondra Lavigne ◽  
Brian T Fisher ◽  
Darcy Ellis ◽  
Theoklis E Zaoutis ◽  
Kevin J Downes
Keyword(s):  
United States ◽  
Information System ◽  
Health Information ◽  
Health Information System ◽  
The United States ◽  
Hospitalized Children ◽  
Pediatric Health ◽  
System A ◽  
Using Data

Abstract In this study, we evaluated posaconazole use among hospitalized children between October 2006 and September 2015 using data from the Pediatric Health Information System. A total of 878 children (in 1949 admissions) received posaconazole, and administration increased 22% per year overall and 27% per year in children aged <13 years for whom the drug was not approved.

National efforts to improve health information system safety in Canada, the United States of America and England

2013 ◽  
Vol 82 (5) ◽  
pp. e149-e160 ◽  
Author(s):  
Andre W. Kushniruk ◽  
David W. Bates ◽  
Michael Bainbridge ◽  
Mowafa S. Househ ◽  
Elizabeth M. Borycki
Keyword(s):  
United States ◽  
Information System ◽  
Health Information ◽  
United States Of America ◽  
Health Information System ◽  
The United States ◽  
System Safety ◽  
Improve Health

Post-Traumatic Hydrocephalus in Children: A Retrospective Study in 42 Pediatric Hospitals Using the Pediatric Health Information System

Neurosurgery ◽  
2017 ◽  
Vol 83 (4) ◽  
pp. 732-739 ◽  
Author(s):  
Robert H Bonow ◽  
Assaf P Oron ◽  
Brian W Hanak ◽  
Samuel R Browd ◽  
Randall M Chesnut ◽  
...  
Keyword(s):  
Information System ◽  
Health Information ◽  
Age Groups ◽  
Health Information System ◽  
International Classification Of Diseases ◽  
Pediatric Health ◽  
Pediatric Hospitals ◽  
Classification Of Diseases ◽  
Post Traumatic ◽  
Early Cranioplasty

Abstract BACKGROUND Post-traumatic hydrocephalus (PTH) is a potentially treatable cause of poor recovery from traumatic brain injury (TBI) that remains poorly understood, particularly among children. OBJECTIVE To better understand the risk factors for pediatric PTH using a large, multi-institutional database. METHODS We conducted a retrospective cohort study using administrative data from 42 pediatric hospitals participating in the Pediatric Health Information System. All patients ≤21 yr surviving a hospitalization with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for TBI were identified. The primary outcome was PTH, defined by an ICD-9-CM procedure code for surgical management of hydrocephalus within 6 mo. Data were analyzed using multivariable logistic regression. RESULTS We identified 91 583 patients ≤21 yr with TBI, 846 of whom developed PTH. Odds of PTH were significantly higher in children &lt;1 yr compared to older age groups. A total of 48.7% of PTH cases were victims of abuse (adjusted odds ratio [aOR] 2.62, 95% confidence interval [CI] 2.16-3.18). PTH was more common after craniotomy (aOR 1.60, 95% CI 1.30-1.97). Craniectomy without early cranioplasty was associated with markedly increased odds of PTH (aOR 3.67, 95% CI 2.66-5.07), an effect not seen in those undergoing cranioplasty within 30 d (aOR 1.19, 95% CI 0.75-1.89). CONCLUSION PTH was seen in 0.9% of children who sustained a TBI and was more common in those &lt;1 yr. Severe injury, abuse, and craniectomy with delayed cranioplasty were associated with greatly increased likelihood of PTH. Early cranioplasty in children who require craniectomy may reduce the risk for PTH.

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