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Variation in Medicare expenditures for surgical complications

Editor's Note In this study, substantial variation was observed across hospitals in Medicare episode payments for patients rescued from surgical complications, and higher payments were not associated with improved clinical performance. Medicare payments for patients rescued at the highest-cost hospitals were two- to threefold higher than the lowest-cost hospitals for…

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By: Judy Mathias
October 6, 2016
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ACS NSQIP develops pediatric surgical risk calculator

Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) has developed a pediatric surgical risk calculator based on 181,353 cases covering 382 CPT codes across all specialties. It was found to have excellent discrimination for mortality, morbidity, and seven additional complications. The calculator can be…

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By: Judy Mathias
October 4, 2016
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Surgical ICU patients benefit from early mobilization

Editor's Note Surgical ICU patients who were assigned to an early mobilization program were discharged sooner from the ICU and the hospital and needed less help after discharge, compared with those who had standard care, this study finds. The analysis included 104 patients assigned to early mobilization and 96 who…

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By: Judy Mathias
October 4, 2016
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Effect of CJR episode of care definition on hospital performance

Editor's Note Comparing the Comprehensive Care for Joint Replacement (CJR) program’s broad definition of a patient’s episode of care (ie, initial hospitalization until 90 days after discharge) with a clinically narrow definition of an episode of care, researchers found that hospital performance was consistent no matter which definition was used.…

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By: Judy Mathias
September 29, 2016
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FDA: Class I recall of DePuy Synthes power tool system battery adaptors

Editor's Note The Food and Drug Administration (FDA) on September 28 identified the recall by DePuy Synthes (a Johnson & Johnson company) of its Adaptor and Light Adaptor for Small Battery Drive and Small Battery Drive II as Class I, the most serious. The recall is due to the potential…

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By: Judy Mathias
September 29, 2016
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Association between bundled payments and quality outcomes

Editor's Note In the first 21 months of the Bundled Payments for Care Improvement (BPCI) initiative for total hips and knees, Medicare payments declined more for BPCI participating hospitals than nonparticipating hospitals, without a significant change in quality outcomes, this study finds. For the analysis, 31,700 total joints at 176…

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By: Judy Mathias
September 28, 2016
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Postoperative outcomes significantly improve in VA hospitals

Editor's Note Postoperative outcomes in the Veterans Affairs (VA) health system have consistently improved for the past 15 years, this study finds. In this analysis of nearly 705,000 patients undergoing noncardiac surgical procedures at 143 hospitals, absolute rates and likelihood of complications, mortality, and failure to rescue significantly decreased 40%…

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By: Judy Mathias
September 26, 2016
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Association between TAVR and endocarditis, mortality

Editor's Note In this study of patients having transcatheter aortic valve replacement (TAVR), younger age, male gender, history of diabetes, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital and 2-year mortality. Of…

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By: Judy Mathias
September 14, 2016
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Survey: Cardiothoracic surgeons love their jobs

Editor's Note Despite significant challenges in their careers, cardiothoracic surgeons report a very high level of job satisfaction in a survey published online September 13 in The Annals of Thoracic Surgery, the Society of Thoracic Surgeons reports. The 63-question survey was administered to more than 4,300 members of the Society…

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By: Judy Mathias
September 13, 2016
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CJR bundled payments may penalize hospitals that treat elderly, sickest patients

Editor's Note Hospitals that care for the oldest, sickest, and most complicated patients could suffer financially under Medicare’s Comprehensive Care for Joint Replacement (CJR) bundled payment program, this study finds. The study analyzed data from more than 23,000 Michigan patients who had hip or knee replacements at 60 hospitals in a…

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By: Judy Mathias
September 8, 2016
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