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hospital length of stay and healthcare costs among African American women due to obesity and diabetic conditions in United States: A model for correlation studies comparing ethnicity, co-morbidities and hospital resources

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慢性疾病与转化医学(英文) 2018年第4期4卷 244-253页

作者： Moss Terris R. Rutgers BioPharma Educational Initiative School of Health Professions Rutgers The State University of New Jersey 65 Bergen Street Newark NJ 07101-1709 USA.

Objective: To examine obesity and diabetes associations with United States hospital use and healthcare costs for African American women, to explore the relationship between co-morbidities of interest (obesity and diabetes) and hospital resources [length of stay (LOS) and costs].Methods: A retrospective, correlation, quantitative analysis for lengths of hospital stay and cost among adult African American women categorized according to their weight status with type 2 diabetes. Healthcare Cost and Utilization Project (HCUP) data which contains the Nationwide Inpatient Sample was used. Focused on 803,163 African American, female inpatients between the ages of 21 and 55 in the United States from 2008 to 2010. Researcher explored the relationship between individual health factors of interest (obesity and diabetes) and the effects on hospital LOS and healthcare costs. All statistical analysis will be performed using Stata v12. All inferential tests will be two-sided and will utilize a 95% significance level. Two separate multiple regressions will be ***: A total of 758,874 records were retained for analysis. The patients in the weighted population ranged in age from 21 to 55 years. The patient LOS ranged from 0 to 333 days. The patients had approximately 2 procedures on average, and presented with approximately 3 chronic conditions on average. The total charges (Cost) ranged from 106 to over 1 million US dollars. The size and direction of the relationship between LOS, healthcare costs and the independent variables of diabetes and obesity suggests that both LOS and health care cost decreased for African American female patients with diabetes or obesity. There is a statistically significant relationship between at least one of the individual health factors of interest (obesity and diabetes) and hospital LOS (F = 13,394.00,P hospital costs (F = 10,171.23,P < 0.0005,R2 = 0.502).Conclusions: There is evidence of racial and ethnic disparities in

关键词： Diabetes Obesity African American Length of stay hospital costs

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Comparison of modified gunsight suture technique and traditional interrupted suture in enterostomy closure

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World Journal of Gastroenterology 2023年第29期29卷 4571-4579页

作者： Chang Chen Xiang Zhang Zhi-Qiang Cheng Bin-Bin Zhang Xin Li Ke-Xin Wang Yong Dai Yan-Lei Wang Department of Colorectal Surgery Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of Nursing Qilu Hospital of Shandong University De Zhou HospitalDezhou 254300Shandong ProvinceChin Department of General Surgery Huantai Branch of Qilu Hospital of Shandong UniversityZibo 255000Shandong ProvinceChina

BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or ***,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative *** address these issues,scholars have proposed the use of a“gunsight suture”*** technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of *** on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative *** To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal *** In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu hospital from April 2017 to December *** patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture *** collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization ***-parametric tests and chi-square tests were utilized for data *** There were no statistica

关键词： Enterostomy Abdominal wound closure technique Suture techniques Surgical wound infection hospital costs hospital stay

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Predictive value of frailty assessment tools in patients undergoingsurgery for gastrointestinal cancer: An observational cohort study

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2525-2536页

作者： Hui-Pin Zhang Hai-Lin Zhang Xiao-Min Zhou Guan-Jie Chen Qi-Fan Zhou Jie Tang Zi-Ye Zhu Wei Wang Department of Gastrointestinal Surgery The Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungang 222061Jiangsu ProvinceChina Department of Gastrointestinal Surgery The First People’s Hospital of ChangzhouChangzhou 213000Jiangsu ProvinceChina Department of Nursing The Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungang 222061Jiangsu ProvinceChina Department of Invasive Technology Zhongda Hospital Southeast UniversityNanjing 210003Jiangsu ProvinceChina Department of Hemopurification Center Lianyungang Clinical College of Nanjing Medical UniversityLianyungang 222061Jiangsu ProvinceChina

BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer ***,it is difficult to determine which assessment tool is most relevant to the prognosis of this *** To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer *** This single-centre,observational,prospective cohort study was conducted at the Affiliated Lianyungang hospital of Xuzhou Medical University from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this *** collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL *** outcome measures were the postoperative severe complications and increased hospital RESULTS The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL *** the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both Phospital costs were observed in 29(12.7%)and 57(24.9%)patients,*** logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe *** The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.

关键词： Gastrointestinal cancer Frailty Assessment tools Prognostic Complication hospital costs

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Determining the hospital cost of anterior epistaxis treatment modalities at a Canadian tertiary care centre

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2019年第4期5卷 193-199页

作者： Harrish Nithianandan Kednapa Thavorn Fatmahalzahra Banaz Kristian Macdonald Andrea Lasso Shaun J.Kilty Faculty of Medicine University of OttawaOttawaOntarioCanada Ottawa hospital Research Institute(OHRI) OttawaOntarioCanada School of Epidemiology and Public Health University of OttawaOttawaOntarioCanada Institute for Clinical and Evaluative Sciences ICES uOttawaOttawaOntarioCanada Department of Otolaryngology-Head and Neck Surgery The University of OttawaOttawaOntarioCanada Dr.S.Kilty Medicine Prof.Corp. OttawaONCanada

Objective:To estimate the hospital costs of managing anterior epistaxis in the Emergency Department at a Tertiary Care centre in *** and methods:A cost analysis was conducted based on a retrospective review of Emergency Department visits from January 2012 to May 2014.A consecutive sample of adult patients with a diagnosis of anterior epistaxis was *** epistaxis was managed via one of:Nasal clip,Merocel(R),Silver Nitrate cautery,Vaseline packing,other treatment or no *** the direct and indirect hospital costs(SCDN)for anterior epistaxis treatment were calculated from the hospital's *** linear models were used to assess the association between treatment modalities and total hospital costs while controlling for potential confounding ***:Three hundred and fifty-three patients(49%female)with a mean age of(69.9±18.5)years were included in the *** median(interquartile ranges)costs of treatment ranged from CS227.83(CS167.96,CS328.69)for observation to CS763.98(CS632.25,CS830.23)for Merocel(R).The overall median total hospital costs incurred across all modalities was CS566.24(CS459.61,CS753.46)for the management of anterior *** Nitrate,nasal clip,and observation were statistically associated with a lower cost when compared to Merocel(R)(Phospital cost of epistaxis across treatment *** cost estimates can help inform future economic evaluation studies aiming to guide the allocation of health care resources for patients with epistaxis.

关键词： Anterior epistaxis Nasal packing Cautery Silver nitrate hospital costs

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