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At least 379 records · Page 21Linked to original sources
PubMed2004

Short-stay carotid endarterectomy in a tertiary-care Veterans Administration hospital.

BACKGROUND: This study focused on 200 carotid endarterectomies (CEA) performed at our Veterans Administration Hospital (VAH) to determine whether 1-day hospitalization after CEA is safe and the degree to which it can be achieved. METHODS: Over 36 months, 200 CEAs were performed for asymptomatic stenosis (n = 104), transient ischemic attacks (n = 68), and stroke (n = 28). General anesthesia was used in 189 procedures. RESULTS: The hospital stay was 1 day for 132 procedures and more than 1 day in 68 CEAs. The average stay was 1.69 +/- 1.5 days. After surgery there were 3 strokes, 5 hematomas that required evacuation, and 5 myocardial infarctions. There were no deaths. Four patients were readmitted in the 1-day and the greater than 1-day stay groups. History of myocardial infarction, renal insufficiency, longer operative time, and complications correlated with a greater than 1-day stay (P <0.05). CONCLUSION: A 1-day hospital stay is safe and practical in a VAH setting, resulting in good clinical outcomes.

Aged↗
PubMed1980

The cost of outpatient physicians' services at a Veterans Administration hospital.

The cost of an average outpatient visit to a physician at a Veterans Administration hospital in 1976 was estimated from hospital records to have been $80.35 ($104.46 in 1979 dollars). When productivity was used to measure relative cost, cost per visit ranged from a low of $32.66 (1979: $42.46) for hypertension clinic to a high of $243.48 (1979; $316.52) for hematology clinic. The average patient was seen 12.6 times annually at a cost of $1012 (1979: $1315). The major cost category for a physician visit was salaries, with nonphysician salaries costing twice as much as physician salaries. The cost of medical equipment was minimal. The findings suggest that the outpatient bookkeeping system was inadequate for cost accounting, the cost per visit was expensive, there were an excessive number of visits, and problems in the institutional delivery system of ambulatory care lowered productivity of physicians.

Cost Allocation↗
PubMed1996

The validity of hospital administrative data in monitoring variations in breast cancer surgery.

To assess the validity of using hospital administrative data to measure variations in surgery for early-stage breast cancer, ICD-9-CM coded information was compared with corresponding tumor registry data for 1293 breast cancer patients undergoing lumpectomy or mastectomy at a tertiary referral center from January 1989 to October 1993. Relative to "gold standard" tumor registry data, the administrative data proved 83.4% sensitive and 80.4% specific in identifying women with localized disease who would be potential candidates for lumpectomy. The proportion of women with localized disease undergoing lumpectomy in groups defined by race and insurance status was nearly identical, whichever data were used. Administrative data, which is often readily and publicly available, may be useful in studying variations in breast cancer treatment in key demographic groups.

Black or African American↗