Comparative Effectiveness Research
Fig. 2.1 Timeline representing the evolution of comparative effectiveness research in each of its forms within the U.S. While there have been many public sector activities in CER including those…
GENERAL SURGERY
An Introduction to Health Services Research
The questions HSR asks broader questions. Rather than assessing clinical treatments, HSR questions often address the organization, delivery, financing, and regulation of the health care system The setting HSR studies…
Using Data for Local Quality Improvement
Fig. 7.1 States adjusted bypass surgery 30-day mortality rate vs. adjusted average yearly decline in bypass surgery mortality risk (1987–1992), controlling for age, gender, race, admission for acute myocardial infarction,…
Health Policy Research in Surgery
Policy option CMS adoption Selective referral National coverage decisions for selected procedures Refer patients to specific providers, i.e., “centers of excellence” Example: Bariatric surgery coverage linked to “center of excellence…
Measuring Health Care Quality in Surgery: Strategies, Limitations, and Currently Available Initiatives
Program Name Established Scope Target audience Surgery-specific Financial incentives Level of reporting Data type VA NSQIP 1994 National – VA VA hospitals Yes No Hospital Clinical registry ACS NSQIP 2001/2005…
Studying Surgical Disparities: It’s Not All Black and White
Fig. 5.1 Factors contributing to health care disparities. Size of font reflects perceived relative importance of factor (Reproduced from Haider et~al. [35]) 5.3.3.2 Hospital Volume Surgical outcomes are directly affected…
Patient Safety in Graduate and Continuing Medical Education
Recommendation Strategy Pursue patient safety initiatives that prevent medical injury Strengthen oversight and accountability mechanisms to better ensure the competencies of physicians and nurses Allow health care researcher access to…
The Preventable Death of Michael Skolnik: An Imperative for Shared Decision-Making
Fig. 33.1 Michael 20 months old, always smiling Fig. 33.2 Michael at age 2 ½ years, being his ‘silly self’ Fig. 33.3 Michael 11 years old, with his younger cousin…
The Ethical Perspective
“When patients die in other areas of medicine the question is ‘what happened?’ However, when a patient dies during or after surgery, the question is, ‘what did you do?’”—Peter Angelos…
Compliance to Patient Safety Culture
Fig. 13.1 Department of Health and Human Services organizational chart [7] The federal government works in partnership with state and local agencies, national quality and safety organizations, accrediting organizations, insurers…
