Managing acute cholecystitis among Medicaid insured in New York State: opportunities to optimize care.

Background: Identifying sources of unnecessary cost within Medicaid will help focus cost containment efforts. This study sought to identify differences in surgical management and associated costs of cholecystitis between Medicaid and privately insured in New York State.

Methods: The New York State all-payer mandatory discharge database from 2003 to 2013, had 297,635 patients with Medicaid (75,512) and privately (222,123) insurance who underwent cholecystectomy for cholecystitis.

Characteristics and costs of surgical scheduling errors.

Background: Errors that increase the risk of wrong-side/-site procedures not only occur the day of surgery but also are often introduced much earlier during the scheduling process. The frequency of these booking errors and their effects are unclear.

Methods: All surgical scheduling errors reported in the institution's medical event reporting system from January 1, 2011, to July 31, 2011, were analyzed.

Factors associated with delays to emergency care for bowel obstruction.

Background: Our objective was to determine factors associated with delays to first treatment for emergency department (ED) patients diagnosed with small-bowel obstruction (SBO).

Methods: This was a retrospective study of ED patients with SBO. Data were collected from medical records, administrative databases, and staffing schedules at an urban, tertiary care medical center from June 1, 2001, to November 30, 2002.

Student perceptions of medical errors: incorporating an explicit professionalism curriculum in the third-year surgery clerkship.

Among medical educators, there is a universal call for curricula that emphasize development of character, compassion, and integrity. A unique challenge to the development of such curricula is the lack of tools with which to assess student progress. To these ends, we created a curriculum designed to inculcate the values of the surgical profession alongside both fact-based and skill-based learning within the triad of medical school education.

The journal: a retrospective.

With this issue, The Mount Sinai Journal of Medicine moves from being a general medical publication to one specializing in translational and personalized medicine. This article traces the history of The Journal from its beginning in 1934 to the present day. The Editors and their editorial policies are discussed, with mention of many articles over the years that have made the Journal truly a part of Mount Sinai's history.

Increased use of computed tomography does not harm patients with acute appendicitis.

The increased use of computed tomography (CT) in patients with appendicitis may cause a delay in surgery and, therefore, higher perforation rates. We examined the use of CT, delay in time to surgery, and perforation rates in appendicitis patients operated on in two periods: Phase 1, 1996 through 1998 and Phase 2, 2001 through 2002. CT was performed in 18 per cent of the Phase 1 group compared with 62 per cent in the Phase 2 group.

How time affects the risk of rupture in appendicitis.

Background: Increasing time between symptom onset and treatment may be a risk factor for a ruptured appendix, but little is known about how the risk changes with passing time. This study aimed to determine the changes in risk of rupture in patients with appendicitis with increasing time from symptom onset to treatment to help guide the swiftness of surgical intervention.

Study Design: We conducted a retrospective chart review of physician office, clinic, emergency room, and inpatient records of a random sample of 219 of 731 appendicitis patients operated on between 1996 and 1998 at 2 inner-city tertiary referral and municipal hospitals.

Influence of time on risk of bowel resection in complete small bowel obstruction.

Background: Little is known about the effect of passing time on risk of resection among patients with complete small bowel obstruction. We sought to provide a benchmark of the relationship of time from symptom onset to surgical treatment on the need for resection in patients with complete small bowel obstruction.

Study Design: We performed an observational study of patients with surgically treated complete small bowel obstruction at an inner-city urban tertiary referral center and a municipal hospital.

Hip fracture in the older patient: reasons for delay in hospitalization and timing of surgical repair.

Objectives: To quantify the interval between injury and hospitalization in older hip fracture patients, to quantify the time from hospital arrival to surgical repair of hip fracture, and to describe factors contributing to extended intervals between injury, hospitalization, and surgical repair of hip fracture.

Design: Prospective cohort study.

Setting: Four hospitals in the New York City metropolitan area.

Anesthesiologists and surgeons at Mount Sinai: a partnership in excellence.

Although anesthesia was available to patients when the doors of The Jews Hospital opened in 1855, "professional anesthetists" were not appointed to the staff until 1902. This article traces the history of the anesthesiology staff and department, and documents their accomplishments over the past century.