Trends in Appendicitis and Perforated Appendicitis Prevalence in Children in the United States, 2001-2015.

This sequential, cross-sectional study examines the prevalence of perforated appendicitis in children in the United States in relation to access to health care from 2001 to 2015.

Racial Disparities in Sepsis-Related In-Hospital Mortality: Using a Broad Case Capture Method and Multivariate Controls for Clinical and Hospital Variables, 2004-2013.

Objectives: As sepsis hospitalizations have increased, in-hospital sepsis deaths have declined. However, reported rates may remain higher among racial/ethnic minorities. Most previous studies have adjusted primarily for age and sex.

Pediatric inpatient hospital resource use for congenital heart defects.

Background: Congenital heart defects (CHDs) occur in approximately 8 per 1000 live births. Improvements in detection and treatment have increased survival. Few national estimates of the healthcare costs for infants, children and adolescents with CHDs are available.

Child and adolescent health care quality and disparities: are we making progress?

Objective: Children and adolescents are known to experience poor health care quality; some groups of children have poorer health care than others. We sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs.

Methods: Source data were extracted from the 2011 National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR) database, which contains aggregated data from many government and private sources for the years 2000 through 2009.

Racial variation in the quality of surgical care for bladder cancer.

Background: Differences in quality of care may contribute to racial variation in outcomes of bladder cancer (BCa). Quality indicators in patients undergoing surgery for BCa include the use of high-volume surgeons and high-volume hospitals, and, when clinically indicated, receipt of pelvic lymphadenectomy, receipt of continent urinary diversion, and undergoing radical cystectomy instead of partial cystectomy. The authors compared these quality indicators as well as adverse perioperative outcomes in black patients and white patients with BCa.

Racial variation in the quality of surgical care for prostate cancer.

Purpose: Difference in the quality of care may contribute to the less optimal prostate cancer treatment outcomes among black men compared with white men. We determined whether a racial quality of care gap exists in surgical care for prostate cancer, as evidenced by racial variation in the use of high volume surgeons and facilities, and in the quality of certain outcome measures of care.

Materials And Methods: We performed cross-sectional and cohort analyses of administrative data from the Healthcare Cost and Utilization Project all-payer State Inpatient Databases, encompassing all nonfederal hospitals in Florida, Maryland and New York State from 1996 to 2007.

Costs and state-specific rates of thoracic and lumbar vertebroplasty, 2001-2005.

Study Design: Sequential cross-sectional analysis.

Objective: To document vertebroplasty rates and costs.

Summary Of Background Data: Little is known about interstate variation in rates or about nation-wide costs associated with the growing use of percutaneous vertebroplasty.

Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?

Study Design: A retrospective analysis of population-based hospital discharge registry from all nonfederal acute care hospitals in Washington State.

Objective: We examined the cumulative incidence of second lumbar spine operation following an initial lumbar operation for degenerative conditions. We aimed to determine if the cumulative incidence of a second lumbar spine operation decreased in the 1990s following an increase in the rate of fusion surgery and the introduction of several newer fusion technologies.

Reoperation rates following lumbar spine surgery and the influence of spinal fusion procedures.

Study Design: Retrospective cohort study using a hospital discharge registry of all nonfederal acute care hospitals in Washington state.

Objectives: To determine the cumulative incidence of reoperation following lumbar surgery for degenerative disease and, for specific diagnoses, to compare the frequency of reoperation following fusion with that following decompression alone.

Summary Of Background Data: Repeat lumbar spine operations are generally undesirable, implying persistent symptoms, progression of degenerative changes, or treatment complications.

Population-based trends in volumes and rates of ambulatory lumbar spine surgery.

Study Design: Sequential cross-sectional study.

Objectives: To quantify patterns of outpatient lumbar spine surgery.

Summary Of Background Data: Outpatient lumbar spine surgery patterns are undocumented.

United States trends in lumbar fusion surgery for degenerative conditions.

Study Design: Retrospective cohort study using national sample administrative data.

Objectives: To determine if lumbar fusion rates increased in the 1990s and to compare lumbar fusion rates with those of other major musculoskeletal procedures.

Summary Of Background Data: Previous studies found that lumbar fusion rates rose more rapidly during the 1980s than did other types of lumbar surgery.

Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial.

Context: Faster magnetic resonance imaging (MRI) scanning has made MRI a potential cost-effective replacement for radiographs for patients with low back pain. However, whether rapid MRI scanning results in better patient outcomes than radiographic evaluation or a cost-effective alternative is unknown.

Objective: To determine the clinical and economic consequences of replacing spine radiographs with rapid MRI for primary care patients.

Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain: activity-based costs and reimbursement.

Purpose: To incorporate personnel and equipment use time in an activity-based cost comparison of conventional radiography and conventional and rapid magnetic resonance (MR) imaging for low back pain (LBP).

Materials And Methods: At each of four Seattle Lumbar Imaging Project (SLIP) sites, patients were randomized to undergo conventional radiography or rapid MR imaging of the lumbar spine. For sample SLIP patients and for similar non-SLIP patients undergoing conventional lumbar spine MR imaging as usual care in calendar year 2000, measured imaging room use and technologist and radiologist times were multiplied by costs per minute of standard equipment acquisition, personnel compensation, and related expenses.

Rapid magnetic resonance imaging for diagnosing cancer-related low back pain.

Objectives: This study compared the relative efficiency of lumbar x-ray and rapid magnetic resonance (MR) imaging for diagnosing cancer-related low back pain (LBP) in primary care patients.

Design: We developed a decision model with Markov state transitions to calculate the cost per case detected and cost per quality-adjusted life year (QALY) of rapid MR imaging. Model parameters were estimated from the medical literature.

Comparative economic analyses of minimally invasive direct coronary artery bypass surgery.

Objective: This study was undertaken to assess the degree to which published cost comparisons of minimally invasive direct coronary artery bypass through a thoracotomy versus conventional coronary artery bypass grafting, off-pump bypass surgery through a sternotomy, or angioplasty with or without stenting adhered to existing guidelines for performing economic analyses.

Methods: We used minimally invasive direct coronary artery bypass (MIDCAB), off-pump bypass surgery, cost-effectiveness, economic analysis, and related keywords to search MEDLINE, other literature databases and article reference lists for English-language economic analyses of minimally invasive direct coronary artery bypass procedures versus other procedures that were published from 1990 to February 2002. We critically appraised article adherence to a 10-item methodologic checklist modified to address issues particularly relevant to minimally invasive direct coronary artery bypass evaluations.