Economic Burden of Postoperative Neurocognitive Disorders Among US Medicare Patients.

Importance: Postoperative neurocognitive disorders (PNDs) after surgical procedures are common and may be associated with increased health care expenditures.

Objective: To quantify the economic burden associated with a PND diagnosis in 1 year following surgical treatment among older patients in the United States.

Design, Setting, And Participants: This retrospective cohort study used claims data from the Bundled Payments for Care Improvement Advanced Model from 4285 hospitals that submitted Medicare Fee-for-service (FFS) claims between January 2013 and December 2016.

The Truth is in the Data - Differences in the Same Measure Based on Different Sources among HVHC Members Using ICU Length of Stay as an Example.

Introduction: Intensive Care Unit (ICU) length of stay is a strong indicator of severity of illness and cost in the care of sepsis patients. In this case study, we examine the difference between an electronic health record (EHR) based submissions with Centers for Medicare and Medicaid Services (CMS) payment data.

Methods: Member submitted EHR data contained 26,733 unique patient's records.

An exploratory analysis of transfer times in a rural trauma system.

Background: Delays to definitive care are of particular concern in rural trauma systems, where prehospital times are significantly longer than average.

Aims: We evaluated for differences between transferring hospitals in the total time required to transport patients to definitive care, and analyzed for associations between transport times and outcomes.

Settings And Design: We employed a cross-sectional design to analyze Level One Trauma Center registry data on interfacility transfer of 3,303 acute trauma patients.

Secondary overtriage: the burden of unnecessary interfacility transfers in a rural trauma system.

Importance: Unnecessary interfacility transfer of minimally injured patients to a level I trauma center (secondary overtriage) can cause inefficient use of resources and personnel within a regional trauma system.

Objective: To describe the burden of secondary overtriage in a rural trauma system with a single level I trauma center.

Design: Retrospective analysis of institutional trauma registry data.

Balancing risk and benefit: maintenance of a thawed Group A plasma inventory for trauma patients requiring massive transfusion.

Background: Transfusion of plasma and red blood cell (RBC) units in a balanced ratio approximating 1:1 has been shown in retrospective studies to be associated with improved outcomes for trauma patients. Our low-volume rural trauma center uses a trauma-activated transfusion algorithm. Plasma is thawed upon activation to avoid wastage.

Blood administration in helicopter emergency medical services patients associated with hypothermia.

Introduction: The infusion of packed red blood cells (PRBCs) in the severely injured patient is not a new practice. It is a potentially lifesaving procedure although it is not without inherent risk. This practice in the helicopter emergency medical services (HEMS) has not been examined in the literature.

Comparing rural ground and air emergency medical services: a level I trauma center's experience.

We sought to compare differences in patients transported by ground and air emergency medical services directly from the scenes of their injuries to a rural level I trauma facility. Variables examined included age, gender, vital signs, Glasgow Coma Scale score, discharge location, length of stay, and survival metrics. Student t tests and odds ratios were used for analysis.

Trauma patients without a trauma diagnosis: the data gap at a level one trauma center.

Background: Trauma registries may contain records without a codable trauma diagnosis, creating a "data gap" that multiplies the number of invalid registry data fields. We designed an investigation intended to determine the incidence of registry records with noncodable trauma diagnoses, characterize those records, and determine the reasons for inadequate diagnosis data.

Methods: We used a retrospective cohort design.