Caseload is increased by resequencing cases before and on the day of surgery at ambulatory surgery centers where initial patient recovery is in operating rooms and cleanup times are longer than typical.

Study Objective: The coronavirus disease 2019 (COVID-19) pandemic impacts operating room (OR) management in regions with high prevalence (e.g., >1.

Health Savings Accounts: Consumer Contribution Strategies and Policy Implications.

Health savings accounts (HSAs) are tax-advantaged savings accounts available only to households with high-deductible health insurance. This article provides initial answers to two questions: 1) How should a household budget for its annual HSA contributions? 2) Do current contribution limits provide households with the flexibility to use HSAs efficiently? To answer these questions, we formulate the household's problem as one of determining a contribution strategy for minimizing total expected discounted medical costs. We use the 2002-2014 Medical Expenditure Panel Survey to develop a novel data-driven model for forecasting a household's health care costs based on its current cost percentile and other characteristics.

Exposure To Harmful Workplace Practices Could Account For Inequality In Life Spans Across Different Demographic Groups.

The existence of important socioeconomic disparities in health and mortality is a well-established fact. Many pathways have been adduced to explain inequality in life spans. In this article we examine one factor that has been somewhat neglected: People with different levels of education get sorted into jobs with different degrees of exposure to workplace attributes that contribute to poor health.

Sustaining pressure ulcer best practices in a high-volume cardiac care environment.

\Narayana Hrudayalaya Cardiac Hospital (NHCH) in Bangalore, India (now known as the Narayana Institute of Cardiac Sciences), is one of the world's largest and busiest cardiac hospitals. In early 2009, NHCH experienced a sharp increase in the number of surgical procedures performed and a corresponding rise in hospital-acquired pressure ulcers. The hospital sought to reduce pressure ulcer prevalence by implementing a portfolio of quality improvement strategies.

Outcomes from a postgraduate biomedical technology innovation training program: the first 12 years of Stanford Biodesign.

The Stanford Biodesign Program began in 2001 with a mission of helping to train leaders in biomedical technology innovation. A key feature of the program is a full-time postgraduate fellowship where multidisciplinary teams undergo a process of sourcing clinical needs, inventing solutions and planning for implementation of a business strategy. The program places a priority on needs identification, a formal process of selecting, researching and characterizing needs before beginning the process of inventing.

Outcome differences across transplant centers: comparison of two methods for public reporting.

Background And Objectives: Reporting of standardized patient and graft survival rates by the Scientific Registry of Transplant Recipients (SRTR) aims to influence transplant centers to improve their performance. The methodology currently used is based on calculating observed-to-expected (OE) ratios for every center. Its accuracy has not been evaluated.

Teaching biomedical technology innovation as a discipline.

Recently, universities in the United States and abroad have developed dedicated educational programs in life science technology innovation. Here, we discuss the two major streams of educational theory and practice that have informed these programs: design thinking and entrepreneurship education. We make the case that the process of innovation for new medical technologies (medtech) is different from that for biopharmaceuticals and outline the challenges and opportunities associated with developing a discipline of medtech innovation.

Disrupting incrementalism in health care innovation.

Objective: To build enabling innovation frameworks for health care entrepreneurs to better identify, evaluate, and pursue entrepreneurial opportunities.

Background: Powerful frameworks have been developed to enable entrepreneurs and investors identify which opportunity areas are worth pursuing and which start-up ideas have the potential to succeed. These frameworks, however, have not been clearly defined and interpreted for innovations in health care.

Reexploring differences among for-profit and nonprofit dialysis providers.

Objective: To determine whether profit status is associated with differences in hospital days per patient, an outcome that may also be influenced by provider financial goals.

Data Sources: United States Renal Data System Standard Analysis Files and Centers for Medicare and Medicaid Services cost reports.

Design: We compared the number of hospital days per patient per year across for-profit and nonprofit dialysis facilities during 2003.

An empiric estimate of the value of life: updating the renal dialysis cost-effectiveness standard.

Objectives: Proposals to make decisions about coverage of new technology by comparing the technology's incremental cost-effectiveness with the traditional benchmark of dialysis imply that the incremental cost-effectiveness ratio of dialysis is seen a proxy for the value of a statistical year of life. The frequently used ratio for dialysis has, however, not been updated to reflect more recently available data on dialysis.

Methods: We developed a computer simulation model for the end-stage renal disease population and compared cost, life expectancy, and quality adjusted life expectancy of current dialysis practice relative to three less costly alternatives and to no dialysis.

Cost-effectiveness of frequent in-center hemodialysis.

Published evidence suggests that frequent hemodialysis (more than three times per week) for patients with ESRD may improve health-related quality of life and has the potential to increase longevity and reduce hospitalization and other complications. Here, a Monte Carlo simulation model was used to compare varying combinations of in-center hemodialysis frequency (three to six treatments per week) and session length (2 to 4.5 h per session) with regard to unadjusted and quality-adjusted life-years and total lifetime costs for a cohort of 200,000 patients, representing the prevalent ESRD population.

A simulation model to estimate the cost and effectiveness of alternative dialysis initiation strategies.

Background: Patients with end-stage renal disease (ESRD) require dialysis to maintain survival. The optimal timing of dialysis initiation in terms of cost-effectiveness has not been established.

Methods: We developed a simulation model of individuals progressing towards ESRD and requiring dialysis.

Health-related quality of life and estimates of utility in chronic kidney disease.

Background: Health-related quality of life and estimates of utility have been carefully evaluated in persons with end-stage renal disease. Fewer studies have examined these parameters in persons with chronic kidney disease (CKD).

Methods: To determine the relations among kidney function, health-related quality of life, and estimates of utility, we administered the Kidney Disease Quality of Life Short Form 36 (KDQOL-36), Health Utilities Index (HUI)-3, and Time Trade-off (TTO) questionnaires to 205 persons with CKD.

Restricting living-donor-cadaver-donor exchanges to ensure that standard blood type O wait-list candidates benefit.

Region 1 of the United Network for Organ Sharing created a consortium that allows a person waiting for a kidney transplant to take a higher priority on the list when a relative makes a living donation to another waiting recipient. This can be done by exchanging kidneys between two living-donor-recipient pairs (living paired exchange) or by exchanging kidneys through a living-donor-cadaver-donor exchange (list paired exchange). In this article, the authors argue that a list paired exchange that allows ABO-incompatible donor-recipient pairs to participate is morally problematic because it harms standard blood type O wait-list candidates who already have the longest waiting times.

Diminishing significance of HLA matching in kidney transplantation.

To determine trends in the significance of HLA matching and other risk factors in kidney transplantation, we analyzed data on graft survival in a consecutive sample of 33 443 transplant recipients who received deceased donor kidneys from December 1994 to December 1998 with a mean follow-up time of 2.2 years. HLA matching and other risk factors (peak panel reactive antibody, donor age, sex and cause of death, cold ischemia time, donor and recipient body size) were examined.

Incorporating recipient choice in kidney transplantation.

Despite the acute shortage of cadaveric organs for kidney transplantation, more than 10% of cadaveric kidneys are discarded each year because of marginal quality. Transplant recipients' access to these kidneys and to information about their quality is limited. A Monte Carlo model was developed to simulate the operations of an organ procurement organization over a 10-yr period.