Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals.

Background: The 2021 Hospital Price Transparency Rule mandated hospitals to publicly disclose their service prices to improve competition and lower healthcare costs. Our aim was to characterize commercial price variation for thyroidectomy and parathyroidectomy.

Methods: We performed a national cross-sectional study of hospital price variation in 2022 and 2023 using the Turquoise Health dataset.

Designing a Perioperative Mind-Body Intervention for Peripheral Vascular Interventions.

Background: Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population.

Objectives: We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA.

Disparities in timely surgery among Asian American women with breast cancer.

Background: We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups.

Methods: We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded.

Does routine upper gastrointestinal swallow study after metabolic and bariatric surgery lead to earlier diagnosis of leak?

Background: It is unclear whether routine upper gastrointestinal swallow study (SS) in the immediate postoperative period is associated with earlier diagnosis of gastrointestinal leak after bariatric surgery.

Objective: To investigate the relationship between routine SS and time to diagnosis of postoperative gastrointestinal leak.

Setting: MBSAQIP-accredited hospitals in the United States and Canada.

First report of outcomes from the patient-reported outcome measures program in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program.

Background: Health-related quality-of-life (HRQoL) is one of the most important outcomes to metabolic and bariatric surgery (MBS) patients but was not measured by the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP). A patient-reported outcome measures (PROMs) program pilot started in 2016 with MBSAQIP implementation in 2019.

Objectives: To measure how MBS impacts patient HRQoL 1 and 2 years after primary laparoscopic Roux-en-Y gastric bypass (bypass) or laparoscopic sleeve gastrectomy (sleeve).

Minority-Serving Hospitals Are Associated With Low Within-Hospital Disparity.

Background: Disparities in obstetric care have been well documented, but disparities in the within-hospital population have not been as extensively explored. The objective is to assess cesarean delivery rate disparities at the hospital level in a nationally recognized low risk of cesarean delivery group.

Methods: An observational study using a national population-based database, Nationwide Inpatient Sample, from 2008 to 2011 was conducted.

Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019.

Importance: Retaining female physicians in the academic health care workforce is necessary to serve the needs of sociodemographically diverse patient populations.

Objective: To investigate differences in rates of leaving academia between male and female physicians.

Design, Setting, And Participants: This cohort study used Care Compare data from the Centers for Medicare & Medicaid Services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019, excluding physicians who retired during the study period.

Greater Patient Travel Distance is Associated with Perioperative and One-Year Cost Increases After Complex Aortic Surgery.

Background: With increasing regionalization of complex aortic surgery within fewer US centers, patients may face increased travel burden when accessing aortic surgery. Longer travel distances have been associated with inferior outcomes after major surgery; however, the impacts of distance on reinterventions and costs have not been described. This study aims to assess the association between patient travel distance and longer-term outcomes including costs and reinterventions after complex aortic surgery.

Time to surgery: A health equity metric in breast cancer patients.

Background: We evaluated whether time to surgery by race can be a health equity metric of surgical access.

Methods: An observational analysis was performed using the National Cancer Database from 2010 to 2019. Inclusion criteria were women with stage I-III breast cancer.

External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement.

Aim: The simple six-variable Codman score is a tool designed to reduce the complexity of contemporary risk-adjusted postoperative mortality rate predictions. We sought to externally validate the Codman score in colorectal surgery.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) participant user file and colectomy targeted dataset of 2020 were merged.

Longer patient travel distance is associated with increased non-index readmission after complex aortic surgery.

Objective: Recently evolving practice patterns in complex aortic surgery have led to regionalization of care within fewer centers in the United States, and thus patients may have to travel farther for complex aortic care. Travel distance has been associated with inferior outcomes after non-vascular surgery, particularly non-index readmission. This study aims to assess the impact of patient travel distance on perioperative outcomes and readmissions after complex aortic surgery.

Evaluating agreement between clinic- and patient-reported outcomes for weight and co-morbidities at 1 year after bariatric surgery.

Background: Development of patient-reported outcomes (PROs) to include traditionally clinic-reported data has the potential to decrease the data-collection burden for patients and clinicians and increase follow-up rates. However, replacing clinic report by patient report requires that the data reasonably agree.

Objective: To assess agreement between PROs and clinical registry data at 1 year after bariatric surgery.

Gender Homophily in Interphysician Referrals to Surgeons.

Introduction: The literature on gender homophily has mostly been focused on patient-physician relationship but not on interprofessional referrals. The goal of this study is to quantify interphysician gender homophily of referring physicians in surgical referrals.

Methods: An observational study of the referral data at a large academic center was performed.

Association of Measured Quality and Future Financial Performance Among Hospitals Performing Cardiac Surgery.

Goal: For decades, hospitals performing cardiac surgery have carried the cost of implementing quality improvement activities and reporting quality outcomes. However, the financial return of such investments is unclear, which weakens the incentive for hospitals to invest in quality improvement activities. This study explored the relationship between a hospital's measured quality and its financial performance.

Association of measured quality with financial health among U.S. hospitals.

Background: High-quality care is a clear objective for hospital leaders, but hospitals must balance investing in quality with financial stability. Poor hospital financial health can precipitate closure, limiting patients' access to care. Whether hospital quality is associated with financial health remains poorly understood.

Association of computed tomography screening with lung cancer stage shift and survival in the United States: quasi-experimental study.

Objective: To determine the effect of the introduction of low dose computed tomography screening in 2013 on lung cancer stage shift, survival, and disparities in the stage of lung cancer diagnosed in the United States.

Design: Quasi-experimental study using Joinpoint modeling, multivariable ordinal logistic regression, and multivariable Cox proportional hazards modeling.

Setting: US National Cancer Database and Surveillance Epidemiology End Results program database.

Do surgeons adjust clinical productivity after maternity leave?

Background: It has been speculated that women's productivity decreases after maternity leave. In this study, we measured if surgeon clinical productivity decreases after a maternity leave or other types of leave.

Methods: Data from a large medical center was used to measure surgeon productivity before (pre) and after (post) a leave of absence.

Four-dimensional computed tomography (4D-CT) for preoperative parathyroid localization: A good study but are we using it?

Background: Four-dimensional computed tomography (4D-CT) scan to localize abnormal parathyroid glands is diagnostically superior to ultrasound (US) and sestamibi. The implementation of 4D-CT imaging is unknown.

Methods: The Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) database from 2014 to 2018 was utilized.

Predictors of Financial Distress Among Private U.S. Hospitals.

Background: Hospitals are closing after poor financial performance leaving many patients without access to medical care. Identifying the factors associated with financial distress offers hospitals avenues for potential intervention to avoid bankruptcy and closure.

Materials And Methods: We performed a retrospective analysis of private U.

Should all patients receive the same prophylaxis? Racial variation in the risk of venous thromboembolism after major abdominal operations.

Background: Whether prevention strategy for postoperative venous thromboembolism (VTE) should be tailored across racial groups remains unknown.

Methods: Patients who underwent major abdominal operation in the Nationwide Inpatient Sample (NIS) were examined. Our primary outcome was postoperative VTE, and the secondary outcome was postoperative bleeding.

Impact of Obesity on Treatment Approach for Resectable Esophageal Cancer.

Background: With the prevalence of obesity and its known association with esophageal cancer, there is increasing need to understand how obesity affects treatment.

Methods: Using The Society of Thoracic Surgeons General Thoracic Surgery Database, we retrospectively evaluated all patients who underwent esophagectomy with gastric conduit reconstruction between 2012 and 2016. Patients were categorized into five body mass index groups.

Racially Conscious Cancer Screening Guidelines: A Path Towards Culturally Competent Science.

Objective: To review the racial composition of the study populations that the current USPSTF screening guidelines for lung, breast, and colorectal cancer are based on, and the effects of their application across non-white individuals.

Summary Of Background Data: USPSTF guidelines commonly become the basis for establishing standards of care, yet providers are often unaware of the racial composition of the study populations they are based on.

Methods: We accessed the USPSTF screening guidelines for lung, breast, and colorectal cancer via their website, and reviewed all referenced publications for randomized controlled trials (RCTs), focusing on the racial composition of their study populations.