Today’s Top Story
Senator seeks information on practice of performing concurrent surgeries.
The Boston Globe reports that the chair of the U.S. Senate Finance Committee has asked 20 hospital systems to provided detailed records regarding the practice of concurrent surgery. A committee staffer refers to the request as a “fact-finding exercise.” A spokesperson for the American Hospital Association states that the organization is aware of the letter and is working to “educate the committee staff about this very complex issue.” Read more…
Other News
Study: Intra-articular injection prior to TKA may increase risk of infection.
Data from a study published online in the journal Clinical Orthopaedics and Related Research suggest that intra-articular injection prior to total knee arthroplasty (TKA) may increase risk of postoperative infection, with shorter time between injection and TKA linked to increased likelihood of infection. The research team reviewed data on 29,603 TKAs (35 percent) treated with injection in the ipsilateral knee before the TKA procedure, and 54,081 (65 percent) treated without injection. Compared to controls, they found increased odds of any postoperative infection or infection resulting in return to the operating room among patients who received injection. In a month-by-month analysis of time between injection and TKA, the research team found the likelihood of infection remained higher for the injection cohort out to a duration of 6 months between injection and TKA. Read the abstract…
Study: RTSA a cost-effective intervention for treatment of complex proximal humerus fracture.
A study published online in the Journal of Shoulder and Elbow Surgery finds that reverse total shoulder arthroplasty (RTSA) may be a cost-effective intervention in the surgical treatment of complex proximal humerus fractures. The researchers developed a Markov model to compare the cost-effectiveness of nonoperative fracture care, hemiarthroplasty (HA), and RTSA for complex proximal humerus fractures. They found that from a payer perspective, RTSA was associated with an incremental cost-effectiveness ratio (ICER) of $8,100/quality-adjusted life-year (QALY); while HA was eliminated from payer analysis as a cost-ineffective strategy. However, the researchers noted that HA was not cost-ineffective from a hospital perspective, with the ICER for HA being $36,700/QALY, and RTSA providing incremental effectiveness at $57,400/QALY. Overall, the researchers noted that RTSA was the optimal strategy in 61 percent and 54 percent of payer and hospital probabilistic sensitivity analyses, respectively. Read the abstract…
Study: What factors contribute to readmission after ASDS?
A study published online in The Spine Journal looks at risk factors for 30-day readmission following adult spine deformity surgery (ASDS). The authors reviewed data from 747 patients in the National Surgical Quality Improvement Program database. They found that 7.5 percent (n = 56) were readmitted within 30 days. Most common causes of readmission included infection (n=11), hematoma or seroma formation (n=5), and postoperative pain (n=3). A univariate analysis revealed that male sex and pulmonary embolism prior to discharge were associated with readmission. A multivariate analysis found that obesity, peripheral vascular disease, pulmonary embolism prior to discharge, and total or partial dependent preoperative functional health status were independent risk factors for readmission. The authors write that age, smoking, and resident involvement during surgical procedure were not linked with increased risk of readmission. Read the abstract…
States move forward with efforts to reduce opioid prescribing.
An article in The New York Times looks at state efforts to limit opioid prescribing. Among other things, Massachusetts legislators recently passed a bill to restrict the number of pain pills a physician can prescribe after surgery or an injury to a 7-day supply, and lawmakers in Vermont and Maine are considering similar proposals. Other states have implemented prescription monitoring rules that require physicians to check databases before prescribing certain medications. In Kentucky, implementation of such a law was linked to an 8.6 percent reduction in opioid prescribing in 1 year. In addition, a number of state governors plan to meet this summer to discuss various approaches to reduce the use of opioids. Read more…
Study: Alcohol abuse among medical students linked to burnout; debt.
According to a study published online in the journal Academic Medicine, burnout may be linked to alcohol use and dependence among medical students. The authors surveyed 4,402 medical students from the American Medical Association’s Physician Masterfile. They found that 1,411 (32.4 percent) met diagnostic criteria for alcohol abuse/dependence. Overall, those who were burned out, depressed, or reported low mental or emotional quality of life were more likely to have alcohol abuse/dependence. After multivariate analysis, the authors found that burnout, having significant educational debt, being unmarried, and younger age were independently associated with increased risk for alcohol abuse/dependence. Read more…
Read the abstract…
Texas.
A report from the Rice University Baker Institute for Public Policy finds that about 25 percent of Texans may lack confidence in understanding some of the most basic terminology about health insurance plans, such as “premium,” “copayment,” and “provider network.” The researchers drew data from the Health Reform Monitoring Survey—a quarterly survey of adults ages 18-64 years—administered between September 2013 and September 2015. Read more…
Read the report (PDF)…
Last call: Annual Meeting Committee.
March 18 is the last day to submit your application for a position on the Annual Meeting Committee (one member opening—allied health representative). The Annual Meeting Committee coordinates all components of the AAOS Annual Meeting, and develops programs to meet the needs of all Annual Meeting attendees. Applicants for this position must be active fellows with an interest in and knowledge of allied health education. Learn more and submit your application…(member login required)
