Literature DB >> 22397976

Acute care surgery: impact on practice and economics of elective surgeons.

Preston R Miller1, Elizabeth A Wildman, Michael C Chang, J Wayne Meredith.   

Abstract

BACKGROUND: The creation of an acute care surgery service provides a rich operative experience for acute care surgeons. Elective surgeons typically have concerns about whether their practice volume will be restored with elective cases. Acute care surgery has financial implications for both groups. The aim of this project is to examine the impact in terms of work relative value units (wRVUs), collections, and cases in both groups with creation of an acute care surgery service at our institution. STUDY
DESIGN: Work RVUs, collections, and case volume were examined from departmental records for 2 groups before and after acute care surgery service creation. The service began on September 1, 2008. Before this time, emergency surgical consults went to the general surgeon on call. After this date, all emergency consults were seen by acute care surgeons.
RESULTS: The number of operations performed by the acute care surgery group increased significantly when the mean of the 2 years after institution of acute care surgery were compared with the mean of the 2 years preceding the service creation (1,639 vs 790/year; p = 0.007). There was no change in total operations done by the elective surgery group (2,763 vs 2,496/year: p = 0.13). Elective caseload, however, did increase by 23% in the elective surgery group. In the acute care surgery group, wRVUs increased by 140% and elective surgery group wRVUs decreased by 8%. Collections increased in both groups (acute care surgery 129%, elective surgery 7%) and the combined collections of the groups increased by $2,138,00 in the year after service creation.
CONCLUSIONS: Acute care surgery service creation took emergency business from the elective surgery group, but this was almost immediately replaced with elective cases. This resulted in higher collections for both groups and a resultant significant increase in collections in aggregate.
Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Mesh:

Year:  2012        PMID: 22397976     DOI: 10.1016/j.jamcollsurg.2011.12.045

Source DB:  PubMed          Journal:  J Am Coll Surg        ISSN: 1072-7515            Impact factor:   6.113


  13 in total

1.  Impact of an acute care surgery model with a dedicated daytime operating room on outcomes and timeliness of care in patients with biliary tract disease.

Authors:  David W Lim; Dejan Ozegovic; Rachel G Khadaroo; Sandy Widder
Journal:  World J Surg       Date:  2013-10       Impact factor: 3.352

Review 2.  GI Surgical Emergencies: Scope and Burden of Disease.

Authors:  Matthew C Hernandez; Firas Madbak; Katherine Parikh; Marie Crandall
Journal:  J Gastrointest Surg       Date:  2018-10-15       Impact factor: 3.452

3.  The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.

Authors:  Doris Sarmiento Altamirano; Amber Himmler; Oscar Chango Sigüenza; Raúl Pino Andrade; Nube Flores Lazo; Jeovanni Reinoso Naranjo; Hernán Sacoto Aguilar; Lenin Fernández de Córdova; Edgar Rodas; Juan Carlos Puyana; Juan Carlos Salamea Molina
Journal:  World J Surg       Date:  2020-06       Impact factor: 3.352

4.  The role of acute care surgeons in treating rib fractures-a retrospective cohort study from a single level I trauma center.

Authors:  Chia-Cheng Wang; Szu-An Chen; Chi-Tung Cheng; Yu-San Tee; Sheng-Yu Chan; Chih-Yuan Fu; Chien-An Liao; Chi-Hsun Hsieh; Ling-Wei Kuo
Journal:  BMC Surg       Date:  2022-07-14       Impact factor: 2.030

5.  Equivalent Operative Outcomes for Emergency Colon Cancer Resections Among Acute Care Surgeons and Specialists in Colorectal Surgery.

Authors:  Ashley L Cairns; Alexis B Hess; Holly Rieken; Nicholas Lin; Shambavi Rao; Yoonsun Jee; Jean H Ashburn; Preston R Miller; Samuel P Carmichael; Nathan T Mowery
Journal:  Am Surg       Date:  2022-02-24       Impact factor: 1.002

6.  Does relative value unit-based compensation shortchange the acute care surgeon?

Authors:  Diane A Schwartz; Xuan Hui; Catherine G Velopulos; Eric B Schneider; Shalini Selvarajah; Donald Lucas; Elliott R Haut; Nathaniel McQuay; Timothy M Pawlik; David T Efron; Adil H Haider
Journal:  J Trauma Acute Care Surg       Date:  2014-01       Impact factor: 3.313

7.  Development of an Acute Care Plastic Surgery Service in the Saskatoon Health Region: Effects on flexor tendon management.

Authors:  Chelsea S Wilgenbusch; Peter W Dust; Ian R Sunderland
Journal:  Plast Surg (Oakv)       Date:  2015       Impact factor: 0.947

8.  The Impact of an Acute Care Surgery Model on General Surgery Service Productivity.

Authors:  Adam N Paine; Bradley L Krompf; Edward C Borrazzo; Thomas P Ahern; Ajai K Malhotra; Mitchell C Norotsky; Mitchell H Tsai
Journal:  Perioper Care Oper Room Manag       Date:  2018-09-24

9.  Allocating operating room resources to an acute care surgery service does not affect wait-times for elective cancer surgeries: a retrospective cohort study.

Authors:  Ram Venkatesh Anantha; Dave Paskar; Kelly Vogt; Silvie Crawford; Neil Parry; Ken Leslie
Journal:  World J Emerg Surg       Date:  2014-03-27       Impact factor: 5.469

10.  Acute Care Surgery Models Worldwide: A Systematic Review.

Authors:  Mats J L van der Wee; Gwendolyn van der Wilden; Rigo Hoencamp
Journal:  World J Surg       Date:  2020-08       Impact factor: 3.352

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