Evidence map›Paper›PMID 24666462›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie2014

Implementation of an acute care emergency surgical service: a cost analysis from the surgeon's perspective.

Ram Venkatesh Anantha, Neil Parry, Kelly Vogt, Vipan Jain, Silvie Crawford, Ken Leslie

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Unintended consequences of changes to lung allocation policy.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019
    Article
  6. Article
  7. A day in the life of emergency general surgery in Canada: a multicentre observational study.Canadian journal of surgery. Journal canadien de chirurgie · 2018
    Observational
  8. Article
  9. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Ram Venkatesh AnanthaThe Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont..
Neil ParryThe Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont., and The Division of Critical Care, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont..
Kelly VogtThe Division of Acute Care Surgery and Surgical Critical Care, Los Angeles County and University of Southern California Medical Center, Los Angeles, Calif.
Vipan JainStrathroy Middlesex General Hospital, Strathroy, Ont.
Silvie CrawfordThe Division of General Surgery, University of Western Ontario, London, Ont.
Ken LeslieThe Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont..
Western University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute care surgical services provide comprehensive emergency general surgical care while potentially using health care resources more efficiently. We assessed the volume and distribution of emergency general surgery (EGS) procedures before and after the implementation of the Acute Care and Emergency Surgery Service (ACCESS) at a Canadian tertiary care hospital and its effect on surgeon billings.

methodsThis single-centre retrospective case-control study compared adult patients who underwent EGS procedures between July and December 2009 (pre-ACCESS), to those who had surgery between July and December 2010 (post-ACCESS). Case distribution was compared between day (7 am to 3 pm), evening (3 pm to 11 pm) and night (11 pm to 7 am). Frequencies were compared using the χ(2) test.

resultsPre-ACCESS, 366 EGS procedures were performed: 24% during the day, 55% in the evening and 21% at night. Post-ACCESS, 463 operations were performed: 55% during the day, 36% in the evening and 9% at night. Reductions in night-time and evening EGS were 57% and 36% respectively (p < 0.001). Total surgeon billings for operations pre- and post-ACCESS were $281 066 and $287 075, respectively: remuneration was $6008 higher post-ACCESS for an additional 97 cases (p = 0.003). Using cost-modelling analysis, post-ACCESS surgeon billing for appendectomies, segmental colectomies, laparotomies and cholecystectomies all declined by $67 190, $125 215, $66 362, and $84 913, respectively (p < 0.001).

conclusionAcute care surgical services have dramatically shifted EGS from nighttime to daytime. Cost-modelling analysis demonstrates that these services have cost-savings potential for the health care system without reducing overall surgeon billing.

Indexed as

AdultAttitude of Health PersonnelCosts and Cost AnalysisEmergency Medical ServicesGeneral SurgeryHumansOntarioProgram EvaluationRemunerationRetrospective StudiesSurgery Department, Hospital

Identifiers

PMID24666462
PMCPMC3968201
OpenAlexW2073474830

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.