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At least 739 records · Page 41Linked to original sources
PubMed1989

Early and five-year results for coronary artery bypass grafting. A benchmark for percutaneous transluminal coronary angioplasty.

Patients currently undergoing coronary artery bypass grafting will likely have worse early and late results because of the selection of patients with fewer risk factors for percutaneous transluminal coronary angioplasty. Therefore, until the results of randomized prospective studies are available, angioplasty should also be compared to bypass grafting before the era of angioplasty to facilitate current comparison with bypass grafting. To obtain these data, I analyzed 500 consecutive patients (aged 33 to 79 years [58 +/- 10 SD], 20% [100/500] female, and 60% [300/500] with three vessel disease) undergoing first-time coronary bypass without associated procedures between late 1976 and mid-1980. Intermittent aortic cross-clamping (for each distal graft) was used for revascularization of all arteries 1.0 mm in internal diameter or larger with stenoses of 50% or greater. This strategy resulted in complete revascularization in 99.8% of patients, averaging 3.2 +/- 1.2 distal grafts per patient. The hospital mortality rate was 0.2% (1/500). The incidence of low output syndrome necessitating pressors (0.8%) or intraaortic balloon pump support (0.2%) was 1% (5/500). Perioperative myocardial infarction rate based on new Q waves was 2.2% (11/500). All but three patients (99.4%) were contacted at 5 years or later with respect to repeat coronary bypass or angioplasty and survival. The survival rate at 5 years, including hospital deaths, was 92.7% +/- 1.2% (70% confidence limits) for cardiac deaths, 89.8% +/- 1.4% for all deaths, and 89.8% +/- 1.4% for all deaths plus three patients lost to follow-up. Approximately 40 factors were screened univariately to determine their effect on survival and survival free from repeat intervention. Multivariate analysis revealed, as in other series, that decreased left ventricular function (ejection fraction less than 50%) was the predominant determinant of decreased 5-year survival for both cardiac death and total mortality. At 5 years, the freedom from reintervention was 97.7% +/- 0.7%. Factors associated with repeat intervention were younger age (52 +/- 11 years versus 58 +/- 10, p less than 0.05) and fewer grafts (2.3 +/- 1.0 versus 3.3 +/- 1.2, p less than 0.01) because of less severe disease (three vessel disease 31% versus 60%, p less than 0.05). These results provide a benchmark for angioplasty which should attain a hospital mortality rate of under 1%, a periprocedure myocardial infarction rate under 3%, and a 5-year survival rate of approximately 90% with more than 95% of survivors free of repeat intervention in unselected patients, not cohorts with primarily single vessel disease.

Adult↗
PubMed1988

Workers' compensation: 1980-84 benchmark revisions.

The first workers' compensation program was introduced 80 years ago. Its purpose was to compensate occupationally injured workers and their families for lost wages and medical expenses from job-related injury, regardless of fault. Today, each of the State and Federal programs that provides coverage to more than 86 percent of the work force uses a combination of private insurance, State or Federal funds, and self-insurance to meet its benefit obligations. The workers' compensation program is of continuing interest to the Social Security Administration (SSA) for several reasons. Since 1965, Social Security Disability Insurance benefits have been subject to reduction if such benefits, when combined with those provided under workers' compensation laws, exceed 80 percent of the worker's earnings. Because the two programs have gaps in protection as well as duplication in coverage, a periodic review of the workers' compensation program is necessary. In addition, SSA administers Part B of the Black Lung program--established to provide income-maintenance protection to coal miners disabled by pneumoconiosis--to about 1 million beneficiaries whose claims were filed before July 1973. This article provides revised benchmark data on the workers' compensation programs and presents a review of program operations during the early 1980's.

Costs and Cost Analysis↗
PubMed1995

Adrenalectomy via the dorsal approach: a benchmark for laparoscopic adrenalectomy.

PURPOSE: We reviewed our experience with posterior surgical excision of aldosteronomas. MATERIALS AND METHODS: A retrospective review identified 40 consecutive cases performed by 1 surgeon. RESULTS: Mean patient age was 46 years and mean blood loss was 237 cc. There was no perioperative mortality or intraoperative complications. Times to unassisted ambulation and return to a normal diet were 2.2 and 2.4 days, respectively, with a mean postoperative hospital stay of 4.4 days. CONCLUSIONS: The removal of aldosteronomas via the dorsal approach is a safe reliable technique with acceptable morbidity. These results provide a benchmark by which the results of laparoscopic adrenalectomy may be judged.

Adrenal Cortex Neoplasms↗
PubMed1996

Benchmarking: a data-oriented look at improving health care performance.

Benchmarking uses measures of comparative performance to develop an understanding of what is possible and how others have achieved higher levels of performance. Companies measure each other's performance, identify the best performer out of a group, and then seek to identify and understand the practices that can improve both clinical and administrative operations. When a powerful consortium of Cincinnati businesses began addressing ways to lower the cost of employee care in a project known as the Iameter study, the University of Cincinnati Hospital joined the effort to identify and improve major cost factors. One aspect highlighted by this review is the length of stay in the neonatal intensive care unit (NICU). The results of the study were incorporated into an NICU early discharge program, which has had a number of positive effects in both patient care quality and cost containment.

Aftercare↗
PubMedDate not supplied

Benchmarks of successful physician-hospital organizations.

In recent years, there have been a proliferation of physician-hospital organizations (PHOs) in the medical community across the country. To date, many of them have been ineffective with unproven track records. This article will explore some of the benchmarks of successful PHOs.

Hospital-Physician Joint Ventures↗
PubMedDate not supplied

Benchmarking: a management tool for academic medical centers.

With a careful cost-restructuring plan based on benchmark information, The Foster G. McGaw Hospital of Loyola University reduced its operating budget by $33 million and put in place the structure for sustained progress in cost reduction.

Academic Medical Centers↗
PubMedDate not supplied

Outcomes and benchmarks in the home medical equipment services industry: the time is now.

The home medical equipment services industry has started to participate in outcomes measurement and benchmarking. As a result, the industry now will be able to capture and to compare treatment, performance, and outcome data to make informed decisions about the benefit and the value of various options to treat illness or to maintain wellness in the home setting.

Durable Medical Equipment↗
PubMedDate not supplied

Benchmarking: a case report.

In mid 1993, administrators and physicians at Bristol Medical Center teams up with HCIA to perform clinical pathway analysis on five diagnosis related groups. The major goal of this project was to establish a partnership between the hospital administration and the medical staff to meet or beat existing benchmarks.

Critical Pathways↗
PubMedDate not supplied

Benchmarking for unrelieved pain in a postanesthesia care unit.

The problem of unrelieved pain in the PostAnesthesia Care Unit (PACU) is an outcomes management concern. This article discusses the steps taken by the PACU staff to establish a benchmark for unrelieved pain and to evaluate the effect of the Multidisciplinary Pain Management Initiative (MPMI) action plan on the outcomes of length of stay and cost.

Critical Pathways↗
PubMed2026

Large-scale benchmarking of prokaryotic annotation tools across thousands of species.

BACKGROUND: Genome annotation is an important step in deriving functional meaning from prokaryotic sequencing data, yet systematic evaluations guiding tool selection are lacking. We present the first large-scale investigation of four prominent open-source annotation tools (Prokka, Bakta, EggNOG-mapper, and PGAP) across 156,033 diverse genomes. This includes Escherichia coli strains for baseline performance, thousands of archaea and bacteria genomes, as well as frameshifted and metagenome-assembled genomes. RESULTS: Bakta excels in annotating high-quality bacterial genomes, while PGAP was better for archaeal genomes and challenging bacterial assemblies, including metagenome-assembled, fragmented, or contaminated samples. For Gene Ontology annotation, PGAP consistently provides broader term coverage, whereas EggNOG-mapper offers more terms per feature. CONCLUSIONS: Our findings highlight tool-specific strengths crucial for selecting optimal solutions based on genome quality, taxonomy, and origin (e.g. MAGs). This study provides an evidence-based guide for users and informs future tool development.

Molecular Sequence Annotation↗
PubMed2000

Psychiatric inpatients and the MMPI-2: providing benchmarks.

The second edition of the Minnesota Multiphasic Personality Inventory (MMPI-2: Butcher & Williams, 1992) has become the standard instrument for assessing individuals in a variety of settings, including inpatient psychiatric facilities (Piotrowski, 1997). This study reports on the responding of 516 adult psychiatric inpatients on an acute-care inpatient unit who were administered the MMPI-2 after they were referred for diagnostic testing. Base-rate responding, two-point code frequencies, and gender- and race-based responding are reported. Differences in gender and race responding are noted to coincide with differences in psychiatric diagnosis for those groups. The importance of having base rates for an inpatient sample is discussed. In particular, it is noted that the high levels of endorsement that are characteristic of this population can be difficult to interpret without access to inpatient comparison profiles.

Adolescent↗
PubMed2001

Benchmarking operator performance in percutaneous coronary intervention: a novel approach using 30-day events.

The infrequency of adverse in-hospital events limits scorecarding individual angioplasty operators. We assessed 30-day events for this purpose. Thirty-nine operators performed 1,950 coronary interventions from 1 April to 30 September 1998. Thirty-day follow-up was obtained in 1,896 (97.2%), who form the basis for this analysis. We recorded 16 baseline variables and chose an endpoint of mortality or target vessel revascularization. The endpoint occurred in 103 (5.4%) patients by 30 days. Independent predictors were identified by multivariate modeling. The expected event rate for the set of patients treated by each operator was determined. Two operators had significantly more adverse events by 30 days than predicted and two others had an event rate approaching significance. Two of these four performed at least 60 procedures during the 6-month period. With 30-day events, operators whose complication rates exceed laboratory standards can be identified with achievable sample sizes. Volume alone does not appear to be sufficient assurance of quality outcomes.

Aged↗
PubMed2004

Use of antibiotics at hospitals in Stockholm: a benchmarking project using internet.

PURPOSE: To evaluate the internet way of feedback to prescribing physicians, providing data on antimicrobial use and to assess the applicability of the DU90% (i.e. Drug Utilisation 90%--the number of drugs accounting for 90% of the volume of usage in defined daily doses, (DDDs)) methodology in the hospital setting. METHODS: Antimicrobial drug use was evaluated in all major departments in seven hospitals in Stockholm in the year 2000. All data were presented anonymously on www.janusinfo.org. Aggregate data on antimicrobial drug use were expressed as the number of DDDs and costs per 100 bed-days. We focused on the number of drugs accounting for 90% of the volume (DDD), including the level of adherence to guidelines. The chief physicians assessed this feedback by a questionnaire. RESULTS: The number of DDDs/100 bed-days varied among different clinics and ranged from 39 to 57 (internal medicine) to 102 to 161 (infectious disease). The cost per 100 bed-days varied more than two-fold. The number of different antibiotics within the DU90% segment ranged from 9 to 13 (orthopaedic clinics) to 16 to 23 (infectious disease). According to the questionnaire, data were considered to be clearly presented and physicians would like to receive this kind of reports in the future, not only for antibiotics but also for other drugs. CONCLUSION: Presenting physicians with aggregate data on drug use via internet could provide a stimulus for prescribing improvement.

Anti-Bacterial Agents↗