Surgery News - September 2008 - (Page 1) VOL. 4 • NO. 9 • SEPTEMBER 2008 MICHAEL MARSLAND/YALE UNIVERSITY Capitol Hill Starts Strategizing for Health Reform Committees crafting legislation. B Y A L I C I A A U LT INSIDE 20/20N VISIO Appreciation Dr. Michael Ellis DeBakey was a pioneer heart surgeon and device innovator. • 4 THE Else vier Global Medical Ne ws Tissue-engineered vascular grafts have been used in 25 children in Tokyo, said Dr. Toshiharu Shinoka (left) and Dr. Christopher Breuer. New Vascular Grafts May Benefit Children BY JANE ANDERSON Else vier Global Medical Ne ws T issue-engineered vascular grafts currently under development show promise as a substitute for prosthetic and bioprosthetic grafts used in pediatric patients, according to Dr. Christopher Breuer, one of the surgeons conducting the research. Unlike prosthetic and bioprosthetic grafts, which must be replaced periodically because they do not grow as young patients mature, tissue-engineered vascular grafts are seeded with bone marrow cells and, as living vascular structures, may have the potential for growth, repair, and remodeling, said Dr. Breuer, as- sistant professor of surgery at Yale University, New Haven, Conn., in an interview. “We developed technology to seed a scaffold to provide the space for 3-D cell growth. We’re very interested in getting this into children in the U.S.,” he said, noting that the technology has been used in pediatric patients in Tokyo. Dr. Breuer presented the results of an animal study at the annual meeting of the American Surgical Association (ASA) earlier this year. In that study, which was supported by a grant from the ASA, polyglycolic acid mesh tubes were statically seeded with mononuclear cells derived from See Vascular Grafts • page 2 emocrats and Republicans are so confident about the chances of some type of health reform in the next administration that staff meetings and hearings geared toward crafting legislation have been going on in earnest in both the House and the Senate, with the goal of being ready to go in January, according to advocates and policy watchers. Many health policy analysts have compared this election cycle with that of 1992, which sent Bill Clinton to the White House and launched the Clintons’ health care reform efforts. Both elections—1992 and 2008—feature a high level of public concern about access to health care and its costs, said Len Nichols, an analyst at the New America Foundation, a nonpartisan public policy institute. For instance, a Harris Inter- D active survey conducted for the Commonwealth Fund in May found that 82% of Americans think the health care system should be fundamentally changed or completely rebuilt. But the differences between the two elections are striking in a positive way, said Mr. Nichols in an interview. First, the two major candidates have acknowledged that cost is an overriding concern, he said. Also, a common theme is the use of private markets, which he called “evidence, I would say, of moderation” and, perhaps, the proposals’ better legislative traction. Both Sen. Barack Obama (DIll.) and Sen. John McCain (RAriz.) have also learned that “no president is going to send [to Congress] a 1,400-page health bill written in a hotel room by 300 wonks,” Mr. Nichols said. Instead, “Congress is going to own this [effort] far earlier and See Health Reform • page 2 Low Scores A scorecard shows a decline in U.S. health care system performance since 2006. • 5 News From the College New Leader Dr. L.D. Britt becomes chair of the ACS Board of Regents. • 8 Practice Trends High Price to Pay Preventable surgical errors are likely costing insurers more than $1 billion annually, a new study says. • 11 Noncovered ‘Never’ Events List Grows B Y M A RY E L L E N SCHNEIDER Else vier Global Medical Ne ws VITAL SIGNS Aggregate Hospital Costs of Select Diagnoses (in millions of dollars) Complications of device, implant, or graft Complications of surgical procedures Intestinal obstruction without hernia Gastrointestinal hemorrhage Pancreatic disorders (not diabetes) Appendicitis Crushing injury or internal injury Abdominal hernia Colon cancer Oct. Medicare won’t a Startingpay for 1, total of 11 preventable conditions acquired during a hospital stay, up from the current 8 such conditions. Added to the list of noncovered preventable conditions are surgical site infections following certain elective procedures, such as orthopedic and bariatric surgery; manifestations of poor glycemic control; and deep vein thrombosis or pulmonary embolism following certain orthopedic procedures, such as total knee replacement and hip replacement. (See box, on p. 10, for current preventable conditions.) The new conditions were included in the Acute Care Hospital Inpatient Prospective Pay- $9,404 $5,086 $3,253 $2,863 $2,767 ELSEVIER GLOBAL MEDICAL NEWS ment final rule, which was published in the Federal Register on Aug. 19 and released earlier on the Centers for Medicare and Medicaid Services’ Web site. The expansion of the preventable conditions list was criticized by the American Medical Association for putting patient care at risk. The AMA said that Medicare officials are lumping together true “never” events such as wrong-site surgery with SURGERY NEWS “often unavoidable” conditions such as surgical site infections. “Focusing on determining whether or not medical conditions exist when the patient enters the hospital will increase Medicare spending on tests and screenings with questionable benefit to patients,” Dr. J. James Rohack, AMA president-elect, said in a statement. “A more efSee Never Events • page 10 Presorted Standard U.S. Postage PAID Permit No. 384 Lebanon Jct. KY 60 Columbia Rd., Bldg. B Morristown, NJ 07960 CHANGE SERVICE REQUESTED $2,449 $1,947 $1,906 $1,837 Note: Based on 2006 data from the Nationwide Inpatient Sample. Source: Agency for Healthcare Research and Quality
Table of Contents Feed for the Digital Edition of Surgery News - September 2008 Surgery News - September 2008 Contents Appreciation Low Scores News From the College: New Leader Practice Trends: High Price to Pay Surgery News - September 2008 Surgery News - September 2008 - Contents (Page 1) Surgery News - September 2008 - Contents (Page 2) Surgery News - September 2008 - Contents (Page 3) Surgery News - September 2008 - Appreciation (Page 4) Surgery News - September 2008 - Low Scores (Page 5) Surgery News - September 2008 - Low Scores (Page 6) Surgery News - September 2008 - Low Scores (Page 7) Surgery News - September 2008 - News From the College: New Leader (Page 8) Surgery News - September 2008 - News From the College: New Leader (Page 9) Surgery News - September 2008 - News From the College: New Leader (Page 10) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 11) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 12) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 13) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 14) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 15) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 16)
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