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Would Knowing Prices for Surgery Influence Patients' Choices?

Patients who are shown the prices of procedures ahead of time are more likely to choose the less-costly option, a new study suggests.

The study, published online by the journal Annals of Surgery, observed the behavior of the parents of 100 children who needed appendectomies. About half of the childrens' parents were told that open surgery averaged about $2,200 less than laparoscopy. The rest were not given pricing information beforehand.

Surveying the parents afterward, researchers found that those who'd known the pricing information chose the open surgery 1.8 times more often than those who didn't. Additionally, 31% of the parents who were made aware of pricing said that it had been the primary influence in their decision and 90% admitted liking having a choice in health care.

The researchers point out that proving prices up front could influence patient choices in surgery and potentially lead to cost savings in health care.

Kendal Gapinski

FDA OK's Drug for Opioid Constipation

The FDA has approved a new drug for treating non-cancer patients suffering from opioid-induced constipation.

Movantik (naloxegol), which is taken orally, was found to be effective in 2 clinical trials. In the first, 3 groups of patients who'd taken opioids for at least 4 weeks were given either 12.5 mg of Movantik, 25 mg of Movantik or a placebo once daily for 12 weeks. Among those given 25 mg, there was a 44% increase in the number of bowel movements per week, compared with a 41% increase for those given 12.5 mg and a 29% increase for those given placebo. Results were similar in the second trial.

Common side effects of the drug, a peripherally acting opioid receptor antagonist distributed by AstraZeneca, include abdominal pain, diarrhea, headache and excessive gas.

Jim Burger

Specialty Doesn't Affect Spine Surgery Outcomes

Do the differences in spine surgery training that orthopods and neurosurgeons undergo ultimately impact their patients' post-op outcomes? Not according to a new study appearing in the journal Spine.

Researchers at Case Western Reserve University in Cleveland reviewed a national database to compare the outcomes of 17,126 elective laminectomies and fusions performed by neurosurgeons and orthopedic surgeons.

After eliminating pre-operative and perioperative risk factors, they found that patients who were operated on by orthopedic surgeons were more than twice as likely to remain hospitalized for a longer period after surgery and more likely to require blood transfusions during procedures. However, the researchers note a minimal difference between the specialists at 30 days post-op in minor (superficial SSIs, UTIs and DVT) and major (deep incision and organ SSIs, wound disruption, pneumonia, nerve damage and cardiac arrest) complications, hospital readmissions, returns to the OR and mortality rates.

The analysis did not take into account fellowship training, surgeon experience or hospital case volume, all of which could influence procedure outcomes. But the researchers say the large, multi-institutional patient sample suggests surgeon specialty has "limited influence" on short-term outcomes after elective spine surgery. They also point out that the differences in post-op lengths of stay and transfusion rates may diminish over time as surgeons at multidisciplinary spine centers share their experiences in efforts to optimize outcomes.

Daniel Cook

InstaPoll: Can High-Volume Docs Get Away With Lewd, Crude Behavior?

Some say the more cases a surgeon brings to your facility, the more latitude he has when it comes to boorish behavior. How likely are you to tolerate disruptive behavior from a high-volume surgeon? Tell us in this week's InstaPoll, then check back next week for the results.

The death of Joan Rivers has put the safety of ambulatory surgical centers under the microscope. Nearly 6 out of 10 of the 602 respondents to last week's poll say the scrutiny is warranted. The results:

Is the scrutiny on for-profit surgery centers after Joan Rivers's death justified?

  • Yes 59%
  • No 32%
  • Unsure 9%

Dan O'Connor

News & Notes
  • Healthcare lags in adopting IT Early adopters of new technologies experience better business outcomes, but healthcare facilities could do more sooner to capitalize on IT's advantages, says a report in the Harvard Business Review. The survey of 672 corporate leaders, which included 74 healthcare executives, revealed that only 27% seek to be among the first to adopt new technology, 35% wait until a technology is established and 36% invest in technology after it has been proven. "Leaders who want to get the most from new technologies must devote time and attention to their organizations' ability to work together in new ways and adapt to change," the authors write.
  • Sharks inspire infection prevention A material whose texture mimics the pattern of shark skin outperforms smooth surfaces and copper in resisting both methicillin-resistant and -susceptible Staphylococcus aureus, a recent study finds. In experiments designed to simulate the effects of sneezing, touching and spillage, the material known as Sharklet harbored 94% less MRSA bacteria than the smooth surface and 80% less than copper, as well as 97% less MSSA bacteria than both.
  • Glaucoma's cellular cause? The endothelial cells in the eyes of patients suffering from glaucoma appear to be stiffer than those in healthy eyes, say researchers. This "mechanical dysfunction" resists the flow of aqueous humor through the endothelium and into Schlemm's canal, which leads to glaucoma's harmful rise in intraocular pressure. The study, published online in the journal Proceedings of the National Academy of Sciences, speculates that therapeutic strategies to reduce the cells' stiffness could result in a cure.