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Andras LM, Whitlock PW, Abousamra O. What's New in Pediatric Orthopaedics. J Bone Joint Surg Am 2022; 104:299-306. [PMID: 34932502 DOI: 10.2106/jbjs.21.01430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Herrero C, Colon Y, Nagapurkar A, Castañeda P. Point-of-Care Ultrasound Reduces Visit Time and Cost of Care for Infants with Developmental Dysplasia of the Hip. Indian J Orthop 2021; 55:1529-1534. [PMID: 34690359 PMCID: PMC8525063 DOI: 10.1007/s43465-021-00541-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/01/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Healthcare institutions and policymakers are searching for system-wide approaches to reduce costs while maintaining quality and improving patient outcomes. In most healthcare systems infants referred for the detecting or treating developmental dysplasia of the hip (DDH) are sent to a radiology department for sonographic evaluation. The total duration of visit and cost of visit are essential variables in any healthcare setting and affect both efficiency and "the bottom line". By having the treating clinician perform point-of-care ultrasound (POCUS) for the detection and follow-up of patients with DDH, we hypothesize that there would be a significant reduction in the time spent on the visit and the cost incurred without compromising quality or patient satisfaction. To our knowledge, no prior study has examined the effect of incorporating POCUS on the duration and cost of the visit in patients with DDH. PURPOSE To determine if there was a difference in the duration of the visit for patients with DDH when POCUS was performed compared to when traditional "formal" sonography was performed. To determine if there was a difference in the cost of the visit for patients with DDH when POCUS was performed compared to when traditional "formal" sonography was performed. METHODS Data for visits to a specialized outpatient office were collected over two years at a single-specialty orthopedic hospital, comparing the duration and cost of the visit between patient encounters for infants who had "formal" sonograms performed in the radiology suite to infants who underwent POCUS of the hip. In all, we included 532 patient encounters, 326 patients had POCUS performed, and 206 had a "formal" ultrasonographic evaluation performed. Of these, 140 were new evaluations and 392 were follow-up evaluations for treatment. Of the 140 new patients, 80 were in the POCUS group, and 60 were in the "formal" US group. Of the 392 follow-ups, 246 were in the POCUS group, and 146 were in the "formal" US group. RESULTS The mean duration of the encounter for the POCUS group was 42 min (range 16-75 min), and for the "formal" US group, it was 92 min (range 36-163 min). This difference was statistically significant (p = 0.002). The mean cost of the encounter for the POCUS group was $121.13, and for the "formal" US group, it was $339.38. This difference was statistically significant (p = 0.002). CONCLUSION Ultimately, our study demonstrated a statistically significant reduction in the duration and cost of a patient encounter for infants with DDH when they undergo POCUS rather than "formal" sonographic evaluation.
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Affiliation(s)
- Christina Herrero
- Department of Orthopaedic Surgery, NYU Langone Health, New York, NY USA
| | - Yhan Colon
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Pablo Castañeda
- Department of Orthopaedic Surgery, NYU Langone Health, New York, NY USA
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Kumar A, Sinha S, Jameel J, Kumar S. Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review. J Taibah Univ Med Sci 2021; 17:203-213. [PMID: 34690642 PMCID: PMC8521392 DOI: 10.1016/j.jtumed.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/13/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives In the wake of recent widespread interest in telemedicine during the COVID-19 era, many orthopaedic surgeons may be unfamiliar with clinical examination skills, patients’ safety, data security, and implementation-related concerns in telemedicine. We present a bibliometric analysis and review of the telemedicine-related publications concerning orthopaedics care during the COVID-19 pandemic. Such analysis can help orthopaedic surgeons become acquainted with the recent developments in telemedicine and its usage in regular orthopaedics practice. Methods We systematically searched the database of Thomson Reuters Web of Science for telemedicine-related articles in orthopaedics published during the COVID-19 pandemic. The selected articles were analysed for their source journals, corresponding authors, investigating institutions, countries of the corresponding authors, number of citations, study types, levels of evidence, and a qualitative review. Results Fifty-nine articles meeting the inclusion criteria were published in 28 journals. Three hundred forty-two authors contributed to these research papers. The United States (US) contributed the most number of articles to the telemedicine-related orthopaedics research during the COVID-19 era. All articles combined had a total of 383 citations and 66.1% were related to the Economic and Decision-making Analyses of telemedicine implementation. By and large, level IV evidence was predominant in our review. Conclusion Telemedicine can satisfactorily cover a major proportion of patients' visits to outpatient departments, thus limiting hospitals’ physical workload. Telemedicine has a potential future role in emergency orthopaedics and inpatient care through virtual aids. The issues related to patient privacy, data security, medicolegal, and reimbursement-related aspects need to be addressed through precise national or regional guidelines. Lastly, the orthopaedic physical examination is a weak link in telemedicine and needs to be strengthened.
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Affiliation(s)
- Arvind Kumar
- Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Siddhartha Sinha
- Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Javed Jameel
- Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Sandeep Kumar
- Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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Trisolino G, Toniolo RM, Marengo L, Dibello D, Guida P, Panuccio E, Evangelista A, Stallone S, Sansò ML, Amati C, Costici PF, Boero S, Farsetti P, De Sanctis N, Verdoni F, Memeo A, Gigante C. Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology. CHILDREN (BASEL, SWITZERLAND) 2021; 8:530. [PMID: 34206218 PMCID: PMC8305147 DOI: 10.3390/children8070530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. METHODS We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the "SITOP Priority Panel". An additional classification in "high-priority" and "low-priority" surgery was also applied. RESULTS Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with "high-priority" surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of "low-priority" surgery and outpatient visits were observed. CONCLUSION Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.
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Affiliation(s)
- Giovanni Trisolino
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Renato Maria Toniolo
- Department of Orthopaedics and Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy;
| | - Lorenza Marengo
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Daniela Dibello
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pasquale Guida
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Elena Panuccio
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Andrea Evangelista
- Unit of General Affairs, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Stefano Stallone
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Maria Lucia Sansò
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Carlo Amati
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pier Francesco Costici
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, IRCCS, 00050 Rome, Italy;
| | - Silvio Boero
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Pasquale Farsetti
- Department of Orthopaedics Surgery, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Nando De Sanctis
- Unit of Pediatric Orthopaedics and Traumatology, Campolongo Hospital, 84025 Marina di Eboli, Italy;
| | - Fabio Verdoni
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Galeazzi, IRCCS, 20161 Milan, Italy;
| | - Antonio Memeo
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Cosimo Gigante
- Pediatric Orthopaedic Unit, Department of Woman and Child Health, Padua General Hospital, 35121 Padua, Italy;
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