1 40 1 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1016/j.jss.2019.08.030" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jss.2019.08.030</a> Rights Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). ISSN 1095-8673 Search for Full-text Locate full-text within NEOMED Library's e-journal collections <a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.jss.2019.08.030" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.jss.2019.08.030</a> <p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Emergency General Surgery Volume and Its Impact on Outcomes in Military Treatment Facilities Publisher An entity responsible for making the resource available The Journal Of Surgical Research Date A point or period of time associated with an event in the lifecycle of the resource 2019 2019-11-04 Subject The topic of the resource Emergency general surgery; Military health system; Volume-based outcomes Creator An entity primarily responsible for making the resource Chaudhary Muhammad Ali; Learn Peter A; Sturgeon Daniel J; Havens Joaquim M; Goralnick Eric; Koehlmoos Tracey; Haider Adil H; Schoenfeld Andrew J Description An account of the resource BACKGROUND: Low hospital volume for emergency general surgery (EGS) procedures is associated with worse patient outcomes within the civilian health care system. The military maintains treatment facilities (MTFs) in remote locations to provide access to service members and their families. We sought to determine if patients treated at low-volume MTFs for EGS conditions experience worse outcomes compared with high-volume centers. MATERIALS AND METHODS: We analyzed TRICARE data from 2006 to 2014. Patients were identified using an established coding algorithm for EGS admission. MTFs were divided into quartiles based on annual EGS volume. Outcomes included 30-d mortality, complications, and readmissions. Logistic regression models adjusting for clinical and sociodemographic differences in case-mix including EGS condition, surgical intervention, and comorbidities were used to determine the influence of hospital volume on outcomes. RESULTS: We identified 106,915 patients treated for an EGS condition at 79 MTFs. The overall mortality rate was 0.21%, with complications occurring in 8.55% and readmissions in 4.45%. After risk adjustment, lowest-volume MTFs did not demonstrate significantly higher odds of mortality (OR: 2.02, CI: 0.45-9.06) or readmissions (OR: 0.77, CI: 0.54-1.11) compared with the highest-volume centers. Lowest-volume facilities exhibited a lower likelihood of complications (OR: 0.76, CI: 0.59-0.98). CONCLUSIONS: EGS patients treated at low-volume MTFs did not experience worse clinical outcomes when compared with high-volume centers. Remote MTFs appear to provide care for EGS conditions comparable with that of high-volume facilities. Our findings speak against the need to reduce services at small, critical access facilities within the military health care system. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1016/j.jss.2019.08.030" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2019.08.030</a> PMID: 31699538 Format The file format, physical medium, or dimensions of the resource Journal Article 2019 Chaudhary Muhammad Ali Emergency general surgery Goralnick Eric Haider Adil H Havens Joaquim M Journal Article Koehlmoos Tracey Learn Peter A Military health system NEOMED Alumnus NEOMED College of Medicine November 2019 Update Schoenfeld Andrew J Sturgeon Daniel J The Journal of surgical research Volume-based outcomes