This study’s objectives are to determine if the ED P4P program is

This study’s objectives are to determine if the ED P4P program is associated with decreases in ED LOS, and to address the ED P4P program’s limitations.

Methods: We analyze monthly hospital-level ED LOS time data since the inception of the financial incentives. Since the ED P4P program was phased in at different hospitals from different JNK-IN-8 datasheet health authorities overtime, hospitals’ data from only two regional health authorities are included in the study.

Results: We find association between the implementation of ED P4P and ED LOS time data. However, due to the lack of control data, the findings cannot demonstrate causality. Furthermore, our findings are from hospitals in the greater Vancouver area

only.

Interpretation:

BC’s ED P4P was introduced to create incentives for hospitals to reduce ED LOS by providing incremental incentive funding. Available data indicate that the ED P4P program is associated with mixed successes in reducing ED LOS among participating hospitals. (C) 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.”
“The study design described here is a posterior C1-C2 fusion technique P5091 composed of bilateral C1 hooks and C2 pedicle screws. In addition, the clinical results of using this method on 13 patients with C1-C2 instability are reported. The objectives are to introduce a new technique for posterior C1-C2 fusion and to evaluate the clinical outcome of using it to treat C1-C2 instability. From Staurosporine order October 2006 to August 2008, 13 patients (9 men and 4 women) with C1-C2 instability were included in this study: 3 had acute odontoid fractures, 4 had obsolete

odontoid fractures, 4 had os odontoideum and 2 had traumatic rupture of the transverse ligament. All patients underwent posterior atlantoaxial fixation with bilateral C1 hooks and C2 pedicle screws. The mean follow-up duration was 25 months (range 13-30 months). Each patient underwent a complete cervical radiograph series, including anterior-posterior, lateral, and flexion-extension views, and a computed tomographic scan. The clinical course was evaluated according to the Frankel grading system. No clinically manifested injury of the nerve structures or the vertebral artery was observed in any of these cases. Five patients with neurological symptoms showed significant improvement in neurological function postoperatively. Bony fusion and construction stability were observed in all 13 patients (100%) on their follow-up radiographs, and no instrument failure was observed. Bilateral C1 hooks combined with C2 pedicle screws can be used as an alternative treatment method for C1-C2 dislocation, especially in cases not suitable for the use of transarticular screws. The clinical follow-up shows that this technique is a safe and effective method of treatment.”
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