David Lesko - Academia.edu (original) (raw)
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University Of The Philippines College Of Medicine
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Papers by David Lesko
MedZou Community Health Clinic is the University of Missouri’s student-run clinic (SRC) that serv... more MedZou Community Health Clinic is the University of Missouri’s student-run clinic (SRC) that serves the uninsured of central Missouri. While successful, MedZou has faced barriers to delivering continuity and coordination of care, spurring the creation of the Case Management Model (CMM) in 2013. This innovative model consists of medical students serving as case managers, case management directors, and MedZou clinic directors, supported by physician advisors. At its foundation, a case manager is paired with a patient who has a chronic, complex medical history along with multifactorial psychosocial issues. The case manager assesses each patient’s health needs, helps them navigate medical resources, and coordinates their medical care with the help of a physician advisor. This report describes two cases that demonstrate how the CMM has led to improvements in coordination and continuity of health care. Case 1 involves a patient with severe psoriasis who obtained mandatory lab testing befo...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017
Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and ... more Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and general surgery residents. Study Design Retrospective database review. Setting Accreditation Council for Graduate Medical Education otolaryngology and general surgery programs. Subjects and Methods Accreditation Council for Graduate Medical Education case log data from 2005 to 2015 for resident graduates in otolaryngology and general surgery were used to obtain mean graduate tracheostomy numbers, mean graduate composite case numbers, and number of graduating residents. Market share for each specialty was estimated through the derived metric of nationwide total tracheostomy graduate experience, calculated by multiplying the number of graduating residents by the mean number of graduate tracheostomies. Linear regression analysis was used to calculate trends. Multiple linear regression analysis was used for pairwise comparison of trends. Results From 2005 to 2015, mean graduate tracheostomy ...
Otolaryngology-Head and Neck Surgery
Objective To perform a cost analysis of the routine use of intraoperative frozen section (iFS) am... more Objective To perform a cost analysis of the routine use of intraoperative frozen section (iFS) among patients undergoing a thyroid lobectomy with “suspicious for malignancy” (SUSP) cytology in the context of the 2015 American Thyroid Association guidelines. Study Design Case series with chart review; cost minimization analysis. Setting Academic. Subjects and Methods Records were reviewed for patients with SUSP cytology who underwent thyroid surgery between 2010 and 2015 in which iFS was utilized. The diagnostic test performance of iFS and the frequency of indicated completion/total thyroidectomies based on the 2015 guidelines were calculated. A cost minimization analysis was performed comparing lobectomy, with and without iFS, and the need for completion thyroidectomy according to costs estimated from 2014 data from Medicare, the Bureau of Labor Statistics, and the Nationwide Inpatient Sample. Results Sixty-five patients met inclusion criteria. The malignancy rate was 61.5%, 45% of ...
MedZou Community Health Clinic is the University of Missouri’s student-run clinic (SRC) that serv... more MedZou Community Health Clinic is the University of Missouri’s student-run clinic (SRC) that serves the uninsured of central Missouri. While successful, MedZou has faced barriers to delivering continuity and coordination of care, spurring the creation of the Case Management Model (CMM) in 2013. This innovative model consists of medical students serving as case managers, case management directors, and MedZou clinic directors, supported by physician advisors. At its foundation, a case manager is paired with a patient who has a chronic, complex medical history along with multifactorial psychosocial issues. The case manager assesses each patient’s health needs, helps them navigate medical resources, and coordinates their medical care with the help of a physician advisor. This report describes two cases that demonstrate how the CMM has led to improvements in coordination and continuity of health care. Case 1 involves a patient with severe psoriasis who obtained mandatory lab testing befo...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017
Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and ... more Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and general surgery residents. Study Design Retrospective database review. Setting Accreditation Council for Graduate Medical Education otolaryngology and general surgery programs. Subjects and Methods Accreditation Council for Graduate Medical Education case log data from 2005 to 2015 for resident graduates in otolaryngology and general surgery were used to obtain mean graduate tracheostomy numbers, mean graduate composite case numbers, and number of graduating residents. Market share for each specialty was estimated through the derived metric of nationwide total tracheostomy graduate experience, calculated by multiplying the number of graduating residents by the mean number of graduate tracheostomies. Linear regression analysis was used to calculate trends. Multiple linear regression analysis was used for pairwise comparison of trends. Results From 2005 to 2015, mean graduate tracheostomy ...
Otolaryngology-Head and Neck Surgery
Objective To perform a cost analysis of the routine use of intraoperative frozen section (iFS) am... more Objective To perform a cost analysis of the routine use of intraoperative frozen section (iFS) among patients undergoing a thyroid lobectomy with “suspicious for malignancy” (SUSP) cytology in the context of the 2015 American Thyroid Association guidelines. Study Design Case series with chart review; cost minimization analysis. Setting Academic. Subjects and Methods Records were reviewed for patients with SUSP cytology who underwent thyroid surgery between 2010 and 2015 in which iFS was utilized. The diagnostic test performance of iFS and the frequency of indicated completion/total thyroidectomies based on the 2015 guidelines were calculated. A cost minimization analysis was performed comparing lobectomy, with and without iFS, and the need for completion thyroidectomy according to costs estimated from 2014 data from Medicare, the Bureau of Labor Statistics, and the Nationwide Inpatient Sample. Results Sixty-five patients met inclusion criteria. The malignancy rate was 61.5%, 45% of ...