Sudha Russell - Academia.edu (original) (raw)

Papers by Sudha Russell

Pediatrics Research International Journal, 2013

Patients who left without being seen (LWBS) by a physician from a pediatric emergency department ... more Patients who left without being seen (LWBS) by a physician from a pediatric emergency department (ED)/urgent care (UC) center have become a serious challenge facing emergency medicine practitioners and hospitals. Not only does this serve as an indicator of patient dissatisfaction and delay of treatment, but it also results in a loss of billable charges for the hospital and physician medical group. This study was intended to estimate the amount of lost billable charges accumulated over one year as a result of 1,193 pediatric patients who LWBS from a large academic tertiary care urban children's hospital. Parents or caretakers of the patients listed as LWBS were contacted by an investigator from the study team, and a telephone interview consisting of 19 questions was conducted, lasting 10 to 15 minutes. Three hundred and twenty three subjects participated in the study, which accounted for 27% of the patients who LWBS after registering. Using the information provided by the respondents, projected lost charges were extrapolated for each patient that LWBS. These included hospital charges and physician charges for each patient visit. The lost hospital charges for the respondents were 232,085,andthelostphysicianchargeswere232,085, and the lost physician charges were 232,085,andthelostphysicianchargeswere69,949. Extrapolating these results for all 1,193 patients who LWBS during the one year study period, we estimated lost charges of approximately 1,115,455(hospitalcharges1,115,455 (hospital charges 1,115,455(hospitalcharges857,170, physician charges $258,284). This study showed that a significant revenue stream is lost when caregivers/parents of patients who register to be seen choose to LWBS.

BMC Research Notes, 2012

Background: Gallstones are relatively rare in children. At-risk populations include patients suff... more Background: Gallstones are relatively rare in children. At-risk populations include patients suffering from hemolysis syndromes. Regardless of etiology, these patients usually will present with postprandial abdominal pain, and ultrasonography is the mainstay of diagnosis. However, some gallstones are radiopaque and can be visualized on plain abdominal radiography. Case presentation: We present the uncommon but classic plain x-ray finding of a calcified gallstone in a 3 year-old Hispanic boy. He was treated with elective laparoscopic cholecystectomy. Conclusions: Cholelithiasis is rare in children, and calcified stones that will appear on plain abdominal x-rays are even rarer. If symptomatic, cholecystectomy by a pediatric surgeon is the treatment of choice. We discuss some of the recent developments in treatment of this condition in this patient population.

Perforated appendicitis and appendicolith in a child presenting as intussusception: a case report

Simultaneous diagnoses of intussusception and appendicitis in the same patient have rarely been d... more Simultaneous diagnoses of intussusception and appendicitis in the same patient have rarely been described in the pediatric literature. A case of a 30-month-old boy is presented with an initial diagnosis of intussusception that was successfully reduced by air contrast enema. When the patient's condition deteriorated, a diagnostic search surprisingly revealed a missed perforated appendicitis with an appendicolith that had been part of the intussusception. The patient's hospitalization and surgical course is described along with a discussion of the intermingling of intussusception and appendicitis in a young child. This case illustrates the need to consider alternative diagnoses when a patient's course takes an unexpected and confusing turn.

Pediatrics Research International Journal, 2013

Patients who left without being seen (LWBS) by a physician from a pediatric emergency department ... more Patients who left without being seen (LWBS) by a physician from a pediatric emergency department (ED)/urgent care (UC) center have become a serious challenge facing emergency medicine practitioners and hospitals. Not only does this serve as an indicator of patient dissatisfaction and delay of treatment, but it also results in a loss of billable charges for the hospital and physician medical group. This study was intended to estimate the amount of lost billable charges accumulated over one year as a result of 1,193 pediatric patients who LWBS from a large academic tertiary care urban children's hospital. Parents or caretakers of the patients listed as LWBS were contacted by an investigator from the study team, and a telephone interview consisting of 19 questions was conducted, lasting 10 to 15 minutes. Three hundred and twenty three subjects participated in the study, which accounted for 27% of the patients who LWBS after registering. Using the information provided by the respondents, projected lost charges were extrapolated for each patient that LWBS. These included hospital charges and physician charges for each patient visit. The lost hospital charges for the respondents were 232,085,andthelostphysicianchargeswere232,085, and the lost physician charges were 232,085,andthelostphysicianchargeswere69,949. Extrapolating these results for all 1,193 patients who LWBS during the one year study period, we estimated lost charges of approximately 1,115,455(hospitalcharges1,115,455 (hospital charges 1,115,455(hospitalcharges857,170, physician charges $258,284). This study showed that a significant revenue stream is lost when caregivers/parents of patients who register to be seen choose to LWBS.

BMC Research Notes, 2012

Background: Gallstones are relatively rare in children. At-risk populations include patients suff... more Background: Gallstones are relatively rare in children. At-risk populations include patients suffering from hemolysis syndromes. Regardless of etiology, these patients usually will present with postprandial abdominal pain, and ultrasonography is the mainstay of diagnosis. However, some gallstones are radiopaque and can be visualized on plain abdominal radiography. Case presentation: We present the uncommon but classic plain x-ray finding of a calcified gallstone in a 3 year-old Hispanic boy. He was treated with elective laparoscopic cholecystectomy. Conclusions: Cholelithiasis is rare in children, and calcified stones that will appear on plain abdominal x-rays are even rarer. If symptomatic, cholecystectomy by a pediatric surgeon is the treatment of choice. We discuss some of the recent developments in treatment of this condition in this patient population.

Perforated appendicitis and appendicolith in a child presenting as intussusception: a case report

Simultaneous diagnoses of intussusception and appendicitis in the same patient have rarely been d... more Simultaneous diagnoses of intussusception and appendicitis in the same patient have rarely been described in the pediatric literature. A case of a 30-month-old boy is presented with an initial diagnosis of intussusception that was successfully reduced by air contrast enema. When the patient's condition deteriorated, a diagnostic search surprisingly revealed a missed perforated appendicitis with an appendicolith that had been part of the intussusception. The patient's hospitalization and surgical course is described along with a discussion of the intermingling of intussusception and appendicitis in a young child. This case illustrates the need to consider alternative diagnoses when a patient's course takes an unexpected and confusing turn.