title: Does implementing a general surgery residency program and resident involvement affect patient outcomes and increase care-associated charges?
abstract: BACKGROUND
  Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP.
  
  
  METHODS
  We analyzed all laparoscopic appendectomies (lap-ap), cholecystectomies (lap-chole), and inguinal hernia repairs (IHR) performed before and after implementing a GRSP.
  
  
  RESULTS
  Operative time significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001) and IHR (p = 0.03). Time to close the incision significantly increased for lap-ap (p < 0.0001), lap-chole (p = 0.006) and IHR (p = 0.03). Length of stay only increased for lap-ap (p = 0.04). Complication rates did not increase for any procedure. However, charges significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001), and IHR (p = 0.03).
  
  
  CONCLUSIONS
  Although a newly implemented GSRP caused increases in overall operative times, times to close incisions, and charges, it did not negatively impact patient outcomes.
authors.affiliation: Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA.
authors.forename: Trevor
authors.initials: T
authors.lastname: Wexner
authors.affiliation: Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA.
authors.forename: Armando
authors.initials: A
authors.lastname: Rosales-Velderrain
authors.affiliation: Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Wexner
authors.affiliation: Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA. Electronic address: rosentr@ccf.org.
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000191:economics; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D005260:Female; D005431:Florida; D013502:General Surgery / Q000193:education*; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000191:economics; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Costs; Education; General surgery residency program; Outcomes