Belinda Agyapong, Charles Chishimba, Yifeng Wei, Raquel da Luz Dias, Ejemai Eboreime, Eleanor Msidi, Syed Sibte Raza Abidi, Maryn Mutaka-Loongo, James Mwansa, Rita Orji, John Mathias Zulu, Vincent Israel Opoku Agyapong
Improving Mental Health Literacy and Reducing Psychological Problems Among Teachers in Zambia: Protocol for Implementation and Evaluation of a Wellness4Teachers Email Messaging Program
JMIR research protocols
study aims characterize delivery pediatric surgical care based hospital volume stratified disease severity geography specialty longitudinal regionalization 10year study period noted explored kids inpatient database kid queried 2000 2009 patients 18 years undergoing noncardiac surgery hospitals nationwide grouped commutable regions identified highvolume centers hvcs 1000 weighted procedures per year regions least one hvc one additional lower volume center included analysis lowrisk highrisk neonatal surgical subspecialties analyzed separately total 385242 weighted pediatric surgical admissions 33 geographical regions 224 hospitals analyzed overall hvcs comprised 33 147 hospitals mediumvolume center mvc 33 147 lowvolume center lvc 158 705 four lowrisk procedures analyzed increasingly regionalized appendectomy 52 hvcs 2000 60 2009 p 0001 fracture reduction 63 68 p 0001 cholecystectomy 54 63 p 0001 pyloromyotomy 65 85 p 0001 neonatal surgery showed significant regionalization trends tracheoesophageal fistula 66 87 p 0001 gastroschisis 76 89 p 0001 first largescale multiregion analysis demonstrate pediatric surgical care transitioned hvcs recent decade particularly lowrisk patients important practitioners policymakers alike understand volume trends order ensure hospital capacity maintaining optimal quality care