Evolution of the Surgeon-Volume, Patient Outcome Relationship

Burns, Elaine; Faiz, Omar

doi:10.1097/sla.0b013e3181db31ea

Cited by 2 publications

(4 citation statements)

References 6 publications

(3 reference statements)

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“…The effects of surgeon experience on clinical outcomes have been reported for other surgical fields, with varying results (6,9). In our study, no significant difference was found in hospitalization expenses according to the operation case order or the experience of the surgeon.…”

Section: Discussioncontrasting

confidence: 45%

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Liu¹,

Yu²,

Wang³

et al. 2020

J Thorac Dis

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Background: Esophageal cancer represents a major health threat in China. Esophagectomy is the standard treatment for respectable esophageal cancer. This study aimed to investigate the costs of hospitalization in esophageal cancer patients undergoing esophagectomy, and to analyze the factors influencing these costs.Methods: A retrospective observational study which enrolled 196 patients who underwent esophagectomy from September, 2018, to April, 2019, in the Affiliated Cancer Hospital of Zhengzhou University were conducted Results: The median inpatient cost was ￥72,772 (range, ￥49,796-128,771). Materials accounted for 39.7% of the direct medical costs, which was the highest proportion for any of the cost components. Minimally invasive esophagectomy (MIE, OR: 0.031; 95% CI: 0.005-0.209), cardiopathy comorbidity (OR: 0.344; 95% CI: 0.136-0.872), and anastomotic leak (OR: 0.012; 95% CI: 0.001-0.131) were risk factors for higher cost, while early oral feeding (OR: 3.979; 95% CI: 1.430-11.067) was a protective factor.Conclusions: Understanding the factors associated with high hospitalization costs will help to reduce healthcare expenditure. By controlling complications and promoting early oral feeding, the economic burden on esophagectomy patients can be relieved. Further research based on a longitudinal design is needed to investigate the full costs of hospitalization associated with esophageal cancer.

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Section: Discussioncontrasting

confidence: 45%

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Liu¹,

Yu²,

Wang³

et al. 2020

J Thorac Dis

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“…This adds further evidence to the conclusion by Burns et al 19 mentioned above – that centralisation may be ineffective in improving results unless the higher volume is directed towards high‐quality providers. This recommendation has been echoed by others 50,64 …”

Section: Discussionmentioning

confidence: 83%

“…We included this contribution to LOS in our study. It has also been suggested that there may be publication bias that may contribute to the impression of the importance of hospital volume 50 …”

Section: Discussionmentioning

confidence: 99%

“…The model was adjusted for various patient and hospital factors that may confound the association between provider volume and LOS 3,8,38,49 . These included patient factors such as: sex; age; Elixhauser Comorbidity Index; the American Society of Anesthesiologists’ physical status classification system (ASA); cancer site (colon, rectum or anus); whether the cancer was metastatic or not based on ICD‐10‐AM codes; admission type; separation mode; 3,50 and the colorectal procedure performed. Hospital factors were: number of daily colorectal surgical admissions; type of hospital (private for profit, private non‐profit or public); and whether the hospital was co‐located or not 51 .…”

Section: Methodsmentioning

confidence: 99%

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Hospital characteristics, rather than surgical volume, predict length of stay following colorectal cancer surgery

Vicendese

Marvelde

McNair

et al. 2020

Australian and New Zealand Journal of Public Health

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Objective: Length of hospital stay (LOS) is considered a vital component for successful colorectal surgery treatment. Evidence of an association between hospital surgery volume and LOS has been mixed. Data modelling techniques may give inconsistent results that adversely impact conclusions. This study applied techniques to overcome possible modelling drawbacks. Method:An additive quantile regression model formulated to isolate hospital contextual effects was applied to every colorectal surgery for cancer conducted in Victoria, Australia, between 2005 and 2015, involving 28,343 admissions in 90 Victorian hospitals. The model compared hospitals' operational efficiencies regarding LOS.Results: Hospital LOS operational efficiencies for colorectal cancer surgery varied markedly between the 90 hospitals and were independent of volume. This result was adjusted for pertinent patient and hospital characteristics. Conclusion:No evidence was found that higher annual surgery volume was associated with lower LOS for patients undergoing colorectal cancer surgery. Our model showed strong evidence that differences in LOS efficiency between hospitals was driven by hospital contextual effects that were not predicted by provider volume. Further study is required to elucidate these inherent differences between hospitals.Implications for public health: Our model indicated improved efficiency would benefit the patient and medical system by lowering LOS and reducing expenditure by more than $3 million per year. Vicendese et al. ArticleEpidemiologyA retrospective analysis of 62,774 colorectal surgeries 2005-2015 Epidemiology A retrospective analysis of 62,774 colorectal surgeries 2005-2015

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Evolution of the Surgeon-Volume, Patient Outcome Relationship

Cited by 2 publications

References 6 publications

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Hospital characteristics, rather than surgical volume, predict length of stay following colorectal cancer surgery

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