The Relation Between Hospital Experience and Mortality for Patients With AIDS

Stone, Valerie E.; Seage, George R.; Hertz, Tom; Epstein, Arnold M.

doi:10.1001/jama.1992.03490190055031

Cited by 77 publications

(12 citation statements)

References 27 publications

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“…As the HIV epidemic continues, it is becoming clearer that most primary care physicians who do not care for large numbers of HIV-infected patients cannot maintain the level of knowledge and experience necessary to provide HIV care. In addition, in both the pre-HAART and HAART eras, HIV-related experience at the physician and hospital level has been demonstrated to be important in predicting patient outcomes [2,[6][7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Differences between Infectious Diseases--Certified Physicians and General Medicine--Certified Physicians in the Level of Comfort with Providing Primary Care to Patients

Fultz

Goulet

Weissman

et al. 2005

Clinical Infectious Diseases

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We found that ID-certified physicians and GM-certified physicians at ID clinics reported less comfort prescribing medications for common comorbid conditions, compared with generalist physicians at GM clinics, despite a substantial prevalence of these conditions at the ID clinics. Methods are needed to increase physicians' level of comfort for prescribing treatment and/or to facilitate referral to other physicians for treatment.

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Section: Discussionmentioning

confidence: 99%

Differences between Infectious Diseases--Certified Physicians and General Medicine--Certified Physicians in the Level of Comfort with Providing Primary Care to Patients

Fultz

Goulet

Weissman

et al. 2005

Clinical Infectious Diseases

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“…Recent evidence favours higher volume hospitals for complex planned surgical procedures [1][2][3][4][5][6]. Such a volume-outcome relationship exists for some medical conditions such as myocardial infarction and diabetes mellitus [7][8][9]. As a result of the difficulty in evaluating actual outcome measures in a reliable and timely fashion volume has become more attractive as a surrogate marker of quality [10].…”

Section: Introductionmentioning

confidence: 99%

Does patient volume affect clinical outcomes in adult intensive care units?

Kanhere

Cameron³

et al. 2012

Intensive Care Med

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“…or several complex medical conditions, such as coronary artery bypass surgery, 1 carotid endarterectomy, 2 and treatment of HIV, 3,4 mortality rates are lower at hospitals that treat a larger number of cases. Better outcomes at these high-volume hospitals could be due to specialized services or greater physician or staff expertise.…”

mentioning

confidence: 99%

Association Between Subarachnoid Hemorrhage Outcomes and Number of Cases Treated at California Hospitals

Bardach

Zhao

Gress

et al. 2002

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Background and Purpose-Studies of several complex medical conditions have shown that outcomes are better at hospitals that treat more cases. We tested the hypothesis that patients with subarachnoid hemorrhage treated at high-volume hospitals have better outcomes. Methods-Using a database of all admissions to nonfederal hospitals in California from 1990 to 1999, we obtained discharge abstracts for patients with a primary diagnosis of subarachnoid hemorrhage who were admitted through the emergency department. Hospital volume, defined as the average number of subarachnoid hemorrhage cases admitted each year, was divided into quartiles. Rates of mortality, adverse outcomes (death or discharge to long-term care), length of stay, and hospital charges were computed by univariate analysis and by multivariable general estimating equations, with adjustment for demographic and admission characteristics. Results-A total of 12 804 patients were admitted for subarachnoid hemorrhage through the emergency departments of 390 hospitals. Hospital volumes varied from 0 to 8 cases per year in the first quartile to 19 to 70 cases per year in the fourth quartile. The mortality rate in the lowest volume quartile (49%) was larger than that in the highest volume quartile (32%, PϽ0.001). In multivariable analysis, the difference persisted (odds ratio comparing highest with lowest volume quartiles 0.57, 95% CI 0.48 to 0.67; PϽ0.001). At higher volume hospitals, lengths of stay were longer, and hospital charges were greater in univariate and multivariable models (all PϽ0.001). Only 4.8% of those admitted to hospitals in the lowest volume quartile were transferred to hospitals in the highest quartile. Conclusions-In this study of discharge abstracts in California, hospitals that treated more cases of subarachnoid hemorrhage had substantially lower rates of in-hospital mortality. Few patients with subarachnoid hemorrhage are being transferred to

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The Relation Between Hospital Experience and Mortality for Patients With AIDS

Abstract: We conclude that mortality of AIDS patients is higher at hospitals with less AIDS experience. This finding is not because of greater severity of illness, differences in discharge patterns of the terminally ill, or less intensive use of resources.

Cited by 77 publications

References 27 publications

Differences between Infectious Diseases--Certified Physicians and General Medicine--Certified Physicians in the Level of Comfort with Providing Primary Care to Patients

Differences between Infectious Diseases--Certified Physicians and General Medicine--Certified Physicians in the Level of Comfort with Providing Primary Care to Patients

Does patient volume affect clinical outcomes in adult intensive care units?

Association Between Subarachnoid Hemorrhage Outcomes and Number of Cases Treated at California Hospitals

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