Navigation Links
Fewer Deaths in Larger, Busier Hospitals
Date:3/24/2010

However, increased volume is only one factor, researchers say

WEDNESDAY, March 24 (HealthDay News) -- Patients suffering from a heart attack, heart failure or pneumonia fare better in hospitals that see more of these patients than in those that see relatively few, a new study finds.

However, once the number of these patients reaches a certain threshold the outcomes are the same regardless of the size of the hospital, the researchers say.

"When you look straight on, you do see that the higher-volume hospitals have slightly better outcomes," said lead researcher Dr. Joseph S. Ross, an assistant professor of geriatrics and palliative medicine at Mount Sinai School of Medicine in New York City.

However, there is a lot of variability, he added. "You see some small hospitals with really good outcomes, but you also see small hospitals with bad outcomes," he said.

In addition, as hospital volume increases in general, "the importance of volume seems to decline," Ross said. "And you can point out a point at which increase in hospital volume wouldn't be expected to have any mortality benefit."

The researchers undertook the study because although the relationship between volume and outcomes in surgery is well-known, little is known about the connection between volume and outcomes for medical conditions, he said.

The report is published in the March 25 issue of the New England Journal of Medicine.

Using Medicare claims for 2004 to 2006, Ross's group collected data on almost 735,000 people hospitalized for heart attack, more than 1,324,000 sent to hospital for heart failure and more than 1,418,000 hospitalized with pneumonia.

The researchers found that, for each condition, increased hospital volume was associated with fewer deaths over 30 days.

However, once the number of patients treated for each condition reached a threshold level, outcomes remained the same.

For example, once a hospital treated 610 heart attack patients per year the outcome for each additional 100 heart attack patients was the same. For heart failure it was 500 patients per year and for pneumonia it was 210 patients annually, Ross's team found.

One factor that may account for the connection between volume and outcome is that larger hospitals can afford to have staff dedicated to specific medical conditions. In addition, they have the resources to provide the best equipment and latest treatments, Ross speculated.

There is more in improving quality care than simply getting more patients, Ross said. "We need to identify what works and make sure all hospitals have it," he said.

Dr. William W. O'Neill, executive dean for clinical affairs at the University of Miami Miller School of Medicine, said that, "bigger volume hospitals generally tend to have better outcomes than the lower volume hospitals, but that's not an absolute rule. There are some low-volume hospitals that are doing very well."

O'Neill said that outcomes in larger hospitals are better because these hospitals have more ancillary services, and more physician's assistants and nurses that help augment medical care.

"If you or a loved one happens to be hospitalized in a hospital that doesn't take of a lot of patients, then you want to be very careful and talk to the doctor about what the outcomes would be, and possibly consider getting transferred to a larger hospital," he said.

Patients need to ask hospitals about their outcomes, O'Neill said. "High-quality institutions are very aware of their outcomes and should be open and actually brag about them," he said.

More information

To compare hospital's quality, visit the U.S. Department of Health and Human Services.



SOURCES: Joseph S. Ross, M.D., assistant professor,geriatrics and palliative medicine, Mount Sinai School of Medicine, New York City; William W. O'Neill, M.D., professor and executive dean, clinical affairs, University of Miami Miller School of Medicine; March 25, 2010, New England Journal of Medicine


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Fewer platelets could be used for some cancer and bone-marrow transplantation patients
2. Recession May Mean Fewer Nips & Tucks
3. Fewer Childhood Deaths From Rheumatic Disease
4. Improved air quality linked to fewer pediatric ear infections
5. Even a Small Dietary Reduction in Salt Could Mean Fewer Heart Attacks, Strokes and Deaths
6. Fewer headaches on the horizon thanks to latest guidelines
7. Fewer left-sided colorectal tumors observed after colonoscopies
8. Wider Adult Screening May Mean Fewer Children With Cystic Fibrosis
9. HIV Therapy Linked to Fewer Suicides
10. PSA Test Reduces Prostate Cancer Deaths by 40%
11. As Temperatures Rise, So Do Cocaine Deaths
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/13/2016)... Coral Springs, FL (PRWEB) , ... February 13, 2016 , ... ... on the environmental impact of American businesses. , The increasingly modern world of ... rely more often on non-renewable energy sources such as oil and coal, which pollutes ...
(Date:2/13/2016)... Canada (PRWEB) , ... February 13, 2016 , ... In ... foot forward. They’ll groom themselves to perfection, go out of their way to be ... date – just take a look at any online dating profile. , A ...
(Date:2/12/2016)... ... February 12, 2016 , ... The law firm of Morrow, ... Parishes. The purpose of these scholarships is to encourage applicants to pursue a ... seek employment within these two parishes. , “We have available jobs in St. ...
(Date:2/12/2016)... Falls Church, VA (PRWEB) , ... February 12, ... ... in Store?, Feb. 29, 2016 — 1:30 p.m. – 3:00 p.m. EST, ... burner issue in the life cycle of pharmaceutical products, garnering increased attention from ...
(Date:2/12/2016)... ... February 12, 2016 , ... T.E.N., a technology and information ... ISE Southeast Awards 2016. Finalists and winners of the ISE® Awards for both ... and Awards Gala on March 15, 2016 at the Westin Peachtree Plaza, Atlanta. ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... , Feb. 11, 2016 Potrero Medical, Inc., the ... to announce the appointment of George M. Rapier, III ... San Antonio, TX , WellMed is one of the ... patients and HMO members in Texas ... 1990 out of his own internal medicine practice, he has ...
(Date:2/11/2016)...  MiMedx Group, Inc. (NASDAQ: MDXG ), the ... other birth tissues, human skin and bone, and patent-protected ... products and therapies, announced today that it will present ... in New York , NY.  Parker ... Senken , Chief Financial Officer and Chris Cashman ...
(Date:2/11/2016)... , Feb. 11, 2016  AfterPill.com is reporting ... recommend alcohol abstinence for all women who are at ... the U.S. each year and raises the risks of ... --> According to the Guttmacher Institute, ... of women of child-bearing age, who have sex without ...
Breaking Medicine Technology: