Navigation Links
Hospital volume inconsistent predictor of quality care
Date:5/4/2009

ATLANTA May 4, 2009A new review finds hospital volume to be a useful, albeit imperfect, predictor of short term mortality. While studies, when combined, show a quantifiable and statistically significant inverse association between case volume and mortality, the review finds that individual studies often fail to show such an association, leading the authors to conclude volume is at best an imperfect proxy for healthcare quality.

For years, a large body of research has examined the relationship between surgical volume and outcome. After early studies found an inverse relation between surgical volume and mortality, healthcare decision-makers became interested in regionalization of surgical services, which many hoped could improve patient outcomes at a lower cost. To investigate the importance of provider case volume, researchers led by Russell Gruen, MBBS, Ph.D. at University of Melbourne and Royal Melbourne Hospital in Melbourne, Australia, systematically reviewed 101 studies on case volume and mortality. The review involved more than a million patients with esophageal, gastric, hepatic, pancreatic, colon, or rectal cancer.

The review found the majority of studies addressed the relation between hospital surgical case volume and short-term perioperative mortality. Few studies addressed surgeon case volume or evaluated long-term survival outcomes. Using statistical meta-analysis, a significant volume-associated effect on mortality was found for five of the six cancer types. Overall, each doubling of hospital case volume decreased the risk of perioperative death by more than 10 percent. The authors calculated that between 10 and 50 patients per year, depending on cancer type, needed to be moved from a "low-volume" hospital to a "high-volume" hospital to prevent one additional volume-associated perioperative death.

Despite that finding, approximately one-third of all analyses, including some large studies, failed to find a significant volume effect on mortality. The authors say the lack of consistent results from individual studies calls into question the validity of case volume as a proxy for care quality, and leads the authors to conclude that more direct quality measures and the validity of their use to inform policy should also be explored. "On the basis of mortality outcomes alone, it appears prudent to support volume-based referral and high-volume centers," write the authors. But they point out outcomes may also depend on an individual surgeon's case volume. A large center where many surgeons each do a low volume of procedures, for example, may have higher mortality rates than a small practice where a one or two surgeons limit their practice to a particular operation. They conclude: "[T]here are also clearly some low-volume providers who get good results, and therefore referral to relatively low-volume providers should be supported if good outcomes can be demonstrated by process measures or by risk-adjusted outcomes, especially if there are compelling personal or medical reasons for the patient to be treated close to home."


'/>"/>

Contact: David Sampson
david.sampson@cancer.org
American Cancer Society
Source:Eurekalert

Related medicine news :

1. Children's Hospital NICU Nurses Recognized
2. Obstetrical unit at Yale-New Haven Hospital achieves dramatic improvement in patient safety
3. Hospital Staffing Cuts - Pragmatic, Panic or Carefully Planned?
4. Hospital Opens New $19 Million Neonatal Intensive Care Unit
5. Hospital Rapid Alert System Supports Swine Flu Pandemic Communications
6. Coalition Says On-Site Infectious Medical Waste Treatment Key To Disease Control and Hospital Sustainability During a Pandemic
7. Wayne State University and Childrens Hospital of Michigan Research Team Discover Chemical That Plays a Major Role in Pediatric Obsessive-Compulsive Disorder
8. TeleHealth Services and UNC-TV Partner to Bring Kids Channel to North Carolina Children's Hospitals
9. Unsung Heroes of Health Care Reform?: $36 Billion in Annual Savings Linked to Group Purchasing Organizations in Major Survey of Over 400 Hospitals
10. ARCADIS Awarded First PPP Hospital Project in Germany
11. TeleHealth Services Chosen by Baptist Hospital East in Development of New Park Tower
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... Los Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... plastic surgery procedures that most people are unfamiliar with. The article goes on to ... known procedures, but also many of these less common operations such as calf and ...
(Date:6/24/2016)... ... ... June 19, 2016 is World Sickle Cell Observance Day. In an effort to ... treatments, Serenity Recovery Center of Marne, Michigan, has issued a pain management ... (SCD) is a disorder of the red blood cells, which can cause episodes of ...
(Date:6/24/2016)... ... 2016 , ... The Pulmonary Hypertension Association (PHA) learned during ... two significant new grants to support its work to advance research and patient ... recognizing patients, medical professionals and scientists for their work in fighting pulmonary hypertension ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas ... , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and ... that call for a minimum wage raise to $12 an hour by 2020 and then ... will restore the lost value of the minimum wage, assure the wage floor does not ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... June 24, 2016 The Academy of Managed ... recommendations that would allow biopharmaceutical companies to more ... that make formulary and coverage decisions, a move that ... new medicines. The recommendations address restrictions in ... on the drug label, a prohibition that hinders decision ...
(Date:6/24/2016)... June 24, 2016 According to ... Type (Standard Pen Needles, Safety Pen Needles), Needle Length ... Growth Hormone), Mode of Purchase (Retail, Non-Retail) - Trends ... report studies the market for the forecast period of ... USD 2.81 Billion by 2021 from USD 1.65 Billion ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced ... as its e-clinical software solution of choice.  This ... best possible value to their clients by offering ... The preferred relationship establishes nowEDC as the EDC ... for MedSource,s full-service clients.  "nowEDC has long been ...
Breaking Medicine Technology: