Navigation Links
Referral to high-volume hospitals for operations fails to improve outcomes statewide

Referring patients to hospitals that have the largest volume of surgical procedures does not necessarily lead to improved outcomes for the overall population, according to the results of a new study in the February issue of the Journal of the American College of Surgeons.

The findings of studies that suggest the higher the volume of specialty surgical procedures performed at any given hospital, the better that hospital's outcomes will be, has resulted in calls for volume-based referrals. Most notably leading that call has been the Leapfrog Group's Evidence-Based Hospital Referral (EBHR) program, which launched a decade ago.

Researchers hypothesized that volume-based referrals would "regionalize" patients to hospitals meeting an EBHR volume metric and that, as a result, overall patient outcomes for these procedures would improve on a statewide basis. However, according to a new study in Washington State, the impact on patient outcomes across the state was negligible when a greater proportion of pancreatic and esophageal resections were performed at higher volume hospitals that met a given EBHR volume metric.

"This statewide analysis suggests Leapfrog's EBHR initiative has not had the intended impact of lowering the rate of adverse outcomes for all surgical patients having higher risk surgical procedures. Although there are many potential reasons for this finding, it may be the result of higher risk surgical patients not seeking care at higher volume centers," said Nader N. Massarweh, MD, MPH, a surgical resident at the University of Washington School of Medicine in Seattle and the study's lead author.

Comparing results before and after 2001 (2004 for pancreatic resection), the proportion of patients treated at hospitals meeting the EBHR volume metric for a given procedure increased for pancreatic (59.4% vs. 75.7%, p < 0.001) and esophageal resection (41.5% vs. 59.2%, p < 0.001), but was similar for abdominal aortic aneurysm (AAA) repair (16.3% vs. 17.6%, p = 0.13). In general, rates of adverse events were lower at hospitals meeting an EBHR volume metric. However, across Washington State and at non-EBHR centers, rates of mortality, readmission, and complications generally did not improve in the seven years following the introduction of the EBHR initiative.

The implications of Leapfrog's EBHR program for the health care system include: limiting patient flow and critically important revenue at smaller hospitals; decreasing surgeon competence and availability for emergency care at lower volume hospitals; providing fewer opportunities for surgical residency training at lower volume centers; and biasing patients toward higher volume centers for procedures not related to the EBHR initiative.

The consequences of referring patients to high-volume surgical centers are still being understood, but it appears as though doing so may not result in improved outcomes in the population as a whole.


Contact: Sally Garneski
Weber Shandwick Worldwide

Related medicine news :

1. Venza Group Announces 5-for-5 Colleague Referral Program
2. Study finds delay in referrals for older women with ovarian cancer
3. Electronic Referral Management Streamlines Referral Process and Boosts Provider Revenues, Says New Carefx Issue Brief
4. High-volume portable music players may impair ability to clearly discriminate sounds
5. The private sale of drugs in public hospitals
6. Most pandemic plans in Ontario hospitals have not been tested: Queens University study
7. SHARECOR Partners With Quantros, Inc. to Facilitate Core Measures and Regulatory Reporting in Louisiana Hospitals
8. Kaiser Foundation Health Plan and Hospitals Report Fourth Quarter and Fiscal Year 2009 Financial Results
9. Father Channels His Grief into Advocacy, Promotes Simple Actions to Make Hospitals Safer for Children
10. Vestara and EXP Pharmaceutical Services Corp. Announce Partnership Making Available Industry's Only Automated Pharmaceutical Waste Management Solution to over 5,000 U.S. Hospitals
11. Small to Mid-Sized Hospitals Turn to Orion Health to Implement Health IT Solutions for Improved Patient Care and Outcomes
Post Your Comments:
(Date:11/27/2015)... ... , ... CBD College is proud to announce that on November ... to its Diagnostic Medical Sonography program. CBD College is honored to join this very ... and universities in the state of California make the cut. CBD College is officially ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... in central Michigan, have come together on Thanksgiving Day to share the things ... for viewing on the Serenity Point YouTube channel, patients displayed what they wrote ...
(Date:11/26/2015)... NE (PRWEB) , ... November 26, 2015 , ... Jobs ... searched by healthcare professionals and offered by healthcare staffing agency Aureus Medical Group ... during the month of October 2015 among those searching for healthcare jobs through the ...
(Date:11/26/2015)... ... November 26, 2015 , ... Indosoft Inc., developer and distributor ... application server to improve system efficiency and reliability. , The new Q-Suite 6 platform ... standards, the system avoids locking itself into a specific piece of software for many ...
(Date:11/25/2015)... ... November 25, 2015 , ... ... been recognized once again for its stellar workplace culture with the company’s Cincinnati ... , Medical Solutions’ Cincinnati office was named a finalist in Cincinnati Business ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... WILMINGTON, N.C. , Nov. 25, 2015 /PRNewswire/ ... announces the planned investment of at least $15.8 ... in Wilmington, NC . The ... services capacity to meet the growing demands of ... Wilmington site expansion will provide up ...
(Date:11/25/2015)... , Nov. 25, 2015  Henry Schein, Inc., the ... to office-based dental, medical and animal health practitioners, will ... the Henry Schein ConnectDental® Pavilion , which brings ... of open solutions designed to help any practice or ... here for a schedule of experts appearing at ...
(Date:11/25/2015)... 25, 2015  Trovagene, Inc. (NASDAQ: TROV ), ... Chief Executive Officer Antonius Schuh, Ph.D., is scheduled to ... Annual Piper Jaffray Healthcare Conference. th ... Palace Hotel in New York ... Mr. Schuh will be available for one-on-one meetings during ...
Breaking Medicine Technology: