Navigation Links
Teaching hospital status associated with death rate after colon surgery
Date:4/19/2010

When both cancer and benign diagnoses are taken into consideration, patients undergoing colon surgery appear to have increased odds of death if their procedure is performed at a teaching hospital, according to a report in the April issue of Archives of Surgery, one of the JAMA/Archives journals.

"Teaching hospitals are responsible for training surgical residents and fellows in the United States, which requires a considerable allocation of resources from the federal government and a large capital outlay to offset the costs of training," the authors write as background information in the article. Although the involvement of trainees in care has raised concerns about possible negative outcomes, teaching hospitals are attractive to patients undergoing complex surgeries because they also typically possess board-certified specialty surgeons, multidisciplinary teams and intensive care unit staffing. "There is a growing interest in the interaction between teaching hospital status and volume and the individual and combined effects of these characteristics on outcomes."

"In contrast to complex procedures performed at teaching hospitals, colon surgery is more commonly performed by general surgeons in non-teaching hospitals and comparatively less sophisticated settings," write Awori J. Hayanga, M.D., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and the University of Michigan Medical School, Ann Arbor, and colleagues. The researchers analyzed data from 115,250 patients who underwent colon resection (removal of part of the organ) for both benign and malignant diseases at 1,045 hospitals in 38 states from 2001 through 2005.

Fewer patients had surgery at teaching hospitals than at non-teaching hospitals (46,656 vs. 68,589). The average length of hospital stay was 10 days, and 4,371 patients (3.8 percent) died in the hospital. Teaching hospitals were associated with an increased length of stay (0.5 days) and also an increased risk of death in the hospital compared with non-teaching hospitals (3.9 percent vs. 3.7 percent).

"While the volume-outcome relationship may favor colon cancer resections performed in teaching hospitals, this advantage might be lost when benign colon disease is factored into the equation," the authors write. "The inclusion of common benign disease might represent the tipping point at which both superior level of care and high volume shift away from teaching hospitals in favor of non-teaching hospital settings. Where teaching hospitals perform surgery in comparatively lower volume, they may also demonstrate comparatively poorer outcomes."

The analysis suggests that both procedure and diagnosis should be taken into account when assessing quality of care and surgical outcomes, the authors note. "As policymakers strive to establish quality measures and rationale for regionalization of surgical care, data gathered in this manner may be of great interest to patients, payers and health care providers," they conclude. "These data might further allow the identification of a similar tipping point in other gastrointestinal surgical disease that allows a demarcation to guide the venues where individual surgical care may be most appropriately and efficiently rendered."


'/>"/>

Contact: Mary Masson
mfmasson@med.umich.edu
734-764-2220
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Manhattans Oldest Dog Dies, Leaves Behind a Legacy of Teaching
2. New Lucian Leape Institute Report Finds That U.S. Medical Schools Are Falling Short in Teaching Physicians How to Provide Safe Patient Care
3. Teaching medicine series covers the most important topics in medical education
4. Childrens Hospital Surgeon Receives Prestigious Paul Tessier Medal
5. VHI Releases Annual Industry Report - Highlights Hospital, Nursing Facility Efficiency
6. Pennsylvania EPA Awards Abington Memorial Hospital Funding for Green Projects
7. Sebastian Ferrero Foundation and Shands HealthCare Have Selected Sg2 to Conduct a Needs Assessment for a Gainesville-Based Childrens Hospital
8. Patients with mild gallstone pancreatitis can undergo surgery sooner, shortening hospital stays
9. 3 years out, safety checklist continues to keep hospital infections in check
10. Tobacco Heir to Speak Out Against Tobacco at Saint Francis Hospital
11. Obamas Budget Proposals Will Thwart Charitable Giving to Keep Nonprofit Hospitals Operating, Association for Healthcare Philanthropy Says
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/6/2016)... ... , ... Keeping Gift Season Safe, In a season stacked with gift-giving opportunities, ... their recipients. This is the idea behind Safe Toys and Gifts Month, which sets ... make good gifts for children. For companies that produce goods that fall into this ...
(Date:12/6/2016)... Park, KS (PRWEB) , ... December 06, 2016 , ... ... retailers of Mobility Scooters . , Mobility Scooters give freedom to people who ... balance problems. Still others may be facing a long period of rehabilitation after an ...
(Date:12/6/2016)... ... December 06, 2016 , ... U.S. Security Associates (USA) was ... for their industry leading training methods that engage their associates and link their ... global elite in employer-sponsored training and development programs. , “The 2017 Training Top ...
(Date:12/5/2016)... ... 2016 , ... Edward Buckingham MD , and the ... the newest Sciton laser in January 2017. The Halo is the first and ... wavelengths for exceptional results. Outperforming more traditional lasers, the innovative Halo automatically customizes ...
(Date:12/5/2016)... ... 2016 , ... SyncDog, Inc., the leading ISV for mobile ... online tech news platform connecting technology innovators with news, experience, and knowledge breaking ... of enterprise mobility security today, and how the SyncDog SentinelSecure™ product line protects ...
Breaking Medicine News(10 mins):
(Date:12/5/2016)... and BOCA RATON, Fla. ... Institute for the Commercialization of Public Research ... finalized a funding agreement SegAna, LLC, an ... at University of Central Florida. The Florida Institute ... and bridges early funding gaps for companies spinning ...
(Date:12/5/2016)... India , December 5, 2016 According to a ... Type and by Application - Global Opportunity Analysis and Industry Forecast, 2014 - ... is expected to reach $5,255 million by 2022, growing at a CAGR of ... with more than four-fifths share. Continue Reading ... ...
(Date:12/5/2016)... -- Wellbridge Health and Gateway Health proudly announce a dynamic collaboration ... Medicaid plan members with specific high risk needs. ... this group of consumers, Wellbridge combines technology and population expertise ... into members, daily behaviors and lifestyle. ... , , ...
Breaking Medicine Technology: