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The Effects of Regionalization on Cost and Outcome for One General High-Risk Surgical Procedure
Open accessAbstract
PURPOSE: The effects of regionalization of tertiary care were studied by analyzing cost and outcome for pancreaticoduodenectomies in a state in which the majority of these high-risk procedures were performed in one hospital. METHODS: Using Maryland inpatient discharge data via a retrospective study, the authors compared cost and outcome data for a hospital with more than one half of the cases in the state to all other hospital providers as a group and with smaller groupings according to the volume of procedures performed. RESULTS: Hospital mortality, length of stay, and costs were significantly less at the high-volume regional medical center when compared with all other hospitals. Mortality and cost increased as volume decreased when hospitals were grouped according to volume. CONCLUSIONS: An academic medical center, functioning as a high-volume regional provider, can deliver tertiary care services with improved outcomes at lower costs than community hospitals.
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Citations
Cited by
Halm, E. A., Lee, C., & Chassin, M. R. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-6-200209170-00012 · Cited by 1,704
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Sosa, J. A., Bowman, H. M., Tielsch, J. M., Powe, N. R., Gordon, T. A., & Udelsman, R. (1998) · Annals of Surgery · doi:10.1097/00000658-199809000-00005 · Cited by 1,118
Self-citationGouma, D. J., van Geenen, R. C. I., van Gulik, T. M., de Haan, R. J., de Wit, L. T., Busch, O. R. C., & Obertop, H. (2000) · Annals of Surgery · doi:10.1097/00000658-200012000-00007 · Cited by 836
A systematic review of the impact of volume of surgery and specialization on patient outcome
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Long-Term Survival Is Superior After Resection for Cancer in High-Volume Centers
Fong, Y., Gonen, M., Rubin, D., Radzyner, M., & Brennan, M. F. (2005) · Annals of Surgery · doi:10.1097/01.sla.0000184190.20289.4b · Cited by 398
Metadata
- Authors
- Gordon, T. A., Burleyson, G. P., Tielsch, J. M., & Cameron, J. L.
- Venue
- Annals of Surgery
- Published
- 1995-01
- Volume
- 221
- Issue
- 1
- Pages
- 43-49
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2093834091
- Cited by
- 471
- References
- 0
- FWCI
- 63.42
- Type
- journal article
- Language
- en
- Open access
- green
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- Gordon, T. A., Burleyson, G. P., Tielsch, J. M., & Cameron, J. L. (1995). The Effects of Regionalization on Cost and Outcome for One General High-Risk Surgical Procedure. Annals of Surgery. https://doi.org/10.1097/00000658-199501000-00005
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