The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Hospital Volume, Length of Stay, and Readmission Rates in High-Risk Surgery
Open accessAbstract
OBJECTIVE: Aimed at reducing surgical deaths, several recent initiatives have attempted to establish volume-based referral strategies in high-risk surgery. Although payers are leading the most visible of these efforts, it is unknown whether volume standards will also reduce resource use. METHODS: We studied postoperative length of stay and 30-day readmission rate after 14 cardiovascular and cancer procedures using the 1994-1999 national Medicare database (total n = 2.5 million). We used regression techniques to examine the relationship between length of stay, 30-day readmission, and hospital volume, adjusting for age, gender, race, comorbidity score, admission acuity, and mean social security income. RESULTS: Mean postoperative length of stay ranged from 3.4 days (carotid endarterectomy) to 19.6 days (esophagectomy). There was no consistent relationship between volume and mean length of stay; it significantly increased across volume strata for 7 of the 14 procedures and significantly decreased across volume strata for the other 7. Mean length of stay at very-low-volume and very-high-volume hospitals differed by more than 1 day for 6 procedures. Of these, the mean length of stay was shorter in high-volume hospitals for 3 procedures (pancreatic resection, esophagectomy, cystectomy), but longer for other procedures (aortic and mitral valve replacement, gastrectomy). The 30-day readmission rate also varied widely by procedure, ranging from 9.9% (nephrectomy) to 22.2% (mitral valve replacement). However, volume was not related to 30-day readmission rate with any procedure. CONCLUSION: Although hospital volume may be an important predictor of operative mortality, it is not associated with resource use as reflected by length of stay or readmission rates.
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Cites
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Hospital Volume and Surgical Mortality in the United States
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Impact of Hospital Volume on Operative Mortality for Major Cancer Surgery
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The Importance of Surgeon Experience for Clinical and Economic Outcomes From Thyroidectomy
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“Although most suggested shorter length of stay at high-volume hospitals, many of these studies were based on relatively old data or information from individual states, which may not be broadly generalizable.(13,21-25) To address this issue systematically, we studied length of stay and 30-day readmission rates with 14…”
BackgroundThe Distinction Between Cost and Charges
FINKLER, S. A. (1982) · Annals of Internal Medicine · doi:10.7326/0003-4819-96-1-102 · Cited by 1,052
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Selective Referral to High-Volume Hospitals: Estimating Potentially Avoidable Deaths
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Publication bias and clinical trials
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Cited by
Adamina, M., Kehlet, H., Tomlinson, G. A., Senagore, A. J., & Delaney, C. P. (2011) · Surgery · doi:10.1016/j.surg.2010.11.003 · Cited by 555
Brott, T. G., Halperin, J. L., Abbara, S., Bacharach, J. M., Barr, J. D., Bush, R. L., Cates, C. U., Creager, M. A., Fowler, S. B., Friday, G., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.11.006 · Cited by 447
Behrns, K. E. (2012) · Yearbook of Surgery · doi:10.1016/j.ysur.2011.11.001 · Cited by 426
Shared decision-making in acute surgical illness: the surgeon’s perspective.
Morris, R. S., Ruck, J. M., Conca-Cheng, A. M., Smith, T. J., Carver, T. W., & Johnston, F. M. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2018.01.008 · Cited by 56
Nejim, B., Beaulieu, R. J., Alshaikh, H., Hamouda, M., Canner, J., & Malas, M. B. (2018) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2018.03.013 · Cited by 16
Metadata
- Authors
- Goodney, P. P., Stukel, T. A., Lucas, F. L., Finlayson, E. V. A., & Birkmeyer, J. D.
- Venue
- Annals of Surgery
- Published
- 2003-08
- Volume
- 238
- Issue
- 2
- Pages
- 161-167
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2017072032
- Cited by
- 314
- References
- 38
- FWCI
- 15.66
- Type
- journal article
- Language
- en
- Open access
- green
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