Elective surgery growth at Florida hospitals accrues mostly from surgeons averaging 2 or fewer cases per week: A retrospective cohort study.
J Clin Anesth
; 78: 110649, 2022 06.
Article
in En
| MEDLINE
| ID: mdl-35168138
ABSTRACT
STUDY OBJECTIVE:
Hospital administrators often seek to increase operating room (OR) elective caseload. Previous studies from Iowa demonstrated that surgical growth is mostly from low-caseload surgeons (ie, ≤2 cases per week). We repeated that study using data from Florida, a much more populous state, to confirm the generalizability of the findings.DESIGN:
Retrospective cohort study.SETTING:
All hospitals in the state of Florida. PATIENTS All patients undergoing elective surgery during 2018 and 2019. MEASUREMENTS We determined growth between 2018 and 2019 in regular-workday elective surgical caseload and intraoperative work relative value units (wRVU) at hospitals. Using the two-sided, one group Student t-test, we compared the fractions of those increases attributable to low-caseload surgeons vs. 50% to assess if they accounted for most surgical growth. We used the exact binomial test to compare the fraction of hospitals where most growth (>50%) occurred from low-caseload surgeons to half (50%). MAINRESULTS:
We studied the 1,629,879 elective cases from 202 hospitals. Surgeons averaging ≤2.0 cases per week accounted for 73.3% (P < 0.0001 compared to 50%) of caseload growth and 68.7% (P < 0.0001 compared to 50%) of wRVU growth. The corresponding overall pooled growth estimates among hospitals were 70.8% for caseload and 65.0% for wRVU. There were 76.2% of the N = 202 hospitals with more than half their growth in cases from surgeons performing, on average, ≤2.0 cases per week (P < 0.0001 compared to 50% of hospitals). The vast majority of surgical growth at hospitals accrued from the contributions of low-caseload surgeons.CONCLUSIONS:
Surgical growth in elective surgery at Florida hospitals accrued mostly from the increased activity of low-caseload surgeons averaging ≤2.0 cases per week during the preceding year, confirming the generalizability of the previous Iowa study. If growth in caseload is desired, surgical governance committees should ensure that low-caseload surgeons have access to the OR schedule.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgeons
/
Hospitals
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
J Clin Anesth
Journal subject:
ANESTESIOLOGIA
Year:
2022
Document type:
Article