Characterizing the role of a high-volume cancer resection ecosystem on low-volume, high-quality surgical care.
Surgery
; 160(4): 839-849, 2016 10.
Article
em En
| MEDLINE
| ID: mdl-27524432
ABSTRACT
BACKGROUND:
Our objective was to determine the hospital resources required for low-volume, high-quality care at high-volume cancer resection centers.METHODS:
Patients who underwent esophageal, pancreatic, and rectal resection for malignancy were identified using Healthcare Cost and Utilization Project State Inpatient Database (Florida and California) between 2007 and 2011. Annual case volume by procedure was used to identify high- and low-volume centers. Hospital data were obtained from the American Hospital Association Annual Survey Database. Procedure risk-adjusted mortality was calculated for each hospital using multilevel, mixed-effects models.RESULTS:
A total of 24,784 patients from 302 hospitals met the inclusion criteria. Of these, 13 hospitals were classified as having a high-volume, oncologic resection ecosystem by being a high-volume hospital for ≥2 studied procedures. A total of 11 of 31 studied hospital factors were strongly associated with hospitals that performed a high volume of cancer resections and were used to develop the High Volume Ecosystem for Oncologic Resections (HIVE-OR) score. At low-volume centers, increasing HIVE-OR score resulted in decreased mortality for rectal cancer resection (P = .038). HIVE-OR was not related to risk-adjusted mortality for esophagectomy (P = .421) or pancreatectomy (P = .413) at low-volume centers.CONCLUSION:
Our study found that in some settings, low-volume, high-quality cancer surgical care can be explained by having a high-volume ecosystem.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pancreatectomia
/
Qualidade da Assistência à Saúde
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Mortalidade Hospitalar
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Esofagectomia
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Colectomia
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Hospitais com Alto Volume de Atendimentos
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article