Led by Dr. Awori J. Hayanga of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and researchers at the University of Michigan Medical School the large population study showed a slight increase in the number of deaths among patients undergoing intestinal surgeries of all types at teaching hospitals.
"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 researchers analyzed data from 115,250 patients who underwent colon surgery (removal of part of the organ) for both benign and malignant diseases at 1,045 hospitals in 38 states from 2001 through 2005.
Most of the surgeries were done at non-teaching hospitals, which performed 68,589 surgical procedures compared to 46,656 performed at teaching hospitals. Overall, the average length of hospital stay was 10 days, and 4,371 of the 115,250 patients (3.8 percent) died in the hospital. People treated in teaching hospitals had a half-day increased length of stay compared with non-teaching hospitals. Similarly, 3.9 percent of those treated in the teaching hospitals died compared to 3.7 percent of those at the non-teaching hospitals.
The analysis suggests that both the type of surgical procedure and diagnosis should be considered when evaluating quality of care and surgical 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," concluded Hayanga.
SOURCE: press materials provided by the Archives of Surgery, re.: 2010;145 [4]:346-350.
"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 researchers analyzed data from 115,250 patients who underwent colon surgery (removal of part of the organ) for both benign and malignant diseases at 1,045 hospitals in 38 states from 2001 through 2005.
Most of the surgeries were done at non-teaching hospitals, which performed 68,589 surgical procedures compared to 46,656 performed at teaching hospitals. Overall, the average length of hospital stay was 10 days, and 4,371 of the 115,250 patients (3.8 percent) died in the hospital. People treated in teaching hospitals had a half-day increased length of stay compared with non-teaching hospitals. Similarly, 3.9 percent of those treated in the teaching hospitals died compared to 3.7 percent of those at the non-teaching hospitals.
The analysis suggests that both the type of surgical procedure and diagnosis should be considered when evaluating quality of care and surgical 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," concluded Hayanga.
SOURCE: press materials provided by the Archives of Surgery, re.: 2010;145 [4]:346-350.
No comments:
Post a Comment