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Journal Article
High-volume surgeons vs high-volume hospitals: are best outcomes more due to who or where?
2016
Overview
High-volume hospitals are purported to provide “best” outcomes. We undertook this study to evaluate the outcomes after pancreaticoduodenectomy when high-volume surgeons relocate to a low-volume hospital (ie, no pancreaticoduodenectomies in >5 years).
Outcomes after the last 50 pancreaticoduodenectomies undertaken at a high-volume hospital in 2012 (ie, before relocation) were compared with the outcomes after the first 50 pancreaticoduodenectomies undertaken at a low-volume hospital (ie, after relocation) in 2012 to 2013.
Patients undergoing pancreaticoduodenectomies at a high-volume vs a low-volume hospital were not different by age or sex. Patients who underwent pancreaticoduodenectomy at the low-volume hospital had shorter operations with less blood loss, spent less time in the intensive care unit, and had shorter length of stay (P < .05 for each); 30-day mortality and 30-day readmission rates were not different.
The salutary benefits of undertaking pancreaticoduodenectomy at a high-volume hospital are transferred to a low-volume hospital when high-volume surgeons relocate. The “best” results follow high-volume surgeons.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Age
/ Aged
/ Critical Care - statistics & numerical data
/ Female
/ Hospitals, High-Volume - manpower
/ Hospitals, High-Volume - statistics & numerical data
/ Hospitals, Low-Volume - manpower
/ Hospitals, Low-Volume - statistics & numerical data
/ Humans
/ Leapfrog
/ Length of Stay - statistics & numerical data
/ Male
/ Outcome Assessment (Health Care)
/ Pancreaticoduodenectomy - mortality
/ Patient Readmission - statistics & numerical data
/ Surgeons - statistics & numerical data
/ Surgeons - supply & distribution
/ Surgery
