Hospital Volume May Affect Surgical Mortality Rate

Increasing hospital volume contributes to decreased mortality for certain procedures

WEDNESDAY, June 1 (HealthDay News) -- Mortality rates for certain high-risk surgical procedures have decreased in the United States, which is partially due to increased market concentration and hospital volume, according to a study published in the June 2 issue of the New England Journal of Medicine.

Jonathan F. Finks, M.D., from the University of Michigan in Ann Arbor, and colleagues examined trends in hospital volume and market concentration for patients undergoing esophagectomy, pancreatectomy, lung resection, cystectomy, repair of abdominal aortic aneurysm (AAA), coronary-artery bypass grafting (CABG), carotid endarterectomy, or aortic-valve replacement (from 1999 through 2008). The effects of hospital volume and market concentration (defined as the proportion of Medicare patients undergoing surgery in the top decile of hospitals per volume per year) on mortality were assessed over time, adjusting for case mix.

The investigators found that the average hospital volumes for lung, esophagus, pancreas, and bladder cancer resections, and AAA repair rose substantially; and, for aortic-valve replacement, the volume rose slightly. Hospital volumes fell for CABG and carotid endarterectomy. Increased hospital volumes could be attributed to a higher number of cases nationwide, an increasing market concentration, or both. Mortality rates decreased for all eight procedures, varying from a relative decrease of 8 percent for carotid endarterectomy to 36 percent for AAA repair. Higher hospital volumes accounted for a large portion of the decrease in mortality for pancreatectomy (67 percent), cystectomy (37 percent), and esophagectomy (32 percent), but not for the other procedures.

"The contribution of increasing hospital volume to declining mortality varied considerably according to procedure," the authors write.

Abstract
Full Text

Copyright © 2011 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

Abdominal Pain: An Approach to a Challenging Diagnosis
AACN Advanced Critical Care, July/September 2014
Free access will expire on October 13, 2014.


HIPAA Compliance Practice Tips
Professional Case Management, July/August 2014
Free access will expire on September 29, 2014.


Follow the leader: How does “followership” influence nurse burnout?
Nursing Management, August 2014
Free access will expire on September 29, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events