Featured Research

from universities, journals, and other organizations

Referral to high-volume hospitals for operations fails to improve outcomes statewide, study finds

Date:
March 10, 2011
Source:
American College of Surgeons
Summary:
Referring patients to hospitals that have the largest volume of surgical procedures does not necessarily lead to improved outcomes for the overall population, according to the results of a new study.

Referring patients to hospitals that have the largest volume of surgical procedures does not necessarily lead to improved outcomes for the overall population, according to the results of a new study in the February issue of the Journal of the American College of Surgeons.

Related Articles


The findings of studies that suggest the higher the volume of specialty surgical procedures performed at any given hospital, the better that hospital's outcomes will be, has resulted in calls for volume-based referrals. Most notably leading that call has been the Leapfrog Group's Evidence-Based Hospital Referral (EBHR) program, which launched a decade ago.

Researchers hypothesized that volume-based referrals would "regionalize" patients to hospitals meeting an EBHR volume metric and that, as a result, overall patient outcomes for these procedures would improve on a statewide basis. However, according to a new study in Washington State, the impact on patient outcomes across the state was negligible when a greater proportion of pancreatic and esophageal resections were performed at higher volume hospitals that met a given EBHR volume metric.

"This statewide analysis suggests Leapfrog's EBHR initiative has not had the intended impact of lowering the rate of adverse outcomes for all surgical patients having higher risk surgical procedures. Although there are many potential reasons for this finding, it may be the result of higher risk surgical patients not seeking care at higher volume centers," said Nader N. Massarweh, MD, MPH, a surgical resident at the University of Washington School of Medicine in Seattle and the study's lead author.

Comparing results before and after 2001 (2004 for pancreatic resection), the proportion of patients treated at hospitals meeting the EBHR volume metric for a given procedure increased for pancreatic (59.4% vs. 75.7%, p < 0.001) and esophageal resection (41.5% vs. 59.2%, p < 0.001), but was similar for abdominal aortic aneurysm (AAA) repair (16.3% vs. 17.6%, p = 0.13). In general, rates of adverse events were lower at hospitals meeting an EBHR volume metric. However, across Washington State and at non-EBHR centers, rates of mortality, readmission, and complications generally did not improve in the seven years following the introduction of the EBHR initiative.

The implications of Leapfrog's EBHR program for the health care system include: limiting patient flow and critically important revenue at smaller hospitals; decreasing surgeon competence and availability for emergency care at lower volume hospitals; providing fewer opportunities for surgical residency training at lower volume centers; and biasing patients toward higher volume centers for procedures not related to the EBHR initiative.

The consequences of referring patients to high-volume surgical centers are still being understood, but it appears as though doing so may not result in improved outcomes in the population as a whole.


Story Source:

The above story is based on materials provided by American College of Surgeons. Note: Materials may be edited for content and length.


Journal Reference:

  1. Nader N. Massarweh, David R. Flum, Rebecca G. Symons, Thomas K. Varghese, Carlos A. Pellegrini. A Critical Evaluation of the Impact of Leapfrog's Evidence-Based Hospital Referral. Journal of the American College of Surgeons, 2011; 212 (2): 150 DOI: 10.1016/j.jamcollsurg.2010.09.027

Cite This Page:

American College of Surgeons. "Referral to high-volume hospitals for operations fails to improve outcomes statewide, study finds." ScienceDaily. ScienceDaily, 10 March 2011. <www.sciencedaily.com/releases/2011/03/110310121017.htm>.
American College of Surgeons. (2011, March 10). Referral to high-volume hospitals for operations fails to improve outcomes statewide, study finds. ScienceDaily. Retrieved November 26, 2014 from www.sciencedaily.com/releases/2011/03/110310121017.htm
American College of Surgeons. "Referral to high-volume hospitals for operations fails to improve outcomes statewide, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/03/110310121017.htm (accessed November 26, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, November 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) — The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) — Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com
Madagascar Working to Contain Plague Outbreak

Madagascar Working to Contain Plague Outbreak

AFP (Nov. 24, 2014) — Madagascar said Monday it is trying to contain an outbreak of plague -- similar to the Black Death that swept Medieval Europe -- that has killed 40 people and is spreading to the capital Antananarivo. Duration: 00:42 Video provided by AFP
Powered by NewsLook.com
Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) — A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins