Featured Research

from universities, journals, and other organizations

Deaths rise with shift from in-hospital to outpatient procedures for common urology surgeries, study shows

Date:
August 19, 2014
Source:
Henry Ford Health System
Summary:
As hospitals have shifted an array of common urological surgeries from inpatient procedures to outpatient, potentially preventable deaths have increased following complications. The study also identified older, sicker, minority patients and those with public insurance as more likely to die after a potentially recognizable or preventable complication.

As hospitals have shifted an array of common urological surgeries from inpatient procedures to outpatient, potentially preventable deaths have increased following complications.

Related Articles


Those were the primary findings of a new study led by Henry Ford Hospital researchers, who initially expected that improved mortality rates recently documented for surgery overall would also translate to commonly performed urologic surgeries.

The opposite turned out to be true.

The research paper has been published online by BJUI, the official journal of the British Association of Urological Surgeons.

The study -- which included researchers at Harvard Medical School, the University of Montreal Health Center, Yale University's Department of Urology and the Harvard School of Public Health -- also identified older, sicker, minority patients and those with public insurance as more likely to die after a potentially recognizable or preventable complication.

"These high-risk patients are ideal targets for new health care initiatives aimed at improving process and results," says Jesse D. Sammon, D.O., a researcher at Henry Ford's Vattikuti Urology Institute and lead author of the study.

"Urologic surgeons and support staff need a heightened awareness of the early signs of complications to prevent such deaths, particularly as our patient population becomes older and has more chronic medical conditions."

The study focused on a measure of hospital quality and safety called Failure to Rescue, or FTR, derived from the Institute of Medicine's landmark 1999 report To Err is Human, which highlighted significant concerns for patient safety in American hospitals.

"Failure to rescue describes the inability of a provider or institution to recognize key complications and intervene before mortality," Dr. Sammon explains. "While comparison of overall complications and mortality rates penalizes hospitals treating sicker patients and more complex cases, FTR rates may be a more accurate way to assess safety and quality of care."

Using the Nationwide Inpatient Sample, the largest all-payer inpatient health care database in the U.S., the researchers identified all patients discharged after urologic surgery between 1998 and 2010.

This pool of more than 7.7 million surgeries was analyzed for overall and FTR mortality as well as changes in mortality rates. The researchers determined that while both admissions for urologic surgery and overall mortality decreased slightly, deaths attributable to FTR increased 5 percent every year during the study period.

The researchers also identified each patient's age, race and insurance status, including private insurance, Medicare, Medicaid and self-pay. In addition, the severity of each patient's illness was determined based on co-morbidity, or the presence of other chronic diseases or conditions at the time of their urologic procedure.

They found that the number of inpatient urologic surgeries dropped during the study period and surmised this was due to a "major shift" to outpatient procedures.

In addition, older, sicker and minority patients, as well as those with public insurance, were more likely to die after a potentially recognizable or preventable complication of their urologic surgery.

Besides the study's primary conclusions, Dr. Sammon says the research also suggested that compared to other medical specialties, "these findings also raise the possibility that the care of urologic surgical patients is suffering from inadequate or poorly applied patient safety measures."

"It's worrisome," he continues, "that the odds of FTR-related deaths have risen over time for the most common types of urologic surgeries including ureteral stenting, treatment of enlarged prostate, bladder biopsies, removal of a diseased kidney and others."


Story Source:

The above story is based on materials provided by Henry Ford Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jesse D. Sammon, Daniel Pucheril, Firas Abdollah, Briony Varda, Akshay Sood, Naeem Bhojani, Steven L. Chang, Simon P. Kim, Nedim Ruhotina, Marianne Schmid, Maxine Sun, Adam S. Kibel, Mani Menon, Marcus E. Semel, Quoc-Dien Trinh. Preventable mortality after common urological surgery: failing to rescue? BJU International, 2014; DOI: 10.1111/bju.12833

Cite This Page:

Henry Ford Health System. "Deaths rise with shift from in-hospital to outpatient procedures for common urology surgeries, study shows." ScienceDaily. ScienceDaily, 19 August 2014. <www.sciencedaily.com/releases/2014/08/140819082910.htm>.
Henry Ford Health System. (2014, August 19). Deaths rise with shift from in-hospital to outpatient procedures for common urology surgeries, study shows. ScienceDaily. Retrieved April 1, 2015 from www.sciencedaily.com/releases/2014/08/140819082910.htm
Henry Ford Health System. "Deaths rise with shift from in-hospital to outpatient procedures for common urology surgeries, study shows." ScienceDaily. www.sciencedaily.com/releases/2014/08/140819082910.htm (accessed April 1, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, April 1, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) — Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com
Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
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