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Patient Outcomes Influenced By Hospital Volume And Surgeon Specialty

June 16, 2012

Authors recommend evaluation program of institutions

In other studies, outcomes of specific surgeries has been shown to improve when performed at high-volume centralized centers. Researchers from the Netherlands Cancer Institute wanted to understand if patients undergoing lung cancer resections would benefit from having their procedures performed in a high-volume specialized center. The study, published in the July 2012 issue of the International Association for the Study of Lung Cancer’s (IASLC) Journal of Thoracic Oncology, concluded that hospital volume and surgeon specialty are important factors in patient outcomes. However, they found there is no evidence-based standard for a minimum volume. To address this lack of standard, they recommend a national audit program to evaluate institutions based on quality of care parameters, including hospital volume.

The authors evaluated articles published between Jan. 1, 1990 and Jan. 20, 2011 that studied the effects of surgeon specialty as well as hospital and surgeon volume of lung resections on mortality and survival. They compiled data from 19 studies that met stringent criteria.

Researchers found that high volume hospitals had lower postoperative deaths compared with lower volume hospitals and thoracic and cardiothoracic surgeons had lower risks of mortality compared to general surgeons. There was a greater association of lower mortality with high volume centers as opposed to individual surgeons suggesting that the system and team involved in the post-operative care are important.

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