Journal of clinical anesthesia
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Comparative Study
Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.
Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. We examined the potential utility of using state data on surgical caseload to predict local growth by using 6 years of data for surgical cases performed at hospitals in the States of Florida and Iowa. ⋯ Even if the data from states or federal agencies reported growth in surgical cases, there is too much concentration of growth at a few hospitals for statewide growth rates to be useful for forecasting by individual hospitals and anesthesiology groups.
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Observational Study
Interchangeability of counts of cases and hours of cases for quantifying a hospital's change in workload among four-week periods of 1 year.
Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics). ⋯ For purposes of time series analysis of total workload at a hospital within 1-year, hours of cases and counts of cases are interchangeable. Simple control chart methods of detecting sudden changes in workload or caseload, based simply on the sample mean and standard deviation from the preceding year, are appropriate.