Articles: hospital-volume.
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The "Volume Pledge" aims to centralize carotid artery stenting (CAS) to hospitals and surgeons performing ≥10 and ≥5 procedures annually, respectively. ⋯ Most patients receive CAS by hospitals and providers meeting the Volume Pledge threshold for CAS. Surgeons but not hospitals who met the policy's volume standards were associated with superior outcomes across all measured outcomes.
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Int J Qual Health Care · Dec 2019
The 30-day unplanned readmission rate and hospital volume: a national population-based study in South Korea.
To examine the association between hospital volume and the unplanned 30-day readmission rate as a quality measure. ⋯ The standardized readmission rates were not associated with hospital volume, except for the neurology cohort, in which the standardized readmission rate was significantly higher in the highest-volume hospitals than in lowest- and intermediate-volume hospitals, which was not consistent with the typical association of greater hospital volume with better outcomes. This association was independent of hospital characteristics. Therefore, the rate of readmissions should be used with caution when gauging the quality of hospital care according to hospital volume.
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Minimum volume thresholds for specific surgical procedures in German hospitals were established in 2004 but remain controversial. For the first time, this study investigated the relationship between hospital performance volume and surgical procedure duration in a multicenter approach. The question here was whether a concentration on frequently performed procedures leads to a reduction in surgical process times. ⋯ The case volume only appeared to have a direct but limited influence on incision to suture times in laparoscopic and arthroscopic procedures. Overall, the hospital performance volume appeared to be of subordinate importance in terms of OR-economics.
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Arch Orthop Trauma Surg · Jan 2019
Review Meta AnalysisShoulder arthroplasty volume standards: the more the better?
The wide use of hip and knee arthroplasty has led to implementation of volume standards for hospitals and surgeons. For shoulder arthroplasty, the effect of volume on outcome has been researched, but no volume standard exists. This review assessed literature reporting on shoulder arthroplasty volumes and its relation to patient-reported and functional outcomes to define an annual volume threshold. ⋯ There is insufficient evidence to support the concept that only the number of shoulder arthroplasties annually performed (either per hospital or per surgeon) results in better patient-reported and functional outcomes. Currently, published volume thresholds are only based on short-term parameters such as length and cost of hospital stay.
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Congenital diaphragmatic hernia is a rare and life-threatening anomaly that occurs during fetal development and results in an incomplete or incorrect formation of the diaphragm. Surgical therapy of the diaphragm should be performed after clinical stabilization of the neonate. Higher hospital or surgeon volume has previously been found to be associated with better clinical outcomes for different especially high-risk, low-volume procedures. Therefore, we aim to examine the relationship between hospital or surgeon volume and outcomes for congenital diaphragmatic hernia. ⋯ PROSPERO ( CRD42018090231 ).