Does Practice Make Perfect?Part I: The Relation Between Hospital Volume and Outcomes for Selected Diagnostic Categories
作者:
Ann Flood,
W Richard Scott,
Wayne Ewy,
期刊:
Medical Care
(OVID Available online 1984)
卷期:
Volume 22,
issue 2
页码: 98-114
ISSN:0025-7079
年代: 1984
出版商: OVID
关键词: volume;outcome;quality of care;regionalization;patient risk
数据来源: OVID
摘要:
The effect of a greater volume of patients with similar conditions being treated at a hospital on the outcomes achieved is studied using a variety of categories of patients, 15 surgical and 2 medical, and involving 550,000 patients treated in over 1,200 nonfederal United States acute care hospitals. After demonstrating that there are significant differences in the outcomes of patients, taking into account patient health status, the authors examine the impact of being treated in a hospital with a high or low volume of similar patients. Strong and consistent evidence is found that high volume is associated with better outcomes for surgical patients, which supports regionalizing patient care by procedure. Two additional variables, relative difficulty of the procedure and risk level of the patients, are analyzed to determine whether they change the relationship between volume and outcome. Some evidence is found that low-volume hospitals are associated with the poorest outcome for low-risk surgical patients. The evidence for medical patients is weak and mixed. Possible alternative explanations for the observed findings for surgical and medical patients are discussed.
点击下载:
PDF
(1007KB)
返 回