A New Look at the Volume and Outcome Relationship in Surgery for Colorectal Cancer
Authors
Damle, Rashelle N.Macomber, Christopher W.
Flahive, Julie M.
Maykel, Justin A.
Sturrock, Paul R.
Sweeney, W. Brian
Santry, Heena P.
Alavi, Karim
Document Type
Poster AbstractPublication Date
2013-05-08Keywords
EpidemiologyHealth Services Administration
Health Services Research
Neoplasms
Surgery
Surgical Procedures, Operative
Translational Medical Research
Metadata
Show full item recordAbstract
Purpose: Surgeon and hospital factors have a significant impact on treatment outcomes for colorectal cancer (CRC). Limited research has been done to assess cost and quality of treatment by surgeon-volume. We aim to identify the surgeon factors impacting cost and quality of surgical care for CRC. Methods: The University HealthSystem Consortium database was queried for patients who underwent colon resection for cancer from 2008 to 2012. Patients were grouped by surgeon-volume. Outcomes of interest were postoperative complications, ICU admission, readmission rate, inpatient hospital length of stay (LOS) and direct hospital cost. Average surgeon-volume per year was categorized as high (>6) or low (16) based on the distribution of surgeon-volume. Results: 29,972 patients over age 18 were identified for inclusion. 25,426 underwent resection by high-volume surgeons (HVS) and 4,547 by low-volume surgeons (LVS). LVS were more likely to admit patients to the ICU than HVS (21% v 33%, p Conclusions: Surgeons who perform greater than 6 colectomies per year for colon cancer are more likely to use laparoscopy, less likely to admit patients to the ICU, have lower complication and readmission rates, and shorter LOS. Hospital cost is significantly lower in patients operated on by high volume surgeons. As health care costs continue to escalate and health care reform efforts gain momentum, factors leading to high-quality, cost-effective care need to be identified.DOI
10.13028/k9x7-t702Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27848Rights
Copyright the Author(s)Distribution License
http://creativecommons.org/licenses/by-nc-sa/3.0/ae974a485f413a2113503eed53cd6c53
10.13028/k9x7-t702