Relationship between patient safety and hospital surgical volume

Health Serv Res. 2012 Apr;47(2):756-69. doi: 10.1111/j.1475-6773.2011.01310.x. Epub 2011 Aug 30.

Abstract

Objective: To examine the relationship between hospital volume and in-hospital adverse events.

Data sources: Patient safety indicator (PSI) was used to identify hospital-acquired adverse events in the Nationwide Inpatient Sample database in abdominal aortic aneurysm, coronary artery bypass graft, and Roux-en-Y gastric bypass from 2005 to 2008.

Study design: In this observational study, volume thresholds were defined by mean year-specific terciles. PSI risk-adjusted rates were analyzed by volume tercile for each procedure.

Principal findings: Overall, hospital volume was inversely related to preventable adverse events. High-volume hospitals had significantly lower risk-adjusted PSI rates compared to lower volume hospitals (p < .05).

Conclusion: These data support the relationship between hospital volume and quality health care delivery in select surgical cases. This study highlights differences between hospital volume and risk-adjusted PSI rates for three common surgical procedures and highlights areas of focus for future studies to identify pathways to reduce hospital-acquired events.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / surgery
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / statistics & numerical data
  • Female
  • Gastric Bypass / adverse effects
  • Gastric Bypass / statistics & numerical data
  • Health Facility Size / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Safety / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Statistics, Nonparametric
  • Surgery Department, Hospital / standards
  • Surgery Department, Hospital / statistics & numerical data*
  • United States