Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Apr;237(4):509-14.
doi: 10.1097/01.SLA.0000059981.13160.97.

Effect of hospital volume and experience on in-hospital mortality for pancreaticoduodenectomy

Vivian Ho  1 , Martin J Heslin
Affiliations

Effect of hospital volume and experience on in-hospital mortality for pancreaticoduodenectomy

Vivian Ho et al. Ann Surg. 2003 Apr.

Abstract

Objective: To examine the relative impact of procedure volume versus years of hospital experience on inpatient death rates after pancreaticoduodenectomy.

Summary background data: Past studies have identified a significant volume-outcome relation for hospitals performing pancreaticoduodenectomy (the Whipple procedure).

Methods: Administrative discharge data were examined for 6,652 patients who underwent the procedure between 1988 and 1998 in California and Florida. Patients were divided into approximate quartiles according to each hospital's annual procedure volume: very low (1), low (2 or 3), medium (4-9), and high (10+). Logistic regression analysis was used to examine differences in inpatient mortality among hospitals with different procedure volume and years of experience, while adjusting for patient characteristics.

Results: Medium- and high-volume hospitals had lower rates of inpatient mortality after pancreaticoduodenectomy relative to very-low-volume facilities. Greater years of hospital experience also reduced the odds of inpatient death. Predictions based on the regression estimates indicate that within volume categories, increased hospital experience did not lead to significant reductions in inpatient mortality. However, high-volume hospitals had significantly lower inpatient mortality rates than very-low-volume facilities with the same amount of experience.

Conclusions: Hospitals with more years of experience with pancreaticoduodenectomy had lower rates of inpatient mortality. However, higher procedure volume has played a larger role than increased experience in reducing inpatient death rates.

PubMed Disclaimer

References

    1. Hughes RG, Garnick DW, Luft HS, et al. Hospital volume and patient outcomes: The case of hip fracture patients. Med Care. 1988; 26: 1057–1067. - PubMed
    1. Hannan EL, Kilburn H Jr, Bernard H, et al. Coronary artery bypass surgery: The relationship between inhospital mortality rate and surgical volume after controlling for clinical risk factors. Med Care. 1991; 29: 1094–1107. - PubMed
    1. Kimmel SE, Berlin JA, Laskey WK. The relationship between coronary angioplasty procedure volume and major complications. JAMA. 1995; 274: 1137–1142. - PubMed
    1. Cebul R, Snow RJ, Pine R, et al. Indications, outcomes, and provider volumes for carotid endarterectomy. JAMA. 1998; 279: 1282–1287. - PubMed
    1. Begg CB, Cramer LD, Hoskins WJ, et al. Impact of hospital volume on operative mortality for major cancer surgery. JAMA. 1998; 280: 1747–1751. - PubMed

Publication types