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. 2018 Feb;53(1):15-34.
doi: 10.1111/1475-6773.12696. Epub 2017 Sep 4.

The Volume-Outcome Relationship Revisited: Practice Indeed Makes Perfect

Corinna Hentschker  1 , Roman Mennicken  2   3
Affiliations

The Volume-Outcome Relationship Revisited: Practice Indeed Makes Perfect

Corinna Hentschker et al. Health Serv Res. 2018 Feb.

Abstract

Objective: To examine the causal effect of a hospital's experience with treating hip fractures (volume) on patient treatment outcomes.

Data sources: We use a full sample of administrative data from German hospitals for 2007. The data provide detailed information on patients and hospitals. We also reference the hospitals' addresses and the zip codes of patients' place of residence.

Study design: We apply an instrumental variable approach to address endogeneity concerns due to reverse causality and unobserved patient heterogeneity. As instruments for case volume, we use the number of potential patients and number of other hospitals in the region surrounding each hospital.

Principal findings: Our results indicate that after applying an instrumental variables (IV) regression of volume on outcome, volume significantly increases quality.

Conclusions: We provide evidence for the practice-makes-perfect hypothesis by showing that volume is a driving factor for quality.

Keywords: Volume; hospital quality; instrumental variables; mortality.

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Figures

Figure 1
Figure 1
Estimated Probability of Death for Different Volume Functions
See this image and copyright information in PMC

References

    1. AHRQ (Agency for Healthcare Research and Quality). 2007. AHRQ Quality Indicators – Guide to Inpatient Quality Indicators: Quality of Care in Hospitals – Volume, Mortality, and Utilization, Version 3.1. Rockville, MD: U. S. Department of Health and Human Services.
    1. Allareddy, V. , Ward M. M., Wehby G. L., and Konety B. R.. 2012. “The Connection Between Selective Referrals for Radical Cystectomy and Radical Prostatectomy and Volume‐Outcome Effects: An Instrumental Variables Analysis.” American Journal of Medical Quality 27 (5): 434–40. - PubMed
    1. AQUA – Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen. 2015. Hüftgelenknahe Femurfraktur – Indikatoren 2014. Göttingen: AQUA GmbH.
    1. Avdic, D. , Lundborg P., and Vikström J.. 2014. “Learning‐by‐Doing in a Highly Skilled Profession When Stakes are High: Evidence from Advanced Cancer Surgery.” IFAU – Institute for Evaluation of Labour Market and Education Policy (No. 7).
    1. Ayanian, J. Z. , and Weissman J. S.. 2002. “Teaching Hospitals and Quality of Care: A Review of the Literature.” Milbank Quarterly 80 (3): 569–93. - PMC - PubMed

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