The Volume-Outcome Paradigm for Gynecologic Surgery: Clinical and Policy Implications
- PMID: 31929332
- DOI: 10.1097/GRF.0000000000000518
The Volume-Outcome Paradigm for Gynecologic Surgery: Clinical and Policy Implications
Abstract
Studies over the past decade have clearly demonstrated an association between high surgeon and hospital volume and improved outcomes for women undergoing gynecologic surgical procedures. In contrast to procedures associated with higher morbidity, the association between higher volume and improved outcomes is often modest for gynecologic surgeries. The lower magnitude of this association has limited actionable policy changes for gynecologic surgery. These data have been driving initiatives such as regionalization of care, targeted quality improvement at low volume centers and volume-based credentialing in gynecology.
References
-
- Luft HS, Bunker JP, Enthoven AC. Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med. 1979;301:1364–1369.
-
- Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–1137.
-
- Birkmeyer JD, Stukel TA, Siewers AE, et al. Surgeon volume and operative mortality in the United States. N Engl J Med. 2003;349:2117–2127.
-
- Hollenbeck BK, Ye Z, Dunn RL, et al. Provider treatment intensity and outcomes for patients with early-stage bladder cancer. J Natl Cancer Inst. 2009;101:571–580.
-
- Schrag D, Cramer LD, Bach PB, et al. Influence of hospital procedure volume on outcomes following surgery for colon cancer. JAMA. 2000;284:3028–3035.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Miscellaneous