Physician and Hospital Factors Associated With Mortality of Surgical Patients

Recent studies have found an inverse relationship between hospital-specific mortality rates for selected conditions and the number of patients hospitalized with these conditions. These studies have not examined whether this inverse relationship is a result primarily of the nature and volume of services provided to patients by individual physicians or whether it reflects special characteristics of high-volume hospitals. This study examines these issues, using data that link characteristics of primary surgeons to the discharge abstract records of patients. The study analyzes variation in hospital mortality associated with: the total volume of specific surgical procedures performed in the hospital, the volume of these procedures performed by the patient's primary surgeon, physician board certification, and other factors including patient severity of illness, patient age, hospital control, teaching status, size, and location. The findings confirm the inverse relationship found in other studies between patient mortality and the total volume of specific surgical procedures performed in the hospital. Physician board certification and hospital's medical school affiliation also are found to be associated with lower patient mortality rates. However, there is no statistical relationship between the volume of services provided by individual surgeons and outcome, suggesting that the volume-outcome relationship reflects hospital rather than physician characteristics

Family medicine · MEDLINE · Political science · Cardiac, Anesthesia and Surgical Outcomes · Emergency Medicine · Medicine

• The Relationship of Hospital Characteristics and the Results of Peer Review in Six Large States

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  Añadir item

• Measuring Hospital Performance

  Susan I Desharnais, Susan DesHarnais et al.•Medical Care•1990

  Añadir item

• Physician Volume and Obstetric Outcome

  Michael Lefevre, Michael L Lefevre•Medical Care•1992

  Añadir item

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  Edward L Hannan, Harold Kilburn et al.•Medical Care•1991

  Añadir item

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  Susanne R Salem-Schatz, Susanne Salem‐Schatz et al.•Medical Care•1993

  Añadir item

• DRGs and Disease Staging for Reimbursing Medicare Patients

  Rosanna M Coffey, Marsha G Goldfarb•Medical Care•1986

  Añadir item

• Lower Medicare Mortality Among a Set of Hospitals Known for Good Nursing Care

  Linda H Aiken, Herbert L Smith et al.•Medical Care•1994

  Añadir item

• The Condition of the Literature on Differences in Hospital Mortality

  Arlene Fink, Elizabeth M Yano et al.•Medical Care•1989

  Añadir item

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  Robert G Hughes, Robert Hughes et al.•Medical Care•1987

  Añadir item

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  Lawton R Burns, Douglas R Wholey•Medical Care•1991

  Añadir item

• Why it is Important to Demonstrate Linkages Between Outcomes of Care and Processes and Structures of Care

  Karl E Hammermeister, A Laurie Shroyer et al.•Medical Care•1995

  Añadir item

• Hospital Volume and Surgical Mortality in the United States

  John D Birkmeyer, Andrea E Siewers et al.•New England Journal of Medicine•2002

  Añadir item

• Hospital Characteristics and Mortality Rates

  Arthur J Hartz, Henry Krakauer et al.•New England Journal of Medicine•1989

  Añadir item

• Mortalidade hospitalar como indicador de qualidade

  Open Access•Claudia Travassos, José Carvalho De Noronha et al.•Ciência & Saúde Coletiva•1999

  Añadir item

• Volume/Outcome Relationships in Small Rural Hospitals

  Open Access•Robert E Schlenker, David F Hittle et al.•The Journal of Rural Health•1996

  Añadir item

• A methodology for targeting hospital cases for quality of care record reviews

  Edward L Hannan, H R Bernard et al.•American Journal of Public Health•1989

  Añadir item

• Hospital volume, calendar age, and short term outcomes in patients undergoing repair of abdominal aortic aneurysms

  Shi Wu Wen, Marko Šimunović et al.•Journal of Epidemiology and…•1996

  Añadir item

• The relationship between physicians' qualifications and experience and the adequacy of prenatal care and low birthweight

  Jennifer S Haas, Endel John Orav et al.•American Journal of Public Health•1995

  Añadir item

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  Donald J Willison, Stephen B Soumerai et al.•Medical Care•2000

  Añadir item

• Adverse Outcomes and Variations in Organization of Care Delivery

  Pamela H Mitchell, Steven M Shortell•Medical Care•1997

  Añadir item

• Time Series Monitors of Outcomes

  Guillermo Marshall, A Laurie Shroyer et al.•Medical Care•1998

  Añadir item

• Experience, Attitudes, and Plans

  Open Access•William Finlay, Elizabeth J Mutran et al.•Work and Occupations•1991

  Añadir item

• Elements of Econometrics

  Jan Kmenta•Elements of econometrics•1997

  Añadir item

• Should Operations Be Regionalized?

  Harold S Luft, John P Bunker et al.•New England Journal of Medicine•1979

  Añadir item

• Regionalization of medical care

  Harold S Luft•American Journal of Public Health•1985

  Añadir item

• Does Practice Make Perfect

  Ann Barry Flood, W Richard Scott et al.•Medical Care•1984

  Añadir item

• The Relation Between Surgical Volume and Mortality

  Harold S Luft•Medical Care•1980

  Añadir item

• Hospital Medical Staff Organization and Quality of Care

  Stephen M Shortell, James P Logerfo•Medical Care•1981

  Añadir item

• DRGs and Disease Staging for Reimbursing Medicare Patients

  Rosanna M Coffey, Marsha G Goldfarb•Medical Care•1986

  Añadir item