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Disease-Oriented Regionalization Approach: Quality of Care and Volume Above All

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The Modern Hospital

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Abstract

The growing complexity of modern medicine introduces the potential for increasing variation in the delivery of healthcare. For patients with the same disease process, outcomes of treatment may vary considerably due to this variation. For a system looking to optimize quality and consistently deliver high-quality care, developing strategies to minimize this variation is imperative. In this chapter regionalization of complex surgery as a policy measure to optimize postoperative outcomes is discussed as a prototype of this approach. The evidence base for regionalization is presented and analyzed, as well as the pros and cons of implementation of such a policy in the United States.

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References

  1. Luft HS, Bunker JP, Enthoven AC. Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med. 1979;301(25):1364–9.

    Article  CAS  Google Scholar 

  2. Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346(15):1128–37.

    Article  Google Scholar 

  3. Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med. 2002;137(6):511–20.

    Article  Google Scholar 

  4. Dudley RA, Johansen KL, Brand R, Rennie DJ, Milstein A. Selective referral to high-volume hospitals: estimating potentially avoidable deaths. JAMA. 2000;283(9):1159–66.

    Article  CAS  Google Scholar 

  5. Finks JF, Osborne NH, Birkmeyer JD. Trends in hospital volume and operative mortality for high-risk surgery. N Engl J Med. 2011;364(22):2128–37.

    Article  CAS  Google Scholar 

  6. Stitzenberg KB, Meropol NJ. Trends in centralization of cancer surgery. Ann Surg Oncol. 2010;17(11):2824–31.

    Article  Google Scholar 

  7. Finley CJ, Bendzsak A, Tomlinson G, Keshavjee S, Urbach DR, Darling GE. The effect of regionalization on outcome in pulmonary lobectomy: a Canadian national study. J Thorac Cardiovasc Surg. 2010;140(4):757–63.

    Article  Google Scholar 

  8. Gordon TA, Bowman HM, Bass EB, et al. Complex gastrointestinal surgery: impact of provider experienceon clinical and economic outcomes. J Am Coll Surg. 1999;189(1):46–56.

    Google Scholar 

  9. Fong Y, Gonen M, Rubin D, Radzyner M, Brennan MF. Long-term survival is superior after resection for cancer in high-volume centers. Ann Surg. 2005;242(4):540–4; discussion 544–547.

    PubMed  PubMed Central  Google Scholar 

  10. Bilimoria KY, Bentrem DJ, Ko CY, et al. Multimodality therapy for pancreatic cancer in the U.S.: utilization, outcomes, and the effect of hospital volume. Cancer. 2007;110(6):1227–34.

    Article  Google Scholar 

  11. Urbach DR, Baxter NN. Does it matter what a hospital is “high volume” for? Specificity of hospital volume-outcome associations for surgical procedures: analysis of administrative data. BMJ. 2004;328(7442):737–40.

    Article  Google Scholar 

  12. Birkmeyer JD, Sun Y, Goldfaden A, Birkmeyer NJ, Stukel TA. Volume and process of care in high-risk cancer surgery. Cancer. 2006;106(11):2476–81.

    Article  Google Scholar 

  13. Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361(14):1368–75.

    Article  CAS  Google Scholar 

  14. Chowdhury MM, Dagash H, Pierro A. A systematic review of the impact of volume of surgery and specialization on patient outcome. Br J Surg. 2007;94(2):145–61.

    Article  CAS  Google Scholar 

  15. Finlayson SR, Birkmeyer JD, Tosteson AN, Nease RF Jr. Patient preferences for location of care: implications for regionalization. Med Care. 1999;37(2):204–9.

    Article  CAS  Google Scholar 

  16. Wasif N, Etzioni D, Habermann EB, et al. Racial and socioeconomic differences in the use of high-volume commission on cancer-accredited hospitals for cancer surgery in the United States. Ann Surg Oncol. 2018;25(5):1116–25.

    Article  Google Scholar 

  17. Zafar SN, Shah AA, Channa H, Raoof M, Wilson L, Wasif N. Comparison of rates and outcomes of readmission to index vs nonindex hospitals after major cancer surgery. JAMA Surg. 2018;153:719.

    Article  Google Scholar 

  18. Stitzenberg KB, Sigurdson ER, Egleston BL, Starkey RB, Meropol NJ. Centralization of cancer surgery: implications for patient access to optimal care. J Clin Oncol. 2009;27(28):4671–8.

    Article  Google Scholar 

  19. Bilimoria KY, Ko CY, Tomlinson JS, et al. Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg. 2011;253(4):779–85.

    Article  Google Scholar 

  20. Livingston EH, Cao J. Procedure volume as a predictor of surgical outcomes. JAMA. 2010;304(1):95–7.

    Article  CAS  Google Scholar 

  21. Thabut G, Christie JD, Kremers WK, Fournier M, Halpern SD. Survival differences following lung transplantation among US transplant centers. JAMA. 2010;304(1):53–60.

    Article  CAS  Google Scholar 

  22. Wasif N, Etzioni DA, Habermann EB, et al. Does improved mortality at low- and medium-volume hospitals lead to attenuation of the volume to outcomes relationship for major visceral surgery? J Am Coll Surg. 2018;227(1):85–93.e9.

    Article  Google Scholar 

  23. PSNet. To err is human: building a safer health system. January 2000. Retrieved from: https://psnet.ahrq.gov/resources/resource/1579/to-err-is-human-building-a-safer-health-system

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Author information

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA

    Nabil Wasif

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  1. Nabil Wasif
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Correspondence to Nabil Wasif .

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Editors and Affiliations

  1. New York Medical College, School of Medicine, Department of Surgery and Westchester Medical Center, Valhalla, NY, USA

    Rifat Latifi

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Wasif, N. (2019). Disease-Oriented Regionalization Approach: Quality of Care and Volume Above All. In: Latifi, R. (eds) The Modern Hospital. Springer, Cham. https://doi.org/10.1007/978-3-030-01394-3_11

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  • DOI: https://doi.org/10.1007/978-3-030-01394-3_11

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01393-6

  • Online ISBN: 978-3-030-01394-3

  • eBook Packages: MedicineMedicine (R0)

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