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Ann Thorac Surg 2000;69:146-150
© 2000 The Society of Thoracic Surgeons

Original Articles

Excellence and low case volume: an example of the inapplicability of volume-based credentialing

Gerald L. Early, MDa, Shauna R. Roberts, MDa

a Heartland Regional Medical Center, St. Joseph, Missouri, USA

Address reprint requests to Dr Early, 9125 SE Hillyard Rd, Easton, MO 64443

Background. Health care reform, public disclosure of hospital and surgeon-specific results, plus changes in reimbursement patterns have raised the specter of volume-based credentialing.

Methods. Using The Society of Thoracic Surgeons Cardiac Database, we examined the data for all coronary artery bypass graft-only patients (n = 615) operated on by us from July 1991 to June 1997.

Results. The observed mortality was 0.33% and the observed-to-expected ratio was 0.12 (p < 0.005). Morbidity was low as well.

Conclusions. Excellent results can be obtained for patients undergoing coronary artery bypass grafting in the presence of both low surgeon and low hospital case volume.




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