| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;75:1048-1058
© 2003 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, Lahey Clinic, Burlington, Massachusetts, USA
b Department of Health Care Policy, Harvard Medical School, Burlington, Massachusetts, USA
c Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
* Address reprint requests to Dr Shahian, Department of Thoracic and Cardiovascular Surgery, Lahey Clinic, 41 Mall Rd, Burlington, MA 01805, USA
e-mail: david.m.shahian{at}lahey.org
Numerous reports have documented a volume-outcome relationship for complex medical and surgical care, although many such studies are compromised by the use of discharge abstract data, inadequate risk adjustment, and problematic statistical methodology. Because of the volume-outcome association, and because valid outcome measurements are unavailable for many procedures, volume-based referral strategies have been advocated as an alternative approach to health-care quality improvement. This is most appropriate for procedures with the greatest outcome variability between low-volume and high-volume providers, such as esophagectomy and pancreatectomy, and for particularly high-risk subgroups of patients. Whenever possible, risk-adjusted outcome data should supplement or supplant volume standards, and continuous quality improvement programs should seek to emulate the processes of high-volume, high-quality providers. The Leapfrog Group has established a minimum volume requirement of 500 procedures for coronary artery bypass grafting. In view of the questionable basis for this recommendation, we suggest that it be reevaluated.
This article has been cited by other articles:
|
|
 |
|
  J. M Fritz Invited Commentary Physical Therapy, September 1, 2008; 88(9): 1007 - 1009. [Full Text] [PDF]
|
|
|
|
|
|
L. Resnik, D. Liu, V. Mor, and D. L Hart Predictors of Physical Therapy Clinic Performance in the Treatment of Patients With Low Back Pain Syndromes Physical Therapy, September 1, 2008; 88(9): 989 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Shahian and S.-L. T. Normand Low-volume coronary artery bypass surgery: Measuring and optimizing performance. J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1202 - 1209. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Carey, J. P. Parker, C. Brandeau, and Z. Li The "occasional open heart surgeon" revisited. J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1254 - 1260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-C. Lin, S. Xirasagar, N.-W. Tsao, Y.-T. Hwang, N.-W. Kuo, and H.-C. Lee Volume-outcome relationships in coronary artery bypass graft surgery patients: 5-year major cardiovascular event outcomes. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 923 - 930. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. Livingston, A. C. Elliott, L. S. Hynan, and E. Engel When Policy Meets Statistics: The Very Real Effect That Questionable Statistical Analysis Has on Limiting Health Care Access for Bariatric Surgery Arch Surg, October 1, 2007; 142(10): 979 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Holzhey, S. Jacobs, T. Walther, M. Mochalski, F. W. Mohr, and V. Falk Cumulative sum failure analysis for eight surgeons performing minimally invasive direct coronary artery bypass J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 663 - 669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Gauvreau Reevaluation of the Volume-Outcome Relationship for Pediatric Cardiac Surgery Circulation, May 22, 2007; 115(20): 2599 - 2601. [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Shahian, F. H. Edwards, V. A. Ferraris, C. K. Haan, J. B. Rich, S.-L. T. Normand, E. R. DeLong, S. M. O'Brien, C. M. Shewan, R. S. Dokholyan, et al. Quality Measurement in Adult Cardiac Surgery: Part 1--Conceptual Framework and Measure Selection Ann. Thorac. Surg., April 1, 2007; 83(4_Supplement): S3 - S12. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Gammie, S. M. O'Brien, B. P. Griffith, T. B. Ferguson, and E. D. Peterson Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation Circulation, February 20, 2007; 115(7): 881 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. W. Steyerberg, B. A. Neville, L. B. Koppert, V. E.P.P. Lemmens, H. W. Tilanus, J.-W. W. Coebergh, J. C. Weeks, and C. C. Earle Surgical Mortality in Patients With Esophageal Cancer: Development and Validation of a Simple Risk Score J. Clin. Oncol., September 10, 2006; 24(26): 4277 - 4284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Shahian, D. F. Torchiana, R. J. Shemin, J. D. Rawn, and S.-L. T. Normand Massachusetts Cardiac Surgery Report Card: Implications of Statistical Methodology Ann. Thorac. Surg., December 1, 2005; 80(6): 2106 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. K. Nallamothu, K. A. Eagle, V. A. Ferraris, and R. M. Sade Should Coronary Artery Bypass Grafting Be Regionalized? Ann. Thorac. Surg., November 1, 2005; 80(5): 1572 - 1581. [Full Text] [PDF]
|
|
|
|
|
|
R. E. Kuntz and S.-L. T. Normand Measuring Percutaneous Coronary Intervention Quality by Simple Case Volume Circulation, August 23, 2005; 112(8): 1088 - 1091. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Rathore, A. J. Epstein, K. G. M. Volpp, and H. M. Krumholz Regionalization of Care for Acute Coronary Syndromes: More Evidence Is Needed JAMA, March 16, 2005; 293(11): 1383 - 1387. [Full Text] [PDF]
|
|
|
|
|
|
V. A. Ferraris INVITED COMMENTARY Ann. Thorac. Surg., November 1, 2004; 78(5): 1534 - 1535. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mullerad, H. Hricak, L. Wang, H.-N. Chen, M. W. Kattan, and P. T. Scardino Prostate Cancer: Detection of Extracapsular Extension by Genitourinary and General Body Radiologists at MR Imaging Radiology, July 1, 2004; 232(1): 140 - 146. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Narayan, M. Caputo, C.A. Rogers, H. Alwair, B. Mahesh, G.D. Angelini, and A.J. Bryan Early and mid-term outcomes of surgery of the ascending aorta/arch: is there a relationship with caseload? Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 676 - 682. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Shahian Improving Cardiac Surgery Quality--Volume, Outcome, Process? JAMA, January 14, 2004; 291(2): 246 - 248. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Mainz Defining and classifying clinical indicators for quality improvement Int. J. Qual. Health Care, December 1, 2003; 15(6): 523 - 530. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
