Hospital Variation in Cholecystectomies in The Netherlands: A Nationwide Observational Study
| Autor: | Femke Atsma, Mark W. Noordenbos, Sarah Z. Wennmacker, Philip R. de Reuver, Carmen S S Latenstein, Stef Groenewoud |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Percentile Databases Factual medicine.medical_treatment Gallstones Hospitals General Time-to-Treatment Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] All institutes and research themes of the Radboud University Medical Center Time to surgery Humans Medicine Cholecystectomy Longitudinal Studies Quality of care Laparoscopy Aged Netherlands medicine.diagnostic_test business.industry General surgery Gastroenterology Emergency department Middle Aged medicine.disease Cholecystectomy Laparoscopic Female Risk Adjustment Surgery Observational study Emergency Service Hospital business |
| Zdroj: | Digestive Surgery, 37, 488-494 Digestive Surgery, 37, 6, pp. 488-494 |
| ISSN: | 0253-4886 |
| Popis: | Background: Practice variation generally raises concerns about the quality of care. This study determined the longitudinal degree of hospital variation in proportion of patients with gallstone disease undergoing cholecystectomy, while adjusted for case-mix, and the effect on clinical outcomes. Methods: A nationwide, longitudinal, database study was performed in all hospitals in the Netherlands in 2013–2015. Patients with gallstone disease were collected from the diagnosis-related group database. Hospital variation in case-mix-adjusted cholecystectomy rates was calculated per year. Clinical outcomes after cholecystectomy were compared between hospitals in the lowest/highest 20th percentile of the distribution of adjusted cholecystectomy rates in all 3 subsequent years. Results: In total, 96,673 patients with gallstones were included. The cholecystectomy rate was 73.6%. In 2013–2015, the case-mix-adjusted performance of cholecystectomies was in hospitals with high rates 1.5–1.6 times higher than in hospitals with low rates. Hospitals with a high adjusted cholecystectomy rate had a higher laparoscopy rate, shorter time to surgery, and less emergency department visits after a cholecystectomy compared to hospitals with a low-adjusted cholecystectomy rate. Conclusion: Hospital variation in cholecystectomies in the Netherlands is modest, cholecystectomy rates varies by |
| Databáze: | OpenAIRE |
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