Surgeon volume plays a significant role in outcomes and cost following open incisional hernia repair.

摘要: Surgeon Volume Plays a Significant Role in Outcomes and Cost Following Open Incisional Hernia Repair hernia is common complication following gastrointestinal surgery. Many surgeons elect to perform incisional repairs despite performing only limited numbers of annually. This study examines the relationship between surgeon/facility volume operative time, reoperation rates, cost initial open repair. The New York Statewide Planning Research Cooperative System was queried for elective hernias from 2001 2006. Surgeon/facility volumes were calculated as mean number per year Reoperations recurrent over 5-year period identified using ICD-9/CPT codes. Multivariable regression used compare patient, surgeon, facility characteristics with reoperation, hospital charges. Eighteen thousand forty-seven patients met inclusion criteria. rate 9 %, median time 1.4 years (mean = 1.8). After adjusting clinical factors, an average ≥36 repairs/year had significantly lower rates (HR = 0.59, 95 % confidence interval (CI) = 0.48,0.72), (incidence ratio (IRR) = 0.67, CI = 0.64,0.71), downstream charges (IRR = 0.63, CI = 0.57,0.69). Facility (volume, academic affiliation, location) not associated reoperation. found strong association individual surgeon repair efficiency, Preferential referral high-volume may lead improved outcomes costs.