Hospital Teaching Status and Outcomes of Complex Surgical Procedures in the United States
作者： Justin B Dimick , John A Cowan Jr , Lisa M Colletti , Gilbert R Upchurch Jr
DOI: 10.1001/ARCHSURG.139.2.137
关键词:
摘要: Hypothesis Complex operations performed in teaching hospitals have similar outcomes as those nonteaching hospitals. Design Observational cohort study with clinical patient data obtained from the Nationwide Inpatient Sample. The Sample were linked to American Hospital Association hospital survey for 1997 determine characteristics. Hospitals considered high volume if they more than median (50th percentile) number of procedures per year. Setting Nationally representative sample during 1996 and 1997. Patients Individuals undergoing esophageal resection (n = 1247), hepatic 2073), or pancreatic 3337) included. Main Outcomes Measures Unadjusted adjusted in-hospital mortality prolonged length stay (>75th percentile). Results None had higher operative rates at In unadjusted analyses, (4.0% vs 8.8%;P Conclusions Teaching lower complex surgical procedures. However, can be explained by procedural volume.
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