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Older patients who need high-risk surgery fare better in experienced hospitals

t are often elective. More than 1,000 of these deaths could be averted if patients at the lowest volume hospitals had surgery instead at the highest volume centers, Birkmeyer says.

He and his colleagues believe the results reflect real differences in quality because the effect - particularly for some procedures - is large and consistent over time. They conclude, "In the absence of better information about surgical quality, patients undergoing many procedures can substantially improve their survival odds by selecting a high volume hospital near them." The nationwide study examined outcomes in approximately 2.5 million Medicare patients (at least 65 years old) who had surgery between 1994 to 1999, and focused on total hospital volume, not total Medicare volume. It used data from the national Medicare database and AHRQ's Healthcare Cost and Utilization Project.


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Contact: Steve Snyder
steve.snyder@dartmouth.edu
603-650-1492
Dartmouth Medical School
11-Apr-2002


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