TITLE

Benchmarking in thoracic surgery

AUTHOR(S)
Freixinet, Jorge L.; Varela, Gonzalo; Molins, Laureano; Rivas, Juan J.; Rodríguez-Paniagua, José M.; de Castro, Pedro López; Izquierdo, José M.; Torres, Juan
PUB. DATE
July 2011
SOURCE
European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, p124
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Presentation of an experience in benchmarking in 13 university Spanish thoracic surgery services. Methods: The minimum basic data set (MBDS) for hospitalization, corresponding to 2007, including all registered hospital discharges, was used. The performance of the hospitals was compared using an external reference pattern (SN) and internal average (BMG). Cases were chosen in which a major pulmonary resection (lobectomy or pneumonectomy) was done for bronchogenic carcinoma. Performance indicators were the complexity of the casuistry (average weight and relative weight). Performance results indicators included average length of stay (preoperative, postoperative, and global lengths of stay were analyzed separately for lobectomies as well as pneumonectomies), complications, mortality, and urgent readmissions. Results: A total number of 4778 cases were analyzed, with major thoracic surgeries being prominent with 1779 (37.3%). For average weight, there was a dispersion between 2.5 and 5.68, with an average of 3.45 for the BMG and 3.43 for the SN. There were some very significant differences in morbidity, with groups having a gross rate of few complications (2.6%) up to many (16.1%). The mortality rate ranged between 1.6% and 6.6%. There were considerable differences in urgent readmissions, with gross rates between 2.6% and 7.3%, considering as points of reference 5.4% (BMG) and 4.7% (SN). Concerning the results of pulmonary resections for bronchogenic carcinoma, the index of pneumonectomies was between 8% and 29%. The average length of stay for lobectomy was between 6 and 9.5, with an average of 7 in BMG. In the case of pneumonectomies, it was between 6 and 26 days, with an average of 9 for BMG. Average preoperative stay also varied widely, between 0.2 and 2.4, while postoperative stay was between 7.5 and 12.1. The gross global rate of complications ranged from 2.7% to 36.7%, with points of reference of 15.6% (BMG) and 13.8% (SN). The complication rate ranged from 3% to 33%, with an average of 14.5% for lobectomies, with higher variability for pneumonectomies (0–58%). Conclusions: Benchmarking could be an effective method for improving clinical management. A considerable variability was detected in our study among the participating groups.
ACCESSION #
61175256

 

Related Articles

  • One year prospective analysis of morbidity and mortality associated with thoracic surgery. Naithani, Udita; Bajaj, Pramila; Bhatnagar, Neelesh; Prasad, Narendra // Anaesthesia, Pain & Intensive Care;Jul-Sep2011, Vol. 15 Issue 2, p86 

    Objectives: To evaluate the morbidity and mortality associated with thoracic surgery in adult patients over a period of one year. Design: Prospective, descriptive, clinical study. Methodology: Thirty patients (24 men and 6 women), who underwent various thoracic surgeries over a period of one...

  • Seasonal variation influences outcomes following lung cancer resections LaPar, Damien J.; Nagji, Alykhan S.; Bhamidipati, Castigliano M.; Kozower, Benjamin D.; Lau, Christine L.; Ailawadi, Gorav; Jones, David R. // European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, p83 

    Abstract: Objective: The effect of seasonal variation on postoperative outcomes following lung cancer resections is unknown. We hypothesized that postoperative outcomes following surgical resection for lung cancer within the United States would not be impacted by operative season. Methods: From...

  • Hospitalization for complications of cirrhosis: does volume matter? Singla, Anand; Hart, James; Li, YouFu; Tseng, Jennifer; Shah, Shimul; Hart, James L; Tseng, Jennifer F; Shah, Shimul A // Journal of Gastrointestinal Surgery;Feb2011, Vol. 15 Issue 2, p330 

    Introduction: Close to 30,000 people die of cirrhosis in the USA each year. Previous studies have shown a survival advantage with high-volume (HV) hospitals for complex surgical procedures. We examined whether a volume benefit exists for hospitals dealing with specialized disorders...

  • Changing patterns of hospital admission for asthma, 1981-97. Morrison, D. S.; McLoone, P. // Thorax;Sep2001, Vol. 56 Issue 9, p687 

    Background-Hospital admission rates for asthma have stopped rising in several countries. The aim of this study was to use linked hospital admission data to explore recent trends in asthma admissions in Scotland. Methods-Linked Scottish Morbidity Records (SMR1) for asthma (ICD-9 493 and ICD-b...

  • An Analysis of Hospital Productivity And Product Change. Ashby, Jack; Guterman, Stuart // Health Affairs;Sep/Oct2000, Vol. 19 Issue 5, p197 

    Analyzes the impact of changes in productivity and hospital product on the inputs required to produce inpatient care in the United States. Trend in inpatient costs per discharge and length of stay since the early 1990s; Presentation of analytical model which measures hospitals' performance in...

  • Letter. ACME: an admission case-mix system for the elderly. Perlado, F; Midón, J; Mesa, P // Age & Ageing;Oct99, Vol. 28 Issue 6, p581 

    Focuses on a study which examined the performance of the admission case-mix system for the elderly in hospital admission assessment in Spain. Review of related study; Correlation between the case-mix index and duration of stay.

  • Prolonged Hospital Stay for Extremely Premature Infants: Risk Factors, Center Differences, and the Impact of Mortality on Selecting a Best-Performing Center. Michael Cotten, C; Oh, William; McDonald, Scott; Carlo, Waldemar; Fanaroff, Avroy A; Duara, Shahnaz; Stoll, Barbara; Laptook, Abbot; Poole, Kenneth; Wright, Linda L; Goldberg, Ronald N // Journal of Perinatology;Oct2005, Vol. 25 Issue 10, p650 

    OBJECTIVE:The first objective was to identify factors associated with prolonged hospital stay (PHS: hospitalized >42 weeks postmenstrual age) in extremely premature (EP: born less than or equal to 28 weeks gestation) infants. The second objective was to identify a PHS best-performing benchmark...

  • Early Outcomes of Single-Port Video-Assisted Thoracic Surgery for Primary Spontaneous Pneumothorax. Do Kyun Kang; Ho Ki Min; Hee Jae Jun; Youn Ho Hwang; Min-Kyun Kang // Korean Journal of Thoracic & Cardiovascular Surgery;Aug2014, Vol. 47 Issue 4, p384 

    Background: Recently, single-port video-assisted thoracic surgery (VATS) has been proposed as an alternative to the conventional three-port VATS for primary spontaneous pneumothorax (PSP). The aim of this study is to evaluate the early outcomes of the single-port VATS for PSP. Methods: VATS was...

  • Identifying causes for high readmission rates after stoma reversal. Keller, Deborah; Khorgami, Zhamak; Swendseid, Brian; Khan, Sadaf; Delaney, Conor // Surgical Endoscopy;Apr2014, Vol. 28 Issue 4, p1263 

    Background: Unplanned readmissions after colorectal surgery impact patient and financial outcomes. Our goal was to identify factors related to readmission in ostomy reversal patients. Methods: Review of a prospective department database was performed from 2006 to 2012 to identify patients who...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics