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Differentiating among hospitals performing physiologically complex operative procedures in the elderly.
Ruth E Wachtel1, Franklin Dexter
1Department of Anesthesia, University of Iowa, Iowa City, 52242, USA.
Anesthesiology
|May 29, 2004
Summary
Discharge abstract data can compare surgical practices for elderly patients, though hospitals performing complex procedures are not easily differentiated. One hospital specialized in rare geriatric procedures, attracting patients from afar.
Area of Science:
- Health Services Research
- Surgical Outcomes Analysis
Background:
- Previous work demonstrated statewide discharge abstract databases can quantify inter-hospital variations in surgical practices.
- Two Iowa pediatric hospitals offer diverse, complex procedures to younger patients, with complex pediatric surgery regionalized to high-volume centers.
Purpose of the Study:
- To quantify physiologically complex operative procedures in elderly patients (80+ years) using the same discharge abstract database.
- To compare surgical practice patterns for geriatric patients with those previously observed for pediatric patients.
Main Methods:
- Utilized an inpatient discharge abstract database for Iowa.
- Analyzed physiologically complex operative procedures performed in patients aged 80 years and older between January and June 2001.
Main Results:
- Hospitals performing complex geriatric procedures were not easily differentiated by volume or type, unlike pediatric centers (P < 0.001).
- One hospital showed a higher volume of rare geriatric procedures and attracted patients from outside their local county.
- Statistical analysis revealed significant differences in procedure distribution between geriatric and pediatric patient groups.
Conclusions:
- Findings support the validity and utility of discharge abstract data for comparing surgical practices across facilities for elderly patients.
- Discharge abstract data can help various stakeholders understand unique hospital contributions to surgical care.