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Relationship between patient safety and hospital surgical volume
Tina Hernandez-Boussard1, John R Downey, Kathryn McDonald
1Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94306, USA. boussard@stanford.edu
Objective:
To examine the relationship between hospital volume and in-hospital adverse events.
Data Sources:
Patient safety indicator (PSI) was used to identify hospital-acquired adverse events in the Nationwide Inpatient Sample database in abdominal aortic aneurysm, coronary artery bypass graft, and Roux-en-Y gastric bypass from 2005 to 2008.
Study Design:
In this observational study, volume thresholds were defined by mean year-specific terciles. PSI risk-adjusted rates were analyzed by volume tercile for each procedure.
Principal Findings:
Overall, hospital volume was inversely related to preventable adverse events. High-volume hospitals had significantly lower risk-adjusted PSI rates compared to lower volume hospitals (p < .05).
Conclusion:
These data support the relationship between hospital volume and quality health care delivery in select surgical cases. This study highlights differences between hospital volume and risk-adjusted PSI rates for three common surgical procedures and highlights areas of focus for future studies to identify pathways to reduce hospital-acquired events.
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