Resource variation in colorectal surgery: a national centre level analysis

Area of Science:

• Colorectal Surgery
• Health Services Research
• Surgical Outcomes

Background:

• Quality colorectal surgery delivery depends on adequate resources.
• Assessing the link between resources and patient outcomes is crucial for service improvement.

Purpose of the Study:

• To evaluate the relationship between healthcare resources and outcomes in English colorectal units.
• To identify specific resources associated with better patient outcomes.

Main Methods:

• Data from the Association of Coloproctology of Great Britain and Ireland resource questionnaire were analyzed.
• Hospital Episode Statistics and Cancer Experience Patient Survey data were correlated with resource profiles.
• Colorectal centers were stratified by workload into low, middle, and top tertiles.

Main Results:

• No significant differences in resources like theatre access, bed availability, or staffing were found across workload tertiles.
• Increased laparoscopic surgery proportion correlated with reduced 90-day unplanned readmissions (RR 0.94).
• Dedicated colorectal wards were associated with significantly lower unplanned readmissions (RR 0.85).

Conclusions:

• Resource distribution across English colorectal units is relatively uniform.
• Enhanced use of laparoscopy and dedicated colorectal wards are linked to improved patient outcomes.
• Further research into metrics like 'failure to rescue' is recommended for UK practice.