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Related Experiment Videos

Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

Roos Mesman1, Marjan J Faber2, Gert P Westert3

  • 11 Researcher, Tias School for Business and Society, Tilburg University, The Netherlands.

Journal of Health Services Research & Policy
|March 24, 2018
PubMed
Summary

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Surgeons acknowledge volume-outcome links but question minimum volume standards in policy. Concerns include validity, strategic behavior, and polarization, hindering quality improvement efforts.

Area of Science:

  • Health Services Research
  • Surgical Quality Improvement
  • Health Policy Analysis

Background:

  • Volume-outcome associations in surgery are widely adopted into policy.
  • Qualitative research on surgeons' perspectives of volume-based policies is limited.
  • Understanding surgeon experiences is crucial for effective quality improvement.

Purpose of the Study:

  • To explore Dutch surgeons' views and experiences with volume-outcome policies.
  • To identify implications of these policies for daily clinical practice.
  • To inform improvements in surgical quality initiatives.

Main Methods:

  • Conducted semi-structured interviews with 20 purposively selected surgeons.
  • Utilized a stratified sample across hospital types and specialties.
Keywords:
interviewminimum volume standardsqualitative methodsquality assessmentsurgeryvolume–outcome relationships

Related Experiment Videos

  • Employed inductive content analysis of transcribed interviews.

    • Main Results:

    • Surgeons recognized the 'more is better' principle but doubted the evidence for minimum volume standards.
    • Identified controversies in threshold determination and insurer purchasing criteria.
    • Noted potential for strategic behavior (e.g., unnecessary surgeries) and impact on low-volume providers.

    Conclusions:

    • Surgeons acknowledge volume-quality links but are critical of current volume-based policies due to validity and application issues.
    • Volume policies create polarization, impeding collective quality improvement.
    • Recommended consensus-based thresholds and supplementary quality criteria.