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Related Experiment Video

Updated: Dec 8, 2025

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Minimum volume standards in day surgery: a systematic review.

Michal Stanak1,2, Christoph Strohmaier3

  • 1Austrian Institute for Health Technology Assessment (former Ludwig Boltzmann Institute for Health Technology Assessment), Vienna, Austria. michal.stanak@protonmail.com.

BMC Health Services Research
|September 19, 2020
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Summary

Minimum volume standards (MVS) show a volume-outcome relationship (VOR) in day surgery for most procedures, but clear MVS thresholds are not established. Evidence quality is low, questioning direct application from inpatient data.

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Quality Improvement

Background:

  • Minimum volume standards (MVS) are debated for day surgery settings.
  • Patient-relevant outcomes associated with MVS in day surgery require investigation.

Purpose of the Study:

  • To determine the application and impact of MVS in day surgery.
  • To assess if MVS improve patient outcomes in ambulatory procedures.

Main Methods:

  • Systematic literature search across seven databases (July 2019).
  • Quality assessment of eight retrospective studies using ISPOR Task Force Checklist.
  • Data extraction on clinical effectiveness and safety for seven surgical indications.

Main Results:

  • A volume-outcome relationship (VOR) was found for most procedures (except carpal tunnel release and thyroidectomy).
  • No studies established specific MVS for the analyzed day surgery interventions.
  • Safety data was reported but not linked to surgeon/hospital volume.

Conclusions:

  • Retrospective data suggests a VOR in day surgery, but evidence quality is low.
  • Clear MVS thresholds for day surgery cannot be determined from current evidence.
  • Directly applying inpatient MVS to day surgery is questionable; further quality assurance policies are needed.