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Longitudinal Trends in 30-Day Mortality Between Multi-Site and Single-Site Surgeons.

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Healthcare Management

Background:

  • Concerns exist regarding fragmented surgical care and patient outcomes with multi-hospital health systems.
  • Limited empirical data compare outcomes between multi-site and single-site surgeons.

Purpose of the Study:

  • To assess trends in multi-site versus single-site surgeons using national Medicare data.
  • To compare 30-day mortality rates between multi-site and single-site surgeons.
  • To examine temporal trends in surgical outcomes based on surgeon practice location.

Main Methods:

  • Analysis of national Medicare data from 2011 to 2016.
  • Multivariable regression to compare 30-day mortality.
  • Stratification by health system and rural status.

Main Results:

  • The proportion of multi-site surgeons decreased from 2011 to 2016.
  • Multi-site surgeons initially showed lower 30-day mortality (2.24% vs 2.50%, P < 0.01).
  • This mortality advantage narrowed over time, with no significant difference by 2016.

Conclusions:

  • Multi-site surgeons demonstrated a decreasing, statistically significant but small, mortality advantage over single-site surgeons.
  • By 2016, outcomes for multi-site and single-site surgeons were equivalent.
  • Surgeons operating at multiple hospitals can provide care without evidence of increased mortality.