Surgeon volume and hospital resource utilization

This study examines whether surgeons who perform a particular procedure more often incur lower hospital charges and shorter lengths of stay than surgeons with less volume. The 43 Pennsylvania hospitals included in the 1991 MedisGroups Comparative Hospital Database form the study hospitals. The analysis looks at four frequently occurring surgical procedures: cholecystectomy, prostatectomy, hysterectomy, and intervertebral disc excision. Regression models are estimated separately for total charges, ancillary charges, and length of stay for each surgical procedure. The explanatory variable of interest is surgeon volume for the specific procedure. Control variables include patient age, sex, admission severity of illness, insurance plan, and hospital. For cholecystectomy, prostatectomy, and intervertebral disc surgery, we find a significant negative association between surgeon volume and both hospital charges and length of stay. We find no such volume effect for hysterectomy. The paper discusses management and policy implications of these findings.