Volume thresholds and hospital characteristics in the United States
Volume thresholds and hospital characteristics in the United States
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DOI：
10.1377/hlthaff.22.2.167
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发表时间：
2003-03-01
期刊：
影响因子：
9.7
通讯作者：
Fraser, I
中科院分区：
文献类型：
--
作者：
Elixhauser, A;Steiner, C;Fraser, I
程序量已被用作质量的代理，并被建议作为医院转诊的基础。我们使用2000年HCUP全国住院病人样本研究了美国医院中10种复杂手术的数量、死亡率以及相关的医院和人员配置特征。虽然大多数患者在规模大的医院进行手术，但就7项手术而言，超过四分之三的医院将被视为规模小的医院。在小容量医院的五种手术中，未经调整的死亡率明显更高。小容量医院的住院医生和注册护士的平均人数也往往较低。然而，对于两种手术，小规模医院的注册护士和住院医生的配备等于或高于大规模医院，未经调整的死亡率没有差异。
Procedure volume has been used as a proxy for quality and recommended as a basis for hospital referrals. We studied the volume, mortality, and associated hospital and staffing characteristics of ten complex procedures in U.S. hospitals using the 2000 HCUP Nationwide Inpatient Sample. Although the majority of patients had their procedures performed in high-volume hospitals, for seven procedures, more than three-fourths of hospitals would be considered low-volume. Unadjusted mortality rates were significantly higher at low-volume hospitals for five procedures. Low-volume hospitals also tended to have lower mean numbers of residents and RNs. However, for two procedures, low-volume hospitals had RN and resident staffing equal to or higher than those of high-volume hospitals, and the unadjusted mortality rates were no different.