Show simple item record

dc.contributor.authorKilleen, S D
dc.contributor.authorO'Sullivan, M J
dc.contributor.authorCoffey, J C
dc.contributor.authorKirwan, W O
dc.contributor.authorRedmond, H P
dc.date.accessioned2012-02-03T15:07:23Z
dc.date.available2012-02-03T15:07:23Z
dc.date.issued2012-02-03T15:07:23Z
dc.identifier.citationBr J Surg. 2005 Apr;92(4):389-402.en_GB
dc.identifier.issn0007-1323 (Print)en_GB
dc.identifier.issn0007-1323 (Linking)en_GB
dc.identifier.pmid15786424en_GB
dc.identifier.doi10.1002/bjs.4954en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208918
dc.description.abstractBACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.
dc.language.isoengen_GB
dc.subject.meshHealth Facility Sizeen_GB
dc.subject.meshHospitals/*statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshNeoplasms/mortality/*surgeryen_GB
dc.subject.meshSurgical Procedures, Operative/*statistics & numerical dataen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshWorkload/*statistics & numerical dataen_GB
dc.titleProvider volume and outcomes for oncological procedures.en_GB
dc.contributor.departmentDepartment of Surgery, Cork University Hospital and University College Cork,, Cork, Ireland.en_GB
dc.identifier.journalThe British journal of surgeryen_GB
dc.description.provinceMunster
html.description.abstractBACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.


This item appears in the following Collection(s)

Show simple item record