Is there a relationship between physician and facility volumes of ambulatory procedures and patient outcomes?

J Ambul Care Manage. 2008 Oct-Dec;31(4):354-69. doi: 10.1097/01.JAC.0000336554.46837.a4.

Abstract

This study explores associations between patient outcomes (7- and 30-day hospitalization and mortality) and healthcare provider (physician and facility) volumes of outpatient colonoscopy, cataract removal, and upper gastrointestinal endoscopy performed in outpatient surgical settings in Florida. Findings indicate that patients treated by high-volume physicians or facilities had lower adjusted odds ratios for hospitalizations and mortality. When physician and facility volume were assessed simultaneously, physician volume accounted for larger effects than facility volume in hospitalization models. When assessing both physician and facility volume together for mortality, facility volume was a stronger predictor of mortality outcomes at 30 days. Further examinations of associations of outpatient physician and facility volumes and patient outcomes are suggested.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities / standards*
  • Ambulatory Care Facilities / statistics & numerical data*
  • Ambulatory Surgical Procedures / classification
  • Ambulatory Surgical Procedures / mortality*
  • Ambulatory Surgical Procedures / statistics & numerical data*
  • Cataract Extraction / mortality
  • Cataract Extraction / statistics & numerical data
  • Colonoscopy / mortality
  • Colonoscopy / statistics & numerical data
  • Endoscopy, Gastrointestinal / mortality
  • Endoscopy, Gastrointestinal / statistics & numerical data
  • Female
  • Florida / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • International Classification of Diseases
  • Length of Stay
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Risk Adjustment
  • Severity of Illness Index
  • Treatment Outcome*
  • Utilization Review