title: Is there a relationship between physician and facility volumes of ambulatory procedures and patient outcomes?
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.
authors.affiliation: Division of Health Affairs, and Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL 32306, USA. askar.chukmaitov@med.fsu.edu
authors.forename: Askar S
authors.initials: AS
authors.lastname: Chukmaitov
authors.forename: Nir
authors.initials: N
authors.lastname: Menachemi
authors.forename: Steven L
authors.initials: SL
authors.lastname: Brown
authors.forename: Charles
authors.initials: C
authors.lastname: Saunders
authors.forename: Anqi
authors.initials: A
authors.lastname: Tang
authors.forename: Robert
authors.initials: R
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000592:standards* / Q000706:statistics & numerical data*; D000556:Ambulatory Surgical Procedures / Q000145:classification / Q000401:mortality* / Q000706:statistics & numerical data*; D002387:Cataract Extraction / Q000401:mortality / Q000706:statistics & numerical data; D003113:Colonoscopy / Q000401:mortality / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D005431:Florida / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D020379:Risk Adjustment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014600:Utilization Review