The relation of annual surgeon case volume to clinical outcomes and resource utilization in abdominal hysterectomy.
OBJECTIVE
To study the relationship of annual surgeon case volume to surgical outcome following hysterectomy.


METHODS
We performed a retrospective cohort study of women who underwent hysterectomy between January 1995 and December 2005 and evaluated the relationship of surgeon volume to complications and resource utilization.


RESULTS
A total of 214 physicians contributed a total of 8,747 patients to the study. Of these patients, 7,166 women underwent abdominal hysterectomy. Overall, rates of complications in the study population were low. However, compared with patients of low annual surgeon case volume (i.e., who performed <10 hysterectomies per year), high annual surgeon case volume (i.e., who performed > or = 10 hysterectomies per year) had fewer intraoperative complications, fewer postoperative complications and shorter procedure times than surgeons with low annual volume for abdominal hysterectomy.


CONCLUSIONS
Among women undergoing abdominal hysterectomy, physicians who operate on more patients annually have fewer complications and faster procedure times, compared with lower volume surgeons. Both groups have low complication rates, however, confirming the safety of the procedure even in the hands of low-volume surgeons.
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, USA.
Miriam M F
MM
Hanstede
Lauren A
LA
Wise
Elizabeth A
EA
Stewart
Sarah
S
Feldman
D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007431:Intraoperative Complications / Q000453:epidemiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome