title: Operative volume in colon surgery: a matched cohort analysis.
abstract: Although previous studies have suggested that higher volumes of colectomies performed by surgeons and hospitals are associated with lower mortality, less is known about the relationship between volume and resource utilization. The research team tested the association between volume, costs, complications, length of stay, and mortality using data from the National Inpatient Sample. Results suggest higher volumes for both surgeons and hospitals were associated with lower costs, fewer complications, shorter length of stay, and lower mortality. Propensity score matching showed no significant difference in mortality by surgeon volume (7.38% vs 7.46%, P=.0.842), but significantly fewer complications (45.06% vs 49.10%, P=.008), shorter length of stay (11.8 vs 13.1 days, P<.0001), and lower costs ($33,142 vs $29,578, P<.0001) for high-volume surgeons. Although the major driver of complications and mortality is burden of disease and comorbid conditions, individual surgeon volume is an important determinant of length of stay and costs.
authors.affiliation: Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Matthew Z
authors.initials: MZ
authors.lastname: Wilson
authors.affiliation: Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: David I
authors.initials: DI
authors.lastname: Soybel
authors.affiliation: Penn State Milton S. Hershey Medical Center, Hershey, PA Penn State College of Medicine, Hershey, PA chollenbeak@psu.edu.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000191:economics* / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006742:Hospital Bed Capacity; D017721:Hospital Costs / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
keywords: case volume; colectomy; length of stay; mortality