{"id":1676,"date":"2022-02-03T00:00:00","date_gmt":"2022-02-03T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/the-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcomes-after-pediatric-thyroidectomy\/"},"modified":"2023-06-14T20:08:21","modified_gmt":"2023-06-15T00:08:21","slug":"the-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcomes-after-pediatric-thyroidectomy","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcomes-after-pediatric-thyroidectomy\/","title":{"rendered":"The impact of hospital surgical volume on healthcare utilization outcomes after pediatric thyroidectomy"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; A positive relationship between an individual surgeon&#x2019;s operative volume and clinical outcomes after pediatric and adult thyroidectomy is well-established. The impact of a hospital&#x2019;s pediatric operative volume on surgical outcomes and healthcare utilization, however, are infrequently reported. We investigated associations between hospital volume and healthcare utilization outcomes following pediatric thyroidectomy in Canada&#x2019;s largest province, Ontario.<\/p>\n<p><strong>Methods<\/strong> &#x2014; Retrospective analysis of administrative and health-related population-level data from 1993 to 2017. A cohort of 1908 pediatric (&lt;18 years) index thyroidectomies was established. Hospital volume was defined per-case as thyroidectomies performed in the preceding year. Healthcare utilization outcomes: length of stay (LOS), same day surgery (SDS), readmission, and emergency department (ED) visits were measured. Multivariate analysis adjusted for patient-level, disease and hospital-level co-variates.<\/p>\n<p><strong>Results<\/strong> &#x2014; Hospitals with the lowest volume of pediatric thyroidectomies, accounted for 30% of thyroidectomies province-wide and performed 0&#x2013;1 thyroidectomies\/year. The highest-volume hospitals performed 19&#x2013;60 cases\/year. LOS was 0.64 days longer in the highest, versus the lowest quartile. SDS was 83% less likely at the highest, versus the lowest quartile. Hospital volume was not associated with rate of readmission or ED visits. Increased ED visits were, however, associated with male sex, increased material deprivation, and rurality.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Increased hospital pediatric surgical volume was associated with increased LOS and lower likelihood of SDS. This may reflect patient complexity at such centers. In this cohort, low-volume hospitals were not associated with poorer healthcare utilization outcomes. Further study of groups disproportionately accessing the ED post-operatively may help direct resources to these populations.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; A positive relationship between an individual surgeon&#x2019;s operative volume and clinical outcomes after pediatric and adult thyroidectomy is well-established. The impact of a hospital&#x2019;s pediatric operative volume on surgical outcomes and healthcare utilization, however, are infrequently reported. We investigated associations between hospital volume and healthcare utilization outcomes following pediatric thyroidectomy in Canada&#x2019;s largest [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1676","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Chesover AD, Eskander A, Griffiths R, Pasternak JD, Pole JD, Wolter NE, Wasserman JD. <em>World J Surg<\/em>. 2022; 46(5):1082-92. Epub 2022 Feb 3.","source_url":"https:\/\/doi.org\/10.1007\/s00268-022-06456-6","ices_scientist":[1227,1098],"site":[6736],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"1543156E-82EB-40A4-A6AC-E3600B25F259","sitecore_item_name":"The-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcome-after-pediatric","sitecore_field_values":"{\n  \"Title\": \"The impact of hospital surgical volume on healthcare utilization outcomes after pediatric thyroidectomy\",\n  \"Short title\": \"The impact of hospital surgical volume\",\n  \"Summary\": \"This study found that increased hospital pediatric surgical volume was associated with increased length of stay and lower likelihood of same day surgery.\",\n  \"Citation\": \"<p>Chesover AD, Eskander A, Griffiths R, Pasternak JD, Pole JD, Wolter NE, Wasserman JD. <em>World J Surg<\/em>. 2022; 46(5):1082-92. Epub 2022 Feb 3. DOI: <a href=\"https:\/\/doi.org\/10.1007\/s00268-022-06456-6\" title=\"opens external link\">https:\/\/doi.org\/10.1007\/s00268-022-06456-6<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; A positive relationship between an individual surgeon&rsquo;s operative volume and clinical outcomes after pediatric and adult thyroidectomy is well-established. The impact of a hospital&rsquo;s pediatric operative volume on surgical outcomes and healthcare utilization, however, are infrequently reported. We investigated associations between hospital volume and healthcare utilization outcomes following pediatric thyroidectomy in Canada&rsquo;s largest province, Ontario.<\/p>n<p><strong>Methods<\/strong> &mdash; Retrospective analysis of administrative and health-related population-level data from 1993 to 2017. A cohort of 1908 pediatric (&lt;18 years) index thyroidectomies was established. Hospital volume was defined per-case as thyroidectomies performed in the preceding year. Healthcare utilization outcomes: length of stay (LOS), same day surgery (SDS), readmission, and emergency department (ED) visits were measured. Multivariate analysis adjusted for patient-level, disease and hospital-level co-variates.<\/p>n<p><strong>Results<\/strong> &mdash; Hospitals with the lowest volume of pediatric thyroidectomies, accounted for 30% of thyroidectomies province-wide and performed 0&ndash;1 thyroidectomies\/year. The highest-volume hospitals performed 19&ndash;60 cases\/year. LOS was 0.64 days longer in the highest, versus the lowest quartile. SDS was 83% less likely at the highest, versus the lowest quartile. Hospital volume was not associated with rate of readmission or ED visits. Increased ED visits were, however, associated with male sex, increased material deprivation, and rurality.<\/p>n<p><strong>Conclusions<\/strong> &mdash; Increased hospital pediatric surgical volume was associated with increased LOS and lower likelihood of SDS. This may reflect patient complexity at such centers. In this cohort, low-volume hospitals were not associated with poorer healthcare utilization outcomes. Further study of groups disproportionately accessing the ED post-operatively may help direct resources to these populations.<\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{5A12C65D-3CDA-413E-BC94-C1D778156CE6}\",\n  \"ICES Scientists\": \"{D7B53E18-8D1F-4D4F-8ADC-9FAB15D9E5EC}|{F5F3AB6E-CD96-4F14-BDD6-206C43AC2DD3}\",\n  \"Posted Date\": \"20220203T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/February\/The-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcome-after-pediatric"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | The impact of hospital surgical volume on healthcare utilization outcomes after pediatric thyroidectomy<\/title>\n<meta name=\"description\" content=\"Background &#x2014; A positive relationship between an individual surgeon&#x2019;s operative volume and clinical outcomes after pediatric and adult\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-impact-of-hospital-surgical-volume-on-healthcare-utilization-outcomes-after-pediatric-thyroidectomy\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | The impact of hospital surgical volume on healthcare utilization outcomes after pediatric thyroidectomy\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; 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