ArticleBMC health services research2012
Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database.
Article in BMC health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Are hospital nurse staffing practices associated with postoperative cardiac events and death? A systematic review.PloS one · 2019Pooled it
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- Impact of COVID-19 on hospital visit behaviour in cancer patients in Japan: a nationwide study.BMJ open · 2024Observational
- Association between body mass index and outcomes after autologous breast reconstruction: a nationwide inpatient database study in Japan.Breast cancer research and treatment · 2024Article
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- Impact of the Comorbidity Polypharmacy Score on Clinical Outcome in Patients with Hip Fracture undergoing surgery Using Real-World Data.Annals of clinical epidemiology · 2023Article
- Comparison of short-term outcomes between pedicled- and free-flap autologous breast reconstruction: a nationwide inpatient database study in Japan.Breast cancer (Tokyo, Japan) · 2022Article
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- Evidence of the Association between Nurse Staffing Levels and Patient and Nurses' Outcomes in Acute Care Hospitals across Japan: A Scoping Review.Healthcare (Basel, Switzerland) · 2022Article
- Between-hospital variations in 3-year survival among patients with newly diagnosed gastric, colorectal, and lung cancer.Scientific reports · 2022Article
- Impact of Corticosteroid Administration within 7 Days of the Hospitalization for Influenza Pneumonia with Respiratory Failure: A Propensity Score Analysis Using a Nationwide Administrative Database.Journal of clinical medicine · 2021Article
- Hospital Surgical Volume and 3-Year Mortality in Severe Prognosis Cancers: A Population-Based Study Using Cancer Registry Data.Journal of epidemiology · 2021Article
- Observational
- Large hospital variation in the utilization of Post-procedural CT to detect pulmonary embolism/Deep Vein Thrombosis in Patients Undergoing Total Knee or Hip Replacement Surgery: Japanese Nationwide Diagnosis Procedure Combination Database Study.The British journal of radiology · 2019Article
- Impact of Number of Drug Types on Clinical Outcome in Patients with Acute Hip Fracture.The journal of nutrition, health & aging · 2019Article
- In-hospital mortality and morbidity of pediatric scoliosis surgery in Japan: Analysis using a national inpatient database.Medicine · 2018Article
- Seeing the forest beyond the trees: Predicting survival in burn patients with machine learning.American journal of surgery · 2018Article
- In-Hospital Mortality for Hepatic Portal Venous Gas: Analysis of 1590 Patients Using a Japanese National Inpatient Database.World journal of surgery · 2018Article
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume.
methodsWe analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007-2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR) and nurse-to-bed ratio (NBR) were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR) was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume.
resultsOverall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds) and high NBR (≥77.0 nurses per 100 beds) was significantly lower than that in the group with low PBR (<19.7) and low NBR (<77.0) (9.2% vs. 14.5%; odds ratio, 0.76; 95% confidence interval, 0.68-0.86; p < 0.001).
conclusionsWell-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.
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