ArticlePediatric surgery international2019
Neonatal surgery in low- vs. high-volume institutions: a KID inpatient database outcomes and cost study after repair of congenital diaphragmatic hernia, esophageal atresia, and gastroschisis.
Article in Pediatric surgery international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improving outcomes for uncomplicated gastroschisis: clinical practice guidelines from the American Pediatric Surgical Association Outcomes and Evidence-based Practice Committee.Pediatric surgery international · 2024Guideline
- Development and Validation of a Realistic Neonatal Intestinal Jejunoileal Atresia Simulator for the Training of Pediatric Surgeons.Children (Basel, Switzerland) · 2024Article
- Crossing birth and mortality data as a clue for prevalence of congenital diaphragmatic hernia in Sao Paulo State: A cross sectional study.Lancet regional health. Americas · 2022Article
- Data resources for evaluating the economic and financial consequences of surgical care in the United States.The journal of trauma and acute care surgery · 2022Review
- Article
- The Financial Burden of Surgery for Congenital Malformations-The Austrian Perspective.International journal of environmental research and public health · 2021Article
- Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany.Children (Basel, Switzerland) · 2021Article
- Letter to the Editor concerning Schmedding et al.: Decentralised surgery of abdominal wall defects in Germany (Pediatr Surg Int (2020) 36:569-578).Pediatric surgery international · 2020Article
- Response to Letter to the Editor concerning Schmedding et al.: Decentralised surgery of abdominal wall defects in Germany (Pediatr Surg Int (2020) 36: 569-578).Pediatric surgery international · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background/purposeThe volume-outcome relationship and optimal surgical volumes for repair of congenital anomalies in neonates is unknown.
methodsA retrospective study of infants who underwent diaphragmatic hernia (CDH), gastroschisis (GS), and esophageal atresia/tracheoesophageal fistula (EA/TEF) repair at US hospitals using the Kids' Inpatient Database 2009-2012. Distribution of institutional volumes was calculated. Multi-level logistic/linear regressions were used to determine the association between volume and mortality, length of stay, and costs.
resultsTotal surgical volumes were 1186 for CDH, 1280 for EA/TEF, and 3372 for GS. Median case volume per institution was three for CDH and EA/TEF, and four for GS. Hospitals with annual case volumes ≥ 75th percentile were considered high volume. Approximately, half of all surgeries were performed at low-volume hospitals. No clinically meaningful association between volume and outcomes was found for any procedure. Median cost was greater at high- vs. low-volume hospitals [CDH: $165,964 (p < 0.0001) vs. $104,107, EA/TEF: $85,791 vs. $67,487 (p < 0.006), GS: $83,156 vs. $72,710 (p < 0.0009)].
conclusionsAn association between volume and outcome was not identified in this study using robust outcome measures. The cost of care was higher in high-volume institutions compared to low-volume institutions. LEVEL OF EVIDENCE: III.
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