Evidence map›Paper›PMID 35113199›Full record

ArticleWorld journal of surgery2022

The Impact of Hospital Surgical Volume on Healthcare Utilization Outcomes After Pediatric Thyroidectomy.

Alexander D Chesover, Antoine Eskander, Rebecca Griffiths, Jesse D Pasternak, Jason D Pole, Nikolaus E Wolter, Jonathan D Wasserman

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Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Alexander D ChesoverDivision of Endocrinology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.ORCID http://orcid.org/0000-0002-6280-5053
Antoine EskanderDepartment of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, M1-102, Toronto, ON, M4N 3M5, Canada.
Rebecca GriffithsICES Queen's, Abramsky Hall, Room 208, 21 Arch Street, Kingston, ON, K7L 3N6, Canada.
Jesse D PasternakDivision of General Surgery, University Health Network, 200 Elizabeth St, Toronto, ON, M5G 2C1, Canada.
Jason D PoleICES Queen's, Abramsky Hall, Room 208, 21 Arch Street, Kingston, ON, K7L 3N6, Canada.
Nikolaus E WolterDepartment of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Jonathan D WassermanDivision of Endocrinology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. jonathan.wasserman@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA positive relationship between an individual surgeon's operative volume and clinical outcomes after pediatric and adult thyroidectomy is well-established. The impact of a hospital'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's largest province, Ontario.

methodsRetrospective analysis of administrative and health-related population-level data from 1993 to 2017. A cohort of 1908 pediatric (<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.

resultsHospitals with the lowest volume of pediatric thyroidectomies, accounted for 30% of thyroidectomies province-wide and performed 0-1 thyroidectomies/year. The highest-volume hospitals performed 19-60 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.

conclusionsIncreased 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.

Indexed as

Hospitals, High-VolumeThyroidectomyAdultChildEmergency Service, HospitalHumansLength of StayMalePatient Acceptance of Health CareRetrospective Studies

Identifiers

PMID35113199

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.