Gutacker, Nils orcid.org/0000-0002-2833-0621, Bloor, Karen Elizabeth orcid.org/0000-0003-4852-9854, Cookson, Richard Andrew orcid.org/0000-0003-0052-996X et al. (6 more authors) (2017) Hospital surgical volumes and mortality after coronary artery bypass grafting: using international comparisons to determine a safe threshold. Health services research. pp. 863-878. ISSN 1475-6773
Abstract
Objective: To estimate a safe minimum hospital volume for hospitals performing coronary artery bypass graft (CABG) surgery. Data Source: Hospital data on all publicly funded CABG in five European countries, 2007–2009 (106,149 patients). Design: Hierarchical logistic regression models to estimate the relationship between hospital volume and mortality, allowing for case mix. Segmented regression analysis to estimate a threshold. Findings: The 30-day in-hospital mortality rate was 3.0 percent overall, 5.2 percent (95 percent CI: 4.0–6.4) in low-volume hospitals, and 2.1 percent (95 percent CI: 1.8–2.3) in high-volume hospitals. There is a significant curvilinear relationship between volume and mortality, flatter above 415 cases per hospital per year. Conclusions: There is a clear relationship between hospital CABG volume and mortality in Europe, implying a “safe” threshold volume of 415 cases per year.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Health Research and Educational Trust. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details |
Keywords: | Coronary artery bypass surgery,center-volume,international comparisons,mortality,Coronary Artery Bypass/mortality,Hospital Mortality,Humans,Middle Aged,England/epidemiology,Diagnosis-Related Groups,Male,Slovenia/epidemiology,Surgical Procedures, Operative/statistics & numerical data,Denmark/epidemiology,Surgery Department, Hospital/standards,Aged, 80 and over,Adult,Female,Aged,Portugal/epidemiology,Spain/epidemiology |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 04 Apr 2017 14:00 |
Last Modified: | 08 Feb 2025 00:18 |
Published Version: | https://doi.org/10.1111/1475-6773.12508 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1111/1475-6773.12508 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:111939 |
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