Abstract
Abstract
This study aimed to evaluate variations in prolonged outcome after proctectomy based on hospital volume.
From the Premier Perspective database (2012–2014), hospital volumes for proctectomy of benign and malignant conditions were classified as low, intermediate and high. Hospitals were grouped into tertiles. Impact of procedure volume on in-hospital as well as 90-day post-discharge complications, length of stay, discharge destination and costs was evaluated.
Of 9306 proctectomy procedures, 6960 occurred at high, 1695 at intermediate and 651 at low volume hospitals. After adjustment, high volume institutions were associated with lower in-hospital surgical complications while low volume centers had higher ninety-day post-discharge medical and surgical complications (p < .05 for all). High volume centers had a shorter hospital stay while the need for extended care facility was higher in low volume centers (p < .05 for all). Healthcare costs were higher for low volume hospitals.
These data suggest that variations in outcomes and costs after complex procedures such as proctectomy exist and are related to institutional familiarity with a procedure.
•This paper is a retrospective analysis of national data.•The aim was to characterize effects of hospital familiarity on proctectomy outcomes.•Low volume centers were associated with greater complications and length of stay.•Low volume centers were associated with greater extended care and costs.•Variations in outcomes were also significant between intermediate and high volume.