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Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample

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Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample. / Becker, Andreas; Bianchi, Marco; Hansen, Jens; Tian, Zhe; Shariat, Shahrokh F; Popa, Ioana; Perrotte, Paul; Trinh, Quoc-Dien; Karakiewicz, Pierre I; Sun, Maxine.

in: WORLD J UROL, Jahrgang 32, Nr. 6, 01.12.2014, S. 1511-1521.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Becker, A, Bianchi, M, Hansen, J, Tian, Z, Shariat, SF, Popa, I, Perrotte, P, Trinh, Q-D, Karakiewicz, PI & Sun, M 2014, 'Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample', WORLD J UROL, Jg. 32, Nr. 6, S. 1511-1521. https://doi.org/10.1007/s00345-014-1256-y

APA

Becker, A., Bianchi, M., Hansen, J., Tian, Z., Shariat, S. F., Popa, I., Perrotte, P., Trinh, Q-D., Karakiewicz, P. I., & Sun, M. (2014). Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample. WORLD J UROL, 32(6), 1511-1521. https://doi.org/10.1007/s00345-014-1256-y

Vancouver

Becker A, Bianchi M, Hansen J, Tian Z, Shariat SF, Popa I et al. Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample. WORLD J UROL. 2014 Dez 1;32(6):1511-1521. https://doi.org/10.1007/s00345-014-1256-y

Bibtex

@article{1f9746fd6fb7430199d6e398963d0d99,
title = "Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample",
abstract = "PURPOSE: To provide in absolute terms a quantification of regionalization of care from low- to high-volume hospitals in patients treated with nephrectomy for non-metastatic renal cell carcinoma.METHODS: Relying on the Nationwide Inpatient Sample, 48,172 patients with non-metastatic renal cell carcinoma undergoing nephrectomy were identified. All analyses focused on five specific endpoints: intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality. First, multivariable logistic regression models for prediction of the aforementioned endpoints were fitted among high-volume hospitals treated patients. Second, obtained coefficients from such models were applied onto low-volume hospitals treated individuals. Potentially avoidable events were computed through differences between observed and predicted adverse events. The number needed to treat was generated.RESULTS: Low-volume hospitals treated individuals were between 11 and 28 % more likely to succumb to an adverse outcome (all P < 0.001). Differences between observed and predicted adverse outcome rates were all in favor of high-volume hospitals, except for in-hospital mortality. Potentially avoidable intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality rates were 1.4, 5.6, 7.6, 24.0, and 0.7 %, respectively. Thus, for every 71, 18, 13, 4, and 143 nephrectomies that are redirected to high-volume hospitals, 1 intraoperative complication, postoperative complication, blood transfusion, prolonged hospitalization, and in-hospital mortality could be potentially avoided.CONCLUSIONS: Regionalization from low- to high-volume hospitals for patients undergoing a nephrectomy is associated with important benefits, for both the payer and patient's perspectives.",
author = "Andreas Becker and Marco Bianchi and Jens Hansen and Zhe Tian and Shariat, {Shahrokh F} and Ioana Popa and Paul Perrotte and Quoc-Dien Trinh and Karakiewicz, {Pierre I} and Maxine Sun",
year = "2014",
month = dec,
day = "1",
doi = "10.1007/s00345-014-1256-y",
language = "English",
volume = "32",
pages = "1511--1521",
journal = "WORLD J UROL",
issn = "0724-4983",
publisher = "Springer",
number = "6",

}

RIS

TY - JOUR

T1 - Benefit in regionalization of care for patients treated with nephrectomy: a Nationwide Inpatient Sample

AU - Becker, Andreas

AU - Bianchi, Marco

AU - Hansen, Jens

AU - Tian, Zhe

AU - Shariat, Shahrokh F

AU - Popa, Ioana

AU - Perrotte, Paul

AU - Trinh, Quoc-Dien

AU - Karakiewicz, Pierre I

AU - Sun, Maxine

PY - 2014/12/1

Y1 - 2014/12/1

N2 - PURPOSE: To provide in absolute terms a quantification of regionalization of care from low- to high-volume hospitals in patients treated with nephrectomy for non-metastatic renal cell carcinoma.METHODS: Relying on the Nationwide Inpatient Sample, 48,172 patients with non-metastatic renal cell carcinoma undergoing nephrectomy were identified. All analyses focused on five specific endpoints: intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality. First, multivariable logistic regression models for prediction of the aforementioned endpoints were fitted among high-volume hospitals treated patients. Second, obtained coefficients from such models were applied onto low-volume hospitals treated individuals. Potentially avoidable events were computed through differences between observed and predicted adverse events. The number needed to treat was generated.RESULTS: Low-volume hospitals treated individuals were between 11 and 28 % more likely to succumb to an adverse outcome (all P < 0.001). Differences between observed and predicted adverse outcome rates were all in favor of high-volume hospitals, except for in-hospital mortality. Potentially avoidable intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality rates were 1.4, 5.6, 7.6, 24.0, and 0.7 %, respectively. Thus, for every 71, 18, 13, 4, and 143 nephrectomies that are redirected to high-volume hospitals, 1 intraoperative complication, postoperative complication, blood transfusion, prolonged hospitalization, and in-hospital mortality could be potentially avoided.CONCLUSIONS: Regionalization from low- to high-volume hospitals for patients undergoing a nephrectomy is associated with important benefits, for both the payer and patient's perspectives.

AB - PURPOSE: To provide in absolute terms a quantification of regionalization of care from low- to high-volume hospitals in patients treated with nephrectomy for non-metastatic renal cell carcinoma.METHODS: Relying on the Nationwide Inpatient Sample, 48,172 patients with non-metastatic renal cell carcinoma undergoing nephrectomy were identified. All analyses focused on five specific endpoints: intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality. First, multivariable logistic regression models for prediction of the aforementioned endpoints were fitted among high-volume hospitals treated patients. Second, obtained coefficients from such models were applied onto low-volume hospitals treated individuals. Potentially avoidable events were computed through differences between observed and predicted adverse events. The number needed to treat was generated.RESULTS: Low-volume hospitals treated individuals were between 11 and 28 % more likely to succumb to an adverse outcome (all P < 0.001). Differences between observed and predicted adverse outcome rates were all in favor of high-volume hospitals, except for in-hospital mortality. Potentially avoidable intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalization, and in-hospital mortality rates were 1.4, 5.6, 7.6, 24.0, and 0.7 %, respectively. Thus, for every 71, 18, 13, 4, and 143 nephrectomies that are redirected to high-volume hospitals, 1 intraoperative complication, postoperative complication, blood transfusion, prolonged hospitalization, and in-hospital mortality could be potentially avoided.CONCLUSIONS: Regionalization from low- to high-volume hospitals for patients undergoing a nephrectomy is associated with important benefits, for both the payer and patient's perspectives.

U2 - 10.1007/s00345-014-1256-y

DO - 10.1007/s00345-014-1256-y

M3 - SCORING: Journal article

C2 - 24515596

VL - 32

SP - 1511

EP - 1521

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 6

ER -