Treatment of Craniosynostosis: The Impact of Hospital Surgical Volume on Cost, Resource Utilization, and Outcomes

被引:12
作者
Chattha, Anmol [1 ]
Bucknor, Alexandra [1 ]
Curiel, Daniel A. [1 ]
Ultee, Klaas H. J. [2 ]
Afshar, Salim [3 ]
Lin, Samuel J. [1 ]
机构
[1] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Plast & Reconstruct Surg, Boston, MA USA
[2] Erasmus Univ, Rotterdam, Netherlands
[3] Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA USA
关键词
Cost; craniosynostosis; hospital volume; Kids' Inpatient Database; outcomes; NONSYNDROMIC CRANIOSYNOSTOSIS; HEALTH-CARE; REPAIR; SURGERY; COMPLICATIONS; PREVALENCE; CHILDREN; QUALITY; RISK; RACE;
D O I
10.1097/SCS.0000000000004561
中图分类号
R61 [外科手术学];
学科分类号
摘要
The authors aim to quantify the impact of hospital volume of craniosynostosis surgery on inpatient complications and resource utilization using national data. Children <12 months with nonsyndromic craniosynostosis who underwent surgery in 2012 at academic hospitals in the United States were identified from the Kids' Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP). Hospital craniosynostosis surgery volume was stratified into tertiles based on total annual hospital cases: low volume (LV, 1-13), intermediate volume (IV, 14-34), and high volume (HV, >= 35). Outcomes of interest include major complications, blood transfusion, charges, and length of stay (LOS). In 2012, 154 hospitals performed 1617 total craniosynostosis surgeries. Of these 580 cases (35.8%) were LV, 549 cases (33.9%) were IV, and 488 cases (30.2%) were HV. There was no difference in major complications between hospital volume tertiles (4.3% LV; 3.8% IV; 3.1% HV; P = 0.487). The highest blood transfusion rates were seen at LV hospitals (47.8% LV; 33.9% IV; 26.2%; P < 0.001). Hospital charges were lowest at HV hospitals ($55,839) compared with IV hospitals ($65,624; P < 0.001) and LV hospitals ($62,325; P = 0.005). Mean LOS was shortest at HV hospitals (2.96 days) compared with LV hospitals (3.31 days; P = 0.001); however, there was no difference when compared with IV hospitals (3.07 days; P = 0.282). Hospital case volume may be an important associative factor of blood transfusion rates, LOS, and hospital charges; however, there is no difference in complication rates. These results may be used to guide quality improvement within the surgical management of craniosynostosis.
引用
收藏
页码:1233 / 1236
页数:4
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