Centralization Harnessing Volume-Outcome Relationships in Vascular Surgery and Aortic Aneurysm Care Should Not Focus Solely on Threshold Operative Caseload

被引：17

作者：

Karthikesalingam, A. ^{[1
]}

Hinchliffe, R. J. ^{[1
]}

Poloniecki, J. D. ^{[1
]}

Loftus, I. M. ^{[1
]}

Thompson, M. M. ^{[1
]}

Holt, P. J. E. ^{[1
]}

机构：

[1] St Georges Healthcare NHS Trust, St Georges Vasc Inst, Dept Outcomes Res, London SW17 0QT, England

来源：

VASCULAR AND ENDOVASCULAR SURGERY | 2010年 / 44卷 / 07期

关键词：

vascular surgery; volume; outcome; centralization; HOSPITAL VOLUME; MORTALITY-RATES; OPEN REPAIR; EXPERIENCE; STANDARDS;

D O I：

10.1177/1538574410375130

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

There has been great interest in the setting of threshold operative volumes for safety to guide centralisation of vascular surgical services by healthcare commissioners. This editorial examines the evidence for designing services around a numeric safety threshold in the relationship between volume and outcome in vascular surgery. Thresholds should be aimed at the best outcomes and equity of care. Equity means access to the most up-to-date technology and all the relevant support services for elective and emergency cases. The relationship of volume and outcome with quality is complex, and demands a shift in focus to infrastructural and procedural improvements that drive high-quality services rather than the concentration of planning exclusively around an operative volume threshold.

引用

页码：556 / 559

页数：4

共 30 条

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