Hospital volumes for common pediatric specialty operations.

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  • Author(s): Berry JG;Berry JG; Lieu TA; Forbes PW; Goldmann DA
  • Source:
    Archives of pediatrics & adolescent medicine [Arch Pediatr Adolesc Med] 2007 Jan; Vol. 161 (1), pp. 38-43.
  • Publication Type:
    Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: American Medical Association Country of Publication: United States NLM ID: 9422751 Publication Model: Print Cited Medium: Print ISSN: 1072-4710 (Print) Linking ISSN: 10724710 NLM ISO Abbreviation: Arch Pediatr Adolesc Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: Chicago, IL : American Medical Association, [1994-
    • Subject Terms:
      Cardiac Surgical Procedures/*statistics & numerical data ; Hospitals, Pediatric/*statistics & numerical data ; Spinal Fusion/*statistics & numerical data ; Tracheotomy/*statistics & numerical data ; Ventriculoperitoneal Shunt/*statistics & numerical data; Adolescent ; Child ; Child, Preschool ; Follow-Up Studies ; Heart Septal Defects, Ventricular/surgery ; Hospital Mortality/trends ; Humans ; Infant ; Infant, Newborn ; Outcome Assessment, Health Care ; Retrospective Studies ; United States
    • Abstract:
      Objectives: To describe hospital volumes for common pediatric specialty operations, to evaluate hospital and patient characteristics associated with operations performed at a low-volume hospital, and to evaluate outcomes with hospital volume.
      Design: Retrospective cohort using the Kids' Inpatient Database 2003.
      Setting: Discharges from 3438 hospitals in 36 states from 2003.
      Participants: Children aged 0 to 18 years undergoing ventriculoseptal defect surgery (n = 2301), tracheotomy (n = 2674), ventriculoperitoneal shunt placement (n = 3378), and posterior spinal fusion (n = 4002).
      Main Exposure: Hospital volume.
      Main Outcome Measures: In-hospital mortality and postoperative complications.
      Results: For tracheotomy and posterior spinal fusion, at least one fourth of the hospitals performed only 1 operation for children aged 0 to 18 years in 2003. For these same operations, at least half of hospitals treated 4 or fewer cases per year. For all operations, discharges from low-volume hospitals were less likely to be from children's or teaching hospitals compared with discharges from higher-volume hospitals. For tracheotomy, children were less likely to experience postoperative complications in high-volume hospitals compared with low-volume hospitals (odds ratio, 0.48; 95% confidence interval, 0.21-1.09).
      Conclusions: Many children undergoing common pediatric specialty operations had these procedures performed in low-volume hospitals. Low-volume hospitals were less likely to be children's or teaching hospitals. Children undergoing tracheotomy experienced higher rates of complications in low-volume hospitals. Further research is needed to identify the reasons why so many children have these operations performed in low-volume hospitals.
    • Grant Information:
      K24 HD 047667 United States HD NICHD NIH HHS; T32 HP 10018 United States PHS HHS
    • Publication Date:
      Date Created: 20070103 Date Completed: 20070118 Latest Revision: 20191210
    • Publication Date:
      20221213
    • Accession Number:
      10.1001/archpedi.161.1.38
    • Accession Number:
      17199065