Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1991-5-31
pubmed:abstractText
This population-based study examines all carotid endarterectomies (CE) performed by all surgeons in a single state over a 10-year period. The methodology is designed to determine morbidity rate, mortality rate, cost, and length of stay, as well as to understand the effect of pre-existing chronic disease, physician, and hospital volume on these outcome variables. The data source consisted of hospital discharge abstract data uniformly collected on all admissions (N = 5.9 million) to acute care hospitals in the state. In the decade 1979 to 1988, 11,199 patients underwent CE. Mortality rate from CE was 2.1%, and the postoperative stroke rate was 3.7% over this period. High physician volume decreased the mortality rate (p less than 0.05) and stroke rate (p less than 0.01) by 50% and significantly (p less than 0.001) reduced hospital cost and length of stay independent of patient complexity. Examination of cost data, adjusted for inflation, showed a decrease in mean cost for CE over the decade. Thus physicians are providing better care for less hospital dollars. Both patient and payor outcome is improved by concentrating CE patients in the hands of high-volume surgeons. Although the data suggests this trend is already evolving, the pace of this evolution can be expected to increase as payors recognize that regionalization of this procedure lowers costs.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-13213095, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2258958, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2313871, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2348726, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2710176, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2745530, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-2774707, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-3050163, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-3358162, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-3599305, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-3629638, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-3701975, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-6364462, http://linkedlifedata.com/resource/pubmed/commentcorrection/2025063-6506121
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0003-4932
pubmed:author
pubmed:issnType
Print
pubmed:volume
213
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
433-8; discussion 438-9
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
1991
pubmed:articleTitle
Evaluating quality, cost-effective health care. Vascular database predicated on hospital discharge abstracts.
pubmed:affiliation
Department of Surgical Services, St. Thomas Hospital, Nashville, Tennessee.
pubmed:publicationType
Journal Article